Formulary
Sugammadex: Indications, Dosing, Side Effects and Interactions
Sugammadex clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Sugammadex: Indications, Dosing, Side Effects and Interactions
Sugammadex clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Routine reversal of neuromuscular blockade induced by rocuronium or vecuronium**
- **Adult** (By Intravenous Injection): Initially 2-4 mg/kg, then 4 mg/kg if required, administered if recurrence of neuromuscular blockade occurs; consult product literature for further details.
**Immediate reversal of neuromuscular blockade induced by rocuronium**
- **Adult** (By Intravenous Injection): 16 mg/kg (consult product literature).
**Routine reversal of neuromuscular blockade induced by rocuronium for sugammadex**
- **Child 2-17 years** (By intravenous injection): 2 mg/kg (consult product literature).
Cautions
Cardiovascular disease (recovery may be delayed); elderly (recovery may be delayed); pre-existing coagulation disorders; recurrence of neuromuscular blockade-monitor respiratory function until fully recovered; use of anticoagulants (unrelated to surgery); wait 24 hours before re-administering rocuronium; wait 24 hours before re-administering vecuronium
Side effects
Common or very common Abdominal pain; cough; dizziness; headache; nausea; procedural complications; skin reactions; taste altered; vomiting Frequency not known Arrhythmias
Interactions
**Severe interactions:**
- Based on these data, no clinically significant pharmacodynamic interaction with other medicinal products is expected, with exception of the following: For toremifene and fusidic acid displacement...
**Other interactions (14):**
- The information in this section is based on binding affinity between sugammadex and other medicinal products, non-clinical experiments, clinical studies and simulations using a model taking into...
- In situations when potential displacement interactions can be anticipated, patients should be carefully monitored for signs of recurrence of neuromuscular blockade (approximately up to 15 minutes)...
- Toremifene: For toremifene, which has a relatively high binding affinity for sugammadex and for which relatively high plasma concentrations might be present, some displacement of vecuronium or...
- Clinicians should be aware that the recovery of the T 4 /T 1 ratio to 0.9 could therefore be delayed in patients who have received toremifene on the same day of the operation.
- For re-administration of sugammadex see section 4.2.
- Interactions potentially affecting the efficacy of other medicinal products (capturing interactions): Due to the administration of sugammadex, certain medicinal products could become less effective...
Pregnancy
Use with caution-no information available.
Renal impairment
Avoid if creatinine clearance less than 30 mL/minute. M See Prescribing in renal impairment .
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.
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