Question:

I have a pseudocholinesterase deficiency. Can I take the muscle relaxer salxin or metaxalone and be okay?

Answer:

Pseudocholinesterase deficiency is an inherited or acquired enzyme abnormality that results in slower-than-normal breakdown of choline ester medicines such as succinylcholine. Acquired pseudocholinesterase deficiency may occur as a result of chronic infections (tuberculosis), extensive burn injuries, liver disease, some types of cancer, malnutrition, organophosphate pesticide poisoning, and uremia

Pseudocholinesterase deficiency may affect the breakdown of a few medicines including: succinylcholine, mivacurium, procaine, and cocaine, which can lead to an increased effect and duration of these medicines.

Other examples of choline ester drugs include carbachol, bethanechol, and methacholine.

We did not find a listing for a drug named Salxin. Perhaps you meant Skelaxin? Skelaxin is a brand name for metaxalone. Metaxalone is a muscle relaxant. However, its exact mechanism of action is unknown. It certainly does not appear to be metabolized by pseudocholinesterase.

Since metaxalone is not broken down by pseudocholinesterase, a deficiency of this enzyme should not preclude its use. Therefore, metaxalone’s use is not contraindicated with pseudocholinesterase deficiency.

Your doctor or a pharmacist who knows you may be able to provide additional information about your condition and which medicines should be safe for you to take.

This response was prepared in part by Ashley Huddleson, a PharmD student at the NetWellness.org James L.Winkle College of Pharmacy.

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Go to the Pharmacy and Medications health topic.