Drug General Information (ID: DDI9TSD5I0)
Drug Name			Pipecuronium		Drug Info		Vecuronium		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Analgesics
Structure

Mechanism of Pipecuronium-Vecuronium Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Pipecuronium				Vecuronium
Mechanism		Neuromuscular blocking agent Neuronal acetylcholine receptor  Antagonist				Neuromuscular blocking agent Neuronal acetylcholine receptor  Antagonist
Key Mechanism Factor 1
		Factor Name		Neuronal acetylcholine receptor				Structure Sequence
		Protein Family		Ligand-gated ion channel (TC 1.A.9) family
		Protein Function		After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.     Click to Show/Hide
Mechanism Description		Additive neuromuscular blocking effects by the combination of Pipecuronium and Vecuronium

Recommended Action
Management		There are insufficient data to support the concomitant use of vecuronium and other neuromuscular blockers.

References
1	Pandit SK, Ferres CJ, Gibson FM, Mirakhur RK "Time course of action of combinations of vecuronium and pancuronium." Anaesthesia 41 (1986): 151-4. [PMID: 2869710]
2	Product Information. Norcuron (vecuronium). Organon, West Orange, NJ.
3	Rashkovsky OM, Agoston S, Ket JM "Interaction between pancuronium bromide and vecuronium bromide." Br J Anaesth 57 (1985): 1063-6. [PMID: 2864945]