Details of Drug

Drug General Information (ID: D1080)
Drug Name	Mivacurium
Drug Type	Small molecule
Drug Synonymous	Mivacron; Chlorure de mivacurium; Chlorure de mivacurium [French]; Cloruro de mivacurio; Cloruro de mivacurio [Spanish]; MIVACURIUM CHLORIDE; Mivacurii chloridum; Mivacurii chloridum [Latin]; BW B109OU dichloride; BWB109OU; BW-B1090U; BW-B109OU; MIVACRON IN DEXTROSE 5% IN PLASTIC CONTAINER; Mivacron (TN); Mivacurium chloride(USAN/INN); Mivacurium chloride [USAN:INN:BAN]; Bis[3-[(1R)-6,7-dimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propyl] (E)-oct-4-enedioate; Bis[3-[(1R)-6,7-dimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propyl] (E)-oct-4-enedioate dichloride; (R)-1,2,3,4-Tetrahydro-2-(3-hydroxypropyl)-6,7-dimethoxy-2-methyl-1-(3,4,5-trimethoxybenzyl)isoquinolinium chloride, (E)-4-octenedioate (2:1) Click to Show/Hide
Disease Class	9A76-9A78: Corneal disease
Therapeutic Class	Neuromuscular Blocking Agents
Structure
Structure	3D Structure		2D Structure
Formula	C58H80N2O14+2
InChI	1S/C58H80N2O14/c1-59(25-21-41-35-47(63-3)49(65-5)37-43(41)45(59)29-39-31-51(67-7)57(71-11)52(32-39)68-8)23-17-27-73-55(61)19-15-13-14-16-20-56(62)74-28-18-24-60(2)26-22-42-36-48(64-4)50(66-6)38-44(42)46(60)30-40-33-53(69-9)58(72-12)54(34-40)70-10/h13-14,31-38,45-46H,15-30H2,1-12H3/q+2/b14-13+/t45-,46-,59?,60?/m1/s1
InChIKey	ILVYCEVXHALBSC-OTBYEXOQSA-N
Canonical SMILES	C[N+]1(CCC2=CC(=C(C=C2C1CC3=CC(=C(C(=C3)OC)OC)OC)OC)OC)CCCOC(=O)CCC=CCCC(=O)OCCC[N+]4(CCC5=CC(=C(C=C5C4CC6=CC(=C(C(=C6)OC)OC)OC)OC)OC)C
External Link
	Pubchem ID	5281042
	CAS Number	133814-19-4
	CHEBI ID	6958
	TTD ID	D0OB2M

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM022 CYP450 enzyme induction BM036 Additive cardiorespiratory depression effects BM042 Additive hypotensive effects BM045 Additive neuromuscular blocking effects BM051 Increased risk of bradycardia BM095 Antagonize the effect of neuromuscular blocking agents
Relation Graph

Full list of drugs interacting with Mivacurium
Affected intra/extra-hepatic metabolism
	CYP450 enzyme induction					Drug Num: 3
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0621		Ethotoin	C11H12N2O2	3292	Moderate		Inter Info	[74], [75]
D0697		Fosphenytoin	C16H15N2O6P	56339	Moderate		Inter Info	[74], [75]
D1283		Phenytoin	C15H12N2O2	1775	Moderate		Inter Info	[74], [75]
Pharmacodynamic additive effects
	Additive cardiorespiratory depression effects					Drug Num: 22
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0010		Acebutolol	C18H28N2O4	1978	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0117		Atenolol	C14H22N2O3	2249	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0173		Betaxolol	C18H29NO3	2369	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0174		Betaxolol (ophthalmic)	C18H29NO3	2369	Moderate		Inter Info	[35], [37], [39]
D0188		Bisoprolol	C18H31NO4	2405	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0265		Carteolol	C16H24N2O3	2583	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0266		Carteolol (ophthalmic)	C16H24N2O3	2583	Moderate		Inter Info	[35], [37], [39]
