Gallamine and Clindamycin: 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
Gallamine
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.
Let me walk you through this one. Gallamine is a muscle relaxant used during surgery to keep your muscles still, including the muscles you breathe with. Clindamycin is an antibiotic. When these two are given together, clindamycin can add to gallamine's effect, making the muscle relaxation stronger and longer-lasting than expected, especially at higher antibiotic doses.
The good news is this almost always happens in a controlled setting like an operating room, where your care team is already watching your breathing very closely. They can adjust the dose and provide breathing support if needed. If you have concerns, just ask your pharmacist or doctor.
Effect: Enhanced and prolonged neuromuscular blockade when clindamycin is combined with the nondepolarizing agent gallamine.
Mechanism: Additive. Clindamycin exerts pre- and postsynaptic neuromuscular effects plus direct action on muscle contractility, augmenting gallamine's blockade. Neither agent requires bioactivation, so this is a direct additive PD interaction.
- Direction: Increased/potentiated blockade (dose-related, greater with higher clindamycin doses)
- Onset: Rapid
- Evidence: Theoretical
- Management: Monitor closely for excessive/prolonged blockade; consider reducing the gallamine dose; anticipate the possible need for ventilatory support and recovery monitoring.
What happens
Enhanced and prolonged neuromuscular blockade
Interaction Deep Dive
Giving clindamycin together with nondepolarizing muscle relaxants can result in an exaggerated neuromuscular blockade, an effect that is particularly likely when clindamycin is used at higher doses1234. This clindamycin effect may arise from a combination of presynaptic and postsynaptic activity along with a direct influence on the contractility of muscle.
Why it happens (mechanism)
Additive effects
How to manage this interaction
This interaction is managed in a monitored setting (usually surgery or intensive care), so the main thing is that your care team keeps a close eye on things.
- Keep taking both as prescribed unless your team tells you otherwise.
- Your team may lower the gallamine dose and individualize it to you.
- They will watch your muscle strength and breathing closely and be ready to provide breathing support if the relaxation lasts longer than expected.
- Tell your anesthesia or care team you are on clindamycin, and raise any questions with your pharmacist or prescriber.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A 58-year-old woman with severe rheumatoid arthritis underwent wrist arthrodesis with general anesthesia. She received a small defasciculating dose of tubocurarine 3 mg along with fentanyl 1.5 mcg/kg intravenously (IV). Induction of anesthesia was achieved with thiopentone 4 mg/kg and succinylcholine 1.5 mg/kg, and it was maintained using nitrous oxide in oxygen together with isoflurane. Complete recovery of neuromuscular function was noted following the succinylcholine injection. At that time, clindamycin phosphate 2400 mg IV was administered; this represented an accidental overdose because 600 mg had been prescribed. Following surgery, the patient made no efforts at spontaneous breathing and did not respond to painful stimuli. She was managed with calcium chloride, edrophonium, atropine, and neostigmine, with minimal effect. Nine hours after the operation the patient coughed and the train-of-four (TOF) had recovered to 1.0. Two hours after that, she was extubated and spontaneous breathing began. The authors proposed that clindamycin produced muscle relaxation mainly through a direct effect on contractility, though some pre-synaptic effects were also considered to occur 1.
Common questions
Can I take Gallamine and Clindamycin together?
Clindamycin can make the muscle relaxant gallamine work more strongly and for longer, so your care team may lower the gallamine dose and watch your breathing closely. This is managed in a monitored setting, so keep both as prescribed and mention the combination to your team. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gallamine and Clindamycin 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 Gallamine and Clindamycin interaction managed?
This interaction is managed in a monitored setting (usually surgery or intensive care), so the main thing is that your care team keeps a close eye on things. Keep taking both as prescribed unless your team tells you otherwise. Your team may lower the gallamine dose and individualize it to you. They will watch your muscle strength and breathing closely and be ready to provide breathing support if t… 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 Gallamine or Clindamycin 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 (4)
- Al Ahdal O & Bevan DR: Clindamycin-induced neuromuscular blockade. Can J Anaesth 1995; 42:614-617. PubMed
- 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
- Fogdall RP & Miller RD: Prolongation of a pancuronium-induced neuromuscular blockade by clindamycin. Anesthesiology 1974; 41:407-408. PubMed
Keep reading about Clindamycin
Keep reading about Gallamine
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