Drug General Information (ID: DDIVHBGO6W)
Drug Name			Clindamycin (topical)		Drug Info		Tubocurarine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antibiotics				Neuromuscular Blocking Agents
Structure

Mechanism of Clindamycin (topical)-Tubocurarine Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Clindamycin (topical)				Tubocurarine
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 Clindamycin (topical) and Tubocurarine

Recommended Action
Management		Patients receiving neuromuscular blockers in conjunction with lincosamide therapy should be monitored closely during and after anesthesia for development of respiratory depression, and life support should be readily available if needed. Anticholinesterases and calcium may not completely antagonize the neuromuscular blockade induced by lincosamides.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Jedeikin R, Dolgunski E, Kaplan R, Hoffman S "Prolongation of neuromuscular blocking effect of vecuronium by antibiotics." Anaesthesia 42 (1987): 858-60. [PMID: 2889390]
3	Product Information. Clindesse (clindamycin topical). Ther-Rx Corporation, Bridgeton, MO.