Clindamycin and Cisatracurium: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 1, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clindamycin
Cisatracurium
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Cisatracurium is a muscle relaxant given during surgery or in intensive care to keep your muscles still while a breathing machine helps you. Clindamycin is an antibiotic that fights infection. When they are used together, the antibiotic can make the muscle relaxant work a bit stronger or last a bit longer.
The good news is that this only happens in a hospital setting, where your care team is already watching your breathing and muscle strength very closely. They can simply fine-tune the muscle relaxant dose for you. If you are worried, just ask your anesthesiologist or pharmacist about it.
Effect: Clindamycin may potentiate the neuromuscular blockade produced by cisatracurium, a nondepolarizing agent. Neither drug is a prodrug; the interaction is pharmacodynamic.
- Direction: Enhanced/prolonged neuromuscular block (increased drug effect).
- Mechanism: Unknown; lincosamides are thought to have intrinsic neuromuscular-blocking properties that are additive with the agent.
- Onset: Rapid.
- Evidence: Theoretical.
- Magnitude: Not quantified.
Management: Anticipate possible deeper/longer block. The cisatracurium dose may need to be adjusted downward and individualized; monitor with peripheral nerve stimulation (train-of-four) and ensure adequate recovery before extubation.
What happens
Enhanced neuromuscular blocking action
Interaction Deep Dive
The neuromuscular blocking action of cisatracurium can be intensified by certain antibiotics, such as aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and colistemethate1. Concurrent administration of these antibiotics may require modifying the dose of cisatracurium.
Why it happens (mechanism)
Unknown
How to manage this interaction
This interaction is managed entirely by your hospital care team, so there is nothing you need to change on your own.
- Keep taking both medications exactly as prescribed.
- Your team may adjust the cisatracurium dose downward and individualize it while you are also receiving clindamycin.
- They typically monitor your muscle function and breathing more closely, including making sure your strength has fully returned before removing any breathing support.
If you or a family member have questions, ask the anesthesiologist, ICU team, or pharmacist to walk you through the plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clindamycin and Cisatracurium together?
Clindamycin can make the surgical muscle relaxant cisatracurium work harder or last longer, so your hospital team may use a lower dose and watch your muscle strength and breathing more closely. This is routinely managed in the hospital setting. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Cisatracurium interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Clindamycin and Cisatracurium interaction managed?
This interaction is managed entirely by your hospital care team, so there is nothing you need to change on your own. Keep taking both medications exactly as prescribed. Your team may adjust the cisatracurium dose downward and individualize it while you are also receiving clindamycin. They typically monitor your muscle function and breathing more closely, including making sure your strength has ful… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Clindamycin or Cisatracurium need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: Nimbex(R), cisatracurium besylate injection. Glaxo Wellcome Inc. Research Triangle Park, NC, 1999. DailyMed
Keep reading about Clindamycin
Keep reading about Cisatracurium
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