Galantamine and Succinylcholine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Galantamine
Succinylcholine
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.
What happens
Prolonged neuromuscular blockade
Interaction Deep Dive
A synergistic effect is expected when cholinesterase inhibitors, such as donepezil, rivastigmine, or galantamine, are given concomitantly with succinylcholine2345. A consensus statement recommends acetylcholinesterase inhibitor therapy to be continued preoperatively, including the day of surgery. Short-acting and nondepolarizing agents such as cisatracurium or atracurium for neuromuscular blockade may be considered as an alternative to succinylcholine 1.
Why it happens (mechanism)
Synergistic effect
Literature reports
1 report — tap to read
a) Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement: Continue donepezil, galantamine, or rivastigmine therapy preoperatively, including the day of surgery due to the risk of relapse or worsening of disease symptoms with discontinuation of therapy. Donepezil, galantamine, or rivastigmine exaggerates and prolongs the duration of action of succinylcholine from 10 to 12 minutes to approximately 25 to 30 minutes. Short-acting and nondepolarizing agents such as cisatracurium or atracurium for neuromuscular blockade may be considered as an alternative to succinylcholine 1.
Common questions
Can I take Galantamine and Succinylcholine together?
Prolonged neuromuscular blockade Always confirm with your pharmacist or prescriber before making any change.
How serious is the Galantamine and Succinylcholine 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 strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Galantamine or Succinylcholine 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 (5)
- Oprea AD, Keshock MC, O'Glasser AY, et al: Preoperative management of medications for neurologic diseases: Society for Perioperative Assessment and Quality Improvement consensus statement. Mayo Clin Proc 2022; 97(2):375-396. DOI
- Product Information: ZUNVEYL oral delayed-release tablets, benzgalantamine oral delayed-release tablets. Alpha Cognition, Inc. (Per FDA), Grapevine, TX, 2024. DailyMed
- Product Information: RAZADYNE(R) ER oral extended-release capsules, galantamine oral extended-release capsules. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2022. DailyMed
- Product Information: Aricept(R) oral tablets, donepezil HCl oral tablets. Eisai Inc (per DailyMed), Nutley, NJ, 2022. DailyMed
- Product Information: Rivastigmine tartrate oral capsules, rivastigmine tartrate oral capsules. Macleods Pharma USA, Inc (per DailyMed), Princeton, NJ, 2022. DailyMed
Keep reading about Galantamine
Keep reading about Succinylcholine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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