Rocuronium

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Generic Name: Rocuronium Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Rocuronium used for?

Rocuronium is used to relax the muscles. It works by blocking the signals between your nerves and your muscles.

Rocuronium is given before general anesthesia in preparing you for surgery. Rocuronium helps to keep your body still during surgery. It also relaxes your throat so a breathing tube can be more easily inserted before the surgery.

How should I take Rocuronium?

Rocuronium is injected into a vein through an IV. A healthcare provider will give you this injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when rocuronium is injected.

Your breathing, blood pressure, oxygen levels, heart function, and other vital signs will be watched closely while you are receiving rocuronium.

It may take you longer to recover from the effects of rocuronium if you have cirrhosis or other liver disease.

How do I store Rocuronium?

Rocuronium Bromide Injection should be stored in a refrigerator, 2° to 8°C (36° to 46°F). DO NOT FREEZE. Upon removal from refrigeration to room temperature storage conditions (25°C/77°F), use rocuronium bromide within 60 days. Use opened vials of rocuronium bromide within 30 days.

There may be different brands of Rocuronium that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Rocuronium down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Rocuronium?

You should not receive rocuronium if you are allergic to it. Tell your doctor if you have ever had a severe allergic reaction to any type of anesthesia.

To make sure rocuronium is safe for you, tell your doctor if you have:

  • myasthenia gravis;
  • cirrhosis or other liver disease;
  