Pipecuronium
- Atc Codes:M03AC06
- CAS Codes:52212-02-9#68399-58-6
- PHARMGKB ID:52212-02-9#68399-58-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Bulgaria: Arduan; Czech Republic: Arduan; Estonia: Arduan; Hungary: Arduan; Latvia: Arduan; Lithuania: Arduan; Poland: Arduan; Slovakia: Arduan.
North America
USA: Arduan (d).
Drug combinations
Chemistry
Pipecuronium Bromide: C~35~H~62~Br~2~N~4~O~4~. Mw: 762.70. (2β,3α,5α,16β,17β)-3,17-bis(acetyloxy)-2,16-bis(4,4-dimethylpiperazin-4-ium-1-yl)androstane dibromide. CAS-52212-02-9; CAS-68399-58-6 (free base).
Pharmacologic Category
Skeletal Muscle Relaxants; Neuromuscular Blocking Agents, Nondepolarizing. (ATC-Code: M03AC06).
Mechanism of action
Nondepolarizing neuromuscular-blocking agents inhibit neuromuscular transmission by competing with acetylcholine for the cholinergic receptors of the motor end plate, thereby reducing the response of the end plate to acetylcholine. This type of neuromuscular block is usually antagonized by anticholinesterase agents.
Therapeutic use
Long-acting neuromuscular-blocking agent, indicated as an adjunct to general anesthesia, to provide skeletal muscle relaxation during surgery and skeletal muscle relaxation for endotracheal intubation.
Pregnancy and lactiation implications
Should be used during pregnancy only if potential benefit justifies potential risk to fetus. Pipecuronium bromide is not recommended for use in patients undergoing cesarean section (duration of action exceeds the duration of operative obstetrics). Not recommended during lactation.
Unlabeled use
Contraindications
Hypersensitivity to the active ingredient or any of the excipients.
Warnings and precautions
Should be administered in carefully adjusted dosages by or under the supervision of experienced clinicians with emergency systems readily available. Since pipecuronium bromide for injection has little or no effect on heart rate, the drug will not counteract the bradycardia produced by many opioid anesthetic agents, or vagal stimulation. Pipecuronium bromide has no known effect on consciousness, the pain threshold or cerebration (administration must be accompanied by adequate anesthesia). Antagonists (such as neostigmine) should not be administered prior to the demonstration of some spontaneous recovery from neuromuscular blockade (the use of a nerve stimulator to document recovery and antagonism of neuromuscular blockade is recommended). Contains benzyl alcohol; not intended for use in newborns.