D0267		Carvedilol	C24H26N2O4	2585	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0602		Esmolol	C16H25NO4	59768	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0884		Labetalol	C19H24N2O3	3869	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0915		Levobunolol (ophthalmic)	C17H25NO3	39468	Moderate		Inter Info	[35], [37], [39]
D1045		Metipranolol (ophthalmic)	C17H27NO4	31477	Moderate		Inter Info	[35], [37], [39]
D1049		Metoprolol	C15H25NO3	4171	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D0914		Levobetaxolol (ophthalmic)	C18H29NO3	60657	Moderate		Inter Info	[35], [37], [39]
D1114		Nebivolol	C22H25F2NO4	71301	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1244		Penbutolol	C18H29NO2	37464	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1098		Nadolol	C17H27NO4	39147	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1293		Pindolol	C14H20N2O2	4828	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1357		Propranolol	C16H21NO2	4946	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1498		Sotalol	C12H20N2O3S	5253	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1585		Timolol	C13H24N4O3S	33624	Moderate		Inter Info	[33], [34], [35], [36], [37], [38], [39], [40]
D1586		Timolol (ophthalmic)	C13H24N4O3S	33624	Moderate		Inter Info	[35], [37], [39]
	Additive neuromuscular blocking effects					Drug Num: 86
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0056		Amikacin	C22H43N5O13	37768	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D0057		Amikacin (liposome)	C22H43N5O13	37768	Major		Inter Info	[4], [8], [9]
D0196		Botulinum toxin type A	NA	NA	Major		Inter Info	[18], [19], [20]
D0197		Botulinum Toxin Type B	NA	NA	Major		Inter Info	[18], [19], [20]
D0383		Colistimethate	C58H105N16O28S5-5	70789202	Major		Inter Info	[21], [22], [23], [24], [25], [26], [9], [27], [28], [29]
D0718		Gentamicin	C21H43N5O7	3467	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D0876		Kanamycin	C18H36N4O11	6032	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1228		Paromomycin	C23H45N5O14	165580	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1304		Plazomicin	C25H48N6O10	42613186	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1120		Neomycin	C23H46N6O13	8378	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1126		Netilmicin	C21H41N5O7	441306	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1310		Polymyxin B	C56H98N16O13	49800004	Major		Inter Info	[30], [31], [32]
D1507		Streptomycin	C21H39N7O12	19649	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D1597		Tobramycin	C18H37N5O9	36294	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
D0012		Acetazolamide	C4H6N4O3S2	1986	Moderate		Inter Info	[41], [42], [43]
D0069		Amlodipine	C20H25ClN2O5	2162	Moderate		Inter Info	[47], [48], [49]
D0075		Amphotericin B	C47H73NO17	5280965	Moderate		Inter Info	[50], [51], [52], [53]
D0076		Amphotericin B (cholesteryl sulfate)	C47H73NO17	5280965	Moderate		Inter Info	[50], [51], [53]
D0077		Amphotericin B (lipid complex)	C47H73NO17	5280965	Moderate		Inter Info	[50], [51], [53]
D0078		Amphotericin B (liposomal)	C47H73NO17	5280965	Moderate		Inter Info	[50], [51], [53]
D0142		Bacitracin	C66H103N17O16S	10909430	Moderate		Inter Info	[26], [9]
D0158		Bendroflumethiazide	C15H14F3N3O4S2	2315	Moderate		Inter Info	[41], [42], [43]
