II. Indications

  1. Rapid reversal of Rocuronium and Vecuronium
  2. FDA approved for reversal in adult surgery cases, to speed recovery after case completion
  3. Emergency reversal is off-label use (can't intubate - can't ventilate, neurologic injury assessment)

III. Background

  1. Approved in Europe in 2008
  2. FDA approved in U.S. in 2016 (initially rejected due to Anaphylaxis risk)

IV. Mechanism

  1. Sugammadex tightly binds Rocuronium and Vecuronium
  2. Prevents paralytic binding to acetylcholine receptors

V. Pharmacokinetics

  1. Reverses paralysis within 3 minutes

VI. Dosing

  1. Typical dose: 4 mg/kg total body weight
  2. Rapid reversal dose: 16 mg/kg total body weight

VII. Adverse Effects

  1. Anaphylaxis in 0.3% of patients
  2. Bradycardia

VIII. References

  1. Braude and Hayes in Herbert (2016) EM:Rap 16(11): 7

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Ontology: Sugammadex (C1700695)

Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH C453980
SnomedCT 442379000, 442340006
English Sugammadex (product), Sugammadex (substance), Sugammadex, sugammadex, SUGAMMADEX
Spanish sugammadex, sugammadex (sustancia), sugammadex (producto)

Ontology: Bridion (C2699711)

Concepts Pharmacologic Substance (T121)
English Bridion