Rocuronium

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Esmeron, Rocuroniumbromid; Belgium: Esmeron, Rocuronium; Bulgaria: Esmeron; Cyprus: Esmeron; Czech Republic: Esmeron, Rocuronium; Denmark: Esmeron; Estonia: Esmeron; Finland: Esmeron; France: Esmeron; Germany: Esmeron, Rocuroniumbromid; Greece: Esmeron; Hungary: Esmeron; Ireland: Esmeron, Rocuronium; Italy: Esmeron, Rocuronio; Latvia: Esmeron; Lithuania: Esmeron; Malta: Esmeron; Netherlands: Esmeron, Rocuroniumbromide; Poland: Esmeron, Rocuronium; Portugal: Esmeron; Romania: Esmeron, Rocuronium; Slovakia: Esmeron, Rocuronium; Slovenia: Esmeron; Spain: Esmeron, Rocuronio; Sweden: Esmeron, Rocuronium; UK: Esmeron.

North America

Canada: Rocuronium, Zemuron; USA: Rocuronium, Zemuron.

Latin America

Brazil: Esmeron; Mexico: Esmeron.

Asia

Japan: Eslax.

Drug combinations

Chemistry

Rocuronium Bromide: C~32~H~53~BrN~2~O~4~. Mw: 609.68. (1) Pyrrolidinium, 1-[(2β,3α,5α,16β,17β)-17-(acetyloxy)-3-hydroxy-2-(4-morpholinyl)androstan-16-yl]-1-(2-propenyl)-, bromide; (2) 1-Allyl-1-(3α,17β-dihydroxy-2β-morpholino-5α-androstan-16β-yl)pyrrolidinium bromide, 17-acetate. CAS-119302-91-9 (1993).

Pharmacologic Category

Neuromuscular-Blocking Agents, Nondepolarizing. (ATC-Code: M03AC09).

Mechanism of action

Blocks acetylcholine from binding to receptors on motor endplate, inhibiting depolarization.

Therapeutic use

Adjunct to general anesthesia to facilitate endotracheal intubation and to relax skeletal muscles during surgery. To facilitate mechanical ventilation in intensive care unit.

Pregnancy and lactiation implications

Crosses placenta. Umbilical venous plasma levels are 18% of maternal concentration. Use not recommended for rapid sequence induction during cesarean section. Excretion in breast milk unknown (use caution).

Unlabeled use

Contraindications

Hypersensitivity to rocuronium or any component of the formulation.

Warnings and precautions

Cross-sensitivity with other neuromuscular-blocking agents may occur (use extreme caution in previous anaphylactic reactions). Resistance may occur in burn patients (>30% of body) for period of 5-70 days postinjury. Use with caution in cardiovascular disease (onset of action may be delayed and duration of action may be prolonged). Alkalosis, hypercalcemia, demyelinating lesions, peripheral neuropathies, denervation, infection, muscle trauma, and diabetes mellitus may result in antagonism of neuromuscular blockade. Electrolyte abnormalities, severe hyponatremia, severe hypocalcemia, severe hypokalemia, hypermagnesemia, neuromuscular diseases, acidosis, acute intermittent porphyria, Eaton-Lambert syndrome, myasthenia gravis, renal failure, and hepatic failure may result in potentiation of neuromuscular blockade. Use with caution in hepatic impairment, in pulmonary hypertension (use may increase pulmonary vascular resistance), and in respiratory disease. Resistance may occur in immobilized patients.

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