Clindamycin and Vecuronium: 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
Vecuronium
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.
These two medicines can add up in a way that affects your breathing. Vecuronium is a muscle relaxant given during surgery or in the hospital to relax your muscles so a machine can help you breathe. Clindamycin is an antibiotic. When they are used together, clindamycin can make the muscle-relaxing effect a bit stronger, which could slow your breathing more than expected.
The good news: this usually happens in a hospital setting where your care team is already watching you closely. They can adjust the vecuronium dose and stand ready to support your breathing. If you take these together, just make sure your doctor and pharmacist know.
Effect: Additive potentiation of nondepolarizing neuromuscular blockade, increasing risk of prolonged block and respiratory depression.
Mechanism: Clindamycin (a lincosamide) has intrinsic neuromuscular-blocking properties that add to vecuronium's effect at the neuromuscular junction. This is a pharmacodynamic (additive), not pharmacokinetic, interaction. Neither agent requires bioactivation.
- Onset: rapid
- Evidence: theoretical / based on reports with lincosamides and various NMBAs
- Severity: moderate
Management: Monitor depth of block (train-of-four). Reduce vecuronium dose if co-administered and anticipate need for ventilatory support and prolonged recovery.
What happens
Vecuronium toxicity (respiratory depression)
Interaction Deep Dive
It has been documented that clindamycin and lincomycin can potentiate the action of muscle relaxants such as pancuronium, tubocurarine, and vecuronium21.
Why it happens (mechanism)
Additive
How to manage this interaction
This interaction is managed in the hospital, where your care team already monitors you closely.
- Keep taking both as prescribed unless your care team tells you otherwise.
- Your team may monitor your muscle strength and breathing more closely and be ready to provide breathing support if needed.
- The vecuronium dose may need to be adjusted and individualized by your anesthesia or ICU team when clindamycin is also being used.
- Tell your care team you are on clindamycin before any surgery or procedure that uses muscle relaxants.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clindamycin and Vecuronium together?
Clindamycin can add to vecuronium's muscle-relaxing effect and increase the risk of slowed breathing, but this is handled in the hospital where your team can lower the vecuronium dose and monitor your breathing. Make sure your care team knows you take clindamycin. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Vecuronium 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 Vecuronium interaction managed?
This interaction is managed in the hospital, where your care team already monitors you closely. Keep taking both as prescribed unless your care team tells you otherwise. Your team may monitor your muscle strength and breathing more closely and be ready to provide breathing support if needed. The vecuronium dose may need to be adjusted and individualized by your anesthesia or ICU team when clindamy… 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 Vecuronium 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 (2)
- Ostergaard D, Engbaek J, & Viby-Mogensen J: Adverse reactions and interactions of the neuromuscular blocking drugs. Med Toxicol Adverse Drug Exp 1989; 4:351-368. PubMed
- Rubbo JT, Gergis SD, & Sokoll MD: Comparative neuromuscular effects of lincomycin and clindamycin. Anesth Analg 1977; 56:329-332. PubMed
Keep reading about Clindamycin
Keep reading about Vecuronium
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