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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

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

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 low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Neuromuscular Blocker drugs

Ask House about Pipecuronium

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Sources: KD Tripathi 7e, Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team