Drug General Information (ID: DDIFAELRCG)
Drug Name			Cyclosporine		Drug Info		Doxacurium		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Analgesics
Structure

Mechanism of Cyclosporine-Doxacurium Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Doxacurium
Mechanism		Neuromuscular blocking effects				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 Cyclosporine and Doxacurium

Recommended Action
Management		Patients should be monitored for excessive and/or prolonged neuromuscular blockade.

References
1	Crosby E, Robblee JA "Cyclosporine-pancuronium interaction in a patient with a renal allograft." Can J Anaesth 35 (1988): 300-2. [PMID: 3289771]
2	Takita K, Goda Y, Kemmotsu O, et al. Does cyclosporine affect the duration of action of vecuronium in renal transplant recipients?.?J Anesth. 1995;9(3):239-242. [PMID: 28921224]
3	Sidi A, Kaplan RF, Davis RF "Prolonged neuromuscular blockade and ventilatory failure after renal transplantation and cyclosporine." Can J Anaesth 37 (1990): 543-8. [PMID: 1973635]
4	Wood GG "Cyclosporin-vercuronium interaction." Can J Anaesth 36 (1989): 358-66. [PMID: 2566392]