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British Journal of Anaesthesia, 1986, Vol. 58, No. 10 1149-1155
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

INTERACTION OF CYCLOSPORIN AND ITS SOLVENT, CREMOPHOR, WITH ATRACURIUM AND VECURONIUM

L. GRAMSTAD, M. D.*,, J. A. GJERLOW, M. D., E. S. HYSING, M. D. and H. E. RUGSTAD, M. D.

Department of Anaesthesia and Institute of Surgical Research, University Hospital N-0027 Oslo 1, Norway
Department of Clinical Pharmacology Rikshospitalet, University Hospital N-0027 Oslo 1, Norway

Interactions between Sandimmun (formulated as cyclosporin (CyA) in Cremophor and ethanol) and atracurium or vecuronium were investigated inanaesthetizedcats. Duringstable50% blockade and with a constant rate of infusion of the neuromuscular blocking drugs, Sandimmun 0.8 mg kg–1 or an equivalent amount of its solvent moiety was injected over 5 min. Sandimmun potentiated the blockade induced by vecuronium (median infusion rate 110 µg kg–1 h–1) from 50.7% before injection to maximum 95.2% 17.3 min after injection (median values), whereas the median blockade in cats receiving atracurium (median 250 pig kg–1 h–1) increased from 51.3% to 72.4% after 32.9 min. At 45 min after the injection the median blockades were 93.1% and 69.8%, respectively. In cats receiving vecuronium (median 104 µg kg–1 h–1) the solvent produced an increase in effect of from 51.1% to maximum 78.0% blockade after 5.4min and 61.5% after 45 min (median values). Interaction with solvent was negligible in cats receiving atracurium. We attribute the effect of the solvent to the Cremophor component. The mechanism of the interaction related to the cyclosporin is unknown.

*Present address: Apothekernes Laboratorium A. S, Harbnitzalleen 3, N-0275 Oslo 2, Norway.


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