Amikacin
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Pipecuronium
Neuromuscular Blocker
Neuromuscular Blocker
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
10 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 10 →
- AmikacinSevereDatabaseDDInter
- Botulinum Toxin Type ASevereDatabaseDDInter
- Botulinum Toxin Type BSevereDatabaseDDInter
- ColistimethateSevereDatabaseDDInter
Mechanism
Pipecuronium produces a competitive (nondepolarizing) block at the end plate of skeletal muscle fibers. As a stabilizing neuromuscular blocking agent, its effects are reversed or antagonized by anticholinesterase agents. It is more selective than older agents like tubocurarine and pancuronium, demonstrating less ganglionic blockade.
Indications
Muscle relaxation for surgeryAdjuvant in surgical anesthesia to obtain relaxation of skeletal muscleProlonged surgeries
Dosing
- Adult
- 3–6 min (onset); 30–90 min (duration)
Pharmacokinetics
Onset
Rapid onset with intravenous administration
Duration
Long acting
Bioavailability
Very poorly absorbed from the GI tract; adequate absorption from intramuscular sites
Excretion
Renal elimination; hepatic metabolism/clearance
Side effects
Common
Transient hypotensionBradycardia
Serious
- Less ganglionic blockade
- Less tendency to release histamine
Drug interactions
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
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
2 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
Other Neuromuscular Blocker drugs
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Textbook-sourced·Sources: KD Tripathi 7e, Goodman & Gilman 14e·Updated: 2026-05-10