D0166		Benzthiazide	C15H14ClN3O4S3	2343	Moderate		Inter Info	[41], [42], [43]
D0172		Betamethasone	C22H29FO5	9782	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D0252		Capreomycin	C50H88N28O15	3000502	Moderate		Inter Info	[21], [26], [9], [59]
D0320		Chloroquine	C18H26ClN3	2719	Moderate		Inter Info	[62], [63]
D0321		Chlorothiazide	C7H6ClN3O4S2	2720	Moderate		Inter Info	[41], [42], [43]
D0326		Chlorthalidone	C14H11ClN2O4S	2732	Moderate		Inter Info	[41], [42], [43]
D0355		Clindamycin (topical)	C18H33ClN2O5S	446598	Moderate		Inter Info	[23], [8], [64]
D0400		Cyclophosphamide	C7H15Cl2N2O2P	2907	Moderate		Inter Info	[62], [63]
D0402		Cyclosporine	C62H111N11O12	5284373	Moderate		Inter Info	[65], [66], [67], [68]
D0441		Demeclocycline	C21H21ClN2O8	54680690	Moderate		Inter Info	[62], [63]
D0445		Desflurane	C3H2F6O	42113	Moderate		Inter Info	[9], [69], [70]
D0479		Diclofenamide	C6H6Cl2N2O4S2	3038	Moderate		Inter Info	[41], [42], [43]
D0497		Diltiazem	C22H26N2O4S	39186	Moderate		Inter Info	[47], [48], [49]
D0530		Doxycycline	C22H24N2O8	54671203	Moderate		Inter Info	[62], [63]
D0570		Enflurane	C3H2ClF5O	3226	Moderate		Inter Info	[9], [69], [70]
D0640		Felodipine	C18H19Cl2NO4	3333	Moderate		Inter Info	[47], [48], [49]
D0671		Fludrocortisone	C21H29FO5	31378	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D0719		Gentamicin (topical)	C21H43N5O7	3467	Moderate		Inter Info	[4], [15], [17]
D0751		Halothane	C2HBrClF3	3562	Moderate		Inter Info	[9], [69], [70]
D0773		Hydrocortisone	C21H30O5	5754	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D0775		Hydroflumethiazide	C8H8F3N3O4S2	3647	Moderate		Inter Info	[41], [42], [43]
D0798		Indapamide	C16H16ClN3O3S	3702	Moderate		Inter Info	[41], [42], [43]
D0855		Isoflurane	C3H2ClF5O	3763	Moderate		Inter Info	[9], [69], [70]
D0865		Isradipine	C19H21N3O5	3784	Moderate		Inter Info	[47], [48], [49]
D0879		Ketamine	C13H16ClNO	3821	Moderate		Inter Info	[23], [25], [41]
D0927		Lidocaine	C14H22N2O	3676	Moderate		Inter Info	[76], [77], [35], [78], [79], [80]
D0975		Magnesium sulfate	MgO4S	24083	Moderate		Inter Info	[81], [57]
D0978		Mannitol	C6H14O6	6251	Moderate		Inter Info	[41], [42], [43]
D1018		Methazolamide	C5H8N4O3S2	4100	Moderate		Inter Info	[41], [42], [43]
D1030		Methoxyflurane	C3H4Cl2F2O	4116	Moderate		Inter Info	[9], [69], [70]
D1048		Metolazone	C16H16ClN3O3S	4170	Moderate		Inter Info	[41], [42], [43]
D1070		Minocycline	C23H27N3O7	54675783	Moderate		Inter Info	[62], [63]
D0453		Dexamethasone	C22H29FO5	5743	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D0911		Levamlodipine	C20H25ClN2O5	9822750	Moderate		Inter Info	[47], [48], [49]
D0931		Lincomycin	C18H34N2O6S	3000540	Moderate		Inter Info	[82], [83], [84], [85], [23], [25], [86], [87], [8], [88], [64], [89], [90]
D0940		Lithium carbonate	CLi2O3	11125	Moderate		Inter Info	[91], [92], [93]
D0969		Magnesium chloride	Cl2H12MgO6	643991	Moderate		Inter Info	[81], [57]
D1046		Metoclopramide	C14H22ClN3O2	4168	Moderate		Inter Info	[62], [63]
D1149		Nitrous oxide	N2O	948	Moderate		Inter Info	[9], [69], [70]
D1311		Polythiazide	C11H13ClF3N3O4S3	4870	Moderate		Inter Info	[41], [42], [43]
D1384		Rapacuronium	C37H61N2O4+	5311399	Moderate		Inter Info	[94], [57], [95]
