Formulary
Rocuronium bromide: Indications, Dosing, Side Effects and Interactions
Rocuronium bromide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Rocuronium bromide: Indications, Dosing, Side Effects and Interactions
Rocuronium bromide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Neuromuscular blockade (intermediate duration) during surgery for rocuronium bromide**
- **Neonate** (Initially by intravenous injection): Initially 600 micrograms/kg, then (by intravenous injection) 150 micrograms/kg, repeated if necessary, alternatively (by intravenous infusion) 300-600 micrograms/kg/hour, adjusted according to response.
- **Child** (Initially by intravenous injection): Initially 600 micrograms/kg, then (by intravenous injection) 150 micrograms/kg, repeated if necessary, alternatively (by intravenous infusion) 300-600 micrograms/kg/hour, adjusted according to response.
**Assisted ventilation in intensive care for rocuronium bromide**
- **Child** (Initially by intravenous injection): Initially 600 micrograms/kg, initial dose is optional, then (by intravenous infusion) 300-600 micrograms/kg/hour for first hour, then (by intravenous infusion), adjusted according to response.
Cautions
For all non-depolarising neuromuscular blocking drugs Burns (resistance can develop, increased doses may be required); cardiovascular disease (reduce rate of administration); electrolyte disturbances (response unpredictable); fluid disturbances (response unpredictable); hypothermia (activity prolonged, lower doses required); myasthenia gravis (activity prolonged, lower doses required); neuromuscular disorders (response unpredictable)
Side effects
For all non-depolarising neuromuscular blocking drugs Common or very common Flushing; hypotension Uncommon Bronchospasm; hypersensitivity; skin reactions; tachycardia Rare or very rare Circulatory collapse; muscle weakness (after prolonged use in intensive care); myopathy (after prolonged use in intensive care); shock Side-effects For rocuronium bromide Uncommon Procedural complications Rare or very rare Angioedema; face oedema; paralysis Frequency not known Malignant hyperthermia
Interactions
**Other interactions (4):**
- Reversal of the block with acetylcholinesterase inhibitors could also be inhibited.
- Other drugs: antibiotics: aminoglycoside, lincosamide and polypeptide antibiotics, acylamino-penicillin antibiotics.
- Recurarisation has been reported after post-operative administration of: aminoglycoside, lincosamide, polypeptide and acylamino-penicillin antibiotics, quinidine, quinine and magnesium salts (see...
- Decreased effect: Prior chronic administration of phenytoin or carbamazepine.
Pregnancy
For all non-depolarising neuromuscular blocking drugs Non-depolarising neuromuscular blocking drugs are highly ionised at physiological pH and are therefore unlikely to cross the placenta in significant amounts.
Breast feeding
For all non-depolarising neuromuscular blocking drugs Non-depolarising neuromuscular blocking drugs are ionised at physiological pH and are unlikely to be present in milk in significant amounts. Breast-feeding may be resumed once the mother has recovered from neuromuscular block.
Hepatic impairment
Manufacturer advises caution (may prolong duration of action). Dose adjustments Manufacturer advises consider dose reduction-consult product literature.
Renal impairment
Use with caution (may prolong duration of block). M Dose adjustments Reduce maintenance dose (consult product literature). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Rocuronium bromide in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

