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Pancuronium

Neuromuscular Blocker · Neuromuscular blockade; Anaesthesia

Also known as Pancuronium bromide

Neuromuscular BlockerNeuromuscular blockade; Anaesthesia
CDSCO approvedSchedule H
EXCRETION
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Mildly prolonged maternal neuromuscular
FDA category + note
Top interactionssee all 12
  • LithiumSevereTextbookKDT 7e
  • AmikacinSevereDatabaseDDInter
  • Botulinum Toxin Type ASevereDatabaseDDInter
  • Botulinum Toxin Type BSevereDatabaseDDInter

Mechanism

Pancuronium competes with acetylcholine for receptor sites at the neuromuscular junction.

Indications

Enable light anaesthesia with adequate relaxation of the muscles of the abdomen and diaphragmRelax vocal cords to allow passage of a tracheal tubeLong-term mechanical ventilation in intensive care unitsAdjuvant in surgical anesthesia to obtain relaxation of skeletal muscleProlonged operations, especially neurosurgery

Dosing

Adult
although duration of action is dose-dependent. Drugs with a shorter or intermediate duration of action, such as atracurium besilate and vecuronium bromide p. 1409, are more widely used than those with a longer duration of action, such as pancuronium bromide.…

Pharmacokinetics

Onset
Slower than suxamethonium chloride
Duration
Long (60 –120 minutes)
Excretion
Renal and hepatic elimination (plasma clearance prolonged by 30-50% in geriatric patients)

Contraindications

  • Use with caution in patients with hepatic or renal dysfunction

Side effects

Common
TachycardiaHypertensionRise in blood pressure and tachycardia (with rapid i.v. injection due to vagal blockade and noradrenaline release)
Serious
  • Vagolytic action (tachycardia)
  • Hypertension
  • Increased cardiac output (due to vagolytic activity)
  • Less ganglionic blockade at common clinical doses

Pregnancy & lactation

Pregnancy

Mildly prolonged maternal neuromuscular

Drug interactions

Lithium
Severe
Textbook

Prolonged paralysis.

Not explicitly stated

Source: KDT 7e

Amikacin
Severe
Database

Clinical effect not specified

Source: DDInter

Botulinum Toxin Type A
Severe
Database

Clinical effect not specified

Source: DDInter

Botulinum Toxin Type B
Severe
Database

Clinical effect not specified

Source: DDInter

Colistimethate
Severe
Database

Clinical effect not specified

Source: DDInter

Kanamycin
Severe
Database

Clinical effect not specified

Source: DDInter

Netilmicin
Severe
Database

Clinical effect not specified

Source: DDInter

Paromomycin
Severe
Database

Clinical effect not specified

Source: DDInter

Plazomicin
Severe
Database

Clinical effect not specified

Source: DDInter

Polymyxin B
Severe
Database

Clinical effect not specified

Source: DDInter

Streptomycin
Severe
Database

Clinical effect not specified

Source: DDInter

Tobramycin
Severe
Database

Clinical effect not specified

Source: DDInter

Related guidelines

Other Neuromuscular Blocker drugs

Ask House about Pancuronium

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, BNF·Verified: 2026-05-13 · House clinical team