D1463		Sevoflurane	C4H3F7O	5206	Moderate		Inter Info	[9], [69], [70]
D1684		Vecuronium	C34H57N2O4+	39765	Moderate		Inter Info	[94], [57], [95]
D1121		Neomycin (topical)	C23H46N6O13	8378	Moderate		Inter Info	[4], [15], [17]
D1130		Nicardipine	C26H29N3O6	4474	Moderate		Inter Info	[47], [48], [49]
D1134		Nifedipine	C17H18N2O6	4485	Moderate		Inter Info	[47], [48], [49]
D1138		Nimodipine	C21H26N2O7	4497	Moderate		Inter Info	[47], [48], [49]
D1209		Oxytetracycline	C22H24N2O9	54675779	Moderate		Inter Info	[62], [63]
D1210		Oxytocin	C43H66N12O12S2	439302	Moderate		Inter Info	[62], [63]
D1332		Prednisolone	C21H28O5	5755	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D1334		Prednisone	C21H26O5	5865	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D1343		Procainamide	C13H21N3O	4913	Moderate		Inter Info	[62], [63]
D1344		Procaine	C13H20N2O2	4914	Moderate		Inter Info	[62], [63]
D1371		Quinidine	C20H24N2O2	441074	Moderate		Inter Info	[98], [99], [100]
D1500		Spectinomycin	C14H24N2O7	15541	Moderate		Inter Info	[62], [63]
D1554		Terbutaline	C12H19NO3	5403	Moderate		Inter Info	[62], [63]
D1564		Tetracycline	C22H24N2O8	54675776	Moderate		Inter Info	[62], [63]
D1628		Triamcinolone	C21H27FO6	31307	Moderate		Inter Info	[21], [25], [54], [55], [56], [57], [58]
D1633		Trichlormethiazide	C8H8Cl3N3O4S2	5560	Moderate		Inter Info	[41], [42], [43]
D1643		Trimethaphan	C22H25N2OS+	23576	Moderate		Inter Info	[62], [63]
D1680		Vancomycin	C66H75Cl2N9O24	14969	Moderate		Inter Info	[26], [9]
D1690		Verapamil	C27H38N2O4	2520	Moderate		Inter Info	[47], [48], [49]
D0516		Donepezil	C24H29NO3	3152	Minor		Inter Info	[25], [101], [41]
D1418		Rivastigmine	C14H22N2O2	77991	Minor		Inter Info	[106]
	Increased risk of bradycardia					Drug Num: 2
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0035		Alfentanil	C21H32N6O3	51263	Moderate		Inter Info	[44], [45], [46]
D0646		Fentanyl	C22H28N2O	3345	Moderate		Inter Info	[44], [45], [46]
Pharmacodynamic antagonistic effects
	Antagonize the effect of neuromuscular blocking agents					Drug Num: 9
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0256		Carbamoylcholine (ophthalmic)	C6H15N2O2+	2551	Moderate		Inter Info	[60], [61]
D0544		Dyphylline	C10H14N4O4	3182	Moderate		Inter Info	[71], [72], [73]
D1201		Oxtriphylline	C12H21N5O3	656652	Moderate		Inter Info	[71], [72], [73]
D1868		Pralidoxime	C7H9N2O+	135398747	Moderate		Inter Info	[96], [97]
D1570		Theophylline	C7H8N4O2	2153	Moderate		Inter Info	[71], [72], [73]
D0845		Irinotecan	C33H38N4O6	60838	Minor		Inter Info	[102]
D0846		Irinotecan (liposomal)	C33H38N4O6	60838	Minor		Inter Info	[102]
D1381		Ranitidine	C13H22N4O3S	3001055	Minor		Inter Info	[103], [104], [105]
D1382		Ranitidine (bismuth citrate)	C13H22N4O3S	3001055	Minor		Inter Info	[103], [104], [105]

References
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2	Chapple DJ, Clark JL, Hughes R "Interaction between atracurium and drugs used in anaesthesia." Br J Anaesth 55 Suppl (1983): s17-22. [PMID: 6688011]
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6	Giala MM, Paradelis AG "Two cases of prolonged respiratory depression due to interaction of pancuronium with colistin and streptomycin." J Antimicrob Chemother 5 (1979): 234-5. [PMID: 429254]
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9	Kronenfeld MA, Thomas SJ, Turndorf H "Recurrence of neuromuscular blockade after reversal of vecuronium in a patient receiving polymyxin/amikacin sternal irrigation." Anesthesiology 65 (1986): 93-4. [PMID: 2873764]
10	Levanen J, Nordman R "Complete respiratory paralysis caused by a large dose of streptomycin and its treatment with calcium chloride." Ann Clin Res 7 (1975): 47-9. [PMID: 1155911]
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13	Product Information. Arikayce (amikacin liposome). Insmed Incorporated, Bridgewater, NJ.
14	Product Information. Humatin (paromomycin). Parke-Davis, Morris Plains, NJ.
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16	Vanacker BF, Van de Walle J "The neuromuscular blocking action of vecuronium in normal patients and in patients with no renal function and interaction vecuronium- tobramycin in renal transplant patients." Acta Anaesthesiol Belg 37 (1986): 95-9. [PMID: 2875595]
17	Warner WA, Sanders E "Neuromuscular blockade associated with gentamicin therapy." JAMA 215 (1971): 1153-4. [PMID: 4250687]
18	Product Information. Myobloc (botulinum toxin type B) Elan Pharmaceuticals, S. San Francisco, CA.
19	Product Information. Dysport (abobotulinumtoxinA). Tercica Inc, Brisbane, CA.
20	Product Information. Jeuveau (prabotulinumtoxinA). Evolus, Inc., Santa Barbara, CA.
21	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
22	Cerner Multum, Inc "ANVISA Bulario Eletrnico.".
23	Cerner Multum, Inc. "Australian Product Information.".
24	Cerner Multum, Inc. "Canadian Product Information.".
25	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
26	Huang KC, Heise A, Shrader AK, Tsueda K "Vancomycin enhances the neuromuscular blockade of vecuronium." Anesth Analg 71 (1990): 194-6. [PMID: 1973882]
27	Product Information. Coly-Mycin M Parenteral (colistimethate). Parke-Davis, Morris Plains, NJ.
28	Product Information. Rocuronium Bromide (rocuronium). Hospira Inc, Lake Forest, IL.
29	Product Information. Vecuronium Bromide (vecuronium). Hospira Inc, Lake Forest, IL.
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43	Product Information. HydroDIURIL (hydrochlorothiazide). Merck &amp Co, Inc, West Point, PA.
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58	Product Information. Zemuron (rocuronium). Organon, West Orange, NJ.
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64	Product Information. Clindesse (clindamycin topical). Ther-Rx Corporation, Bridgeton, MO.
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88	Product Information. Cleocin (clindamycin). Pharmacia and Upjohn, Kalamazoo, MI.
89	Product Information. Lincocin (lincomycin). Pharmacia and Upjohn, Kalamazoo, MI.
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101	Product Information. Aricept (donepezil). Pfizer US Pharmaceuticals, New York, NY.
102	Product Information. Camptosar (irinotecan). Pharmacia and Upjohn, Kalamazoo, MI.
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106	Product Information. Exelon (rivastigmine) Novartis Pharmaceuticals, East Hanover, NJ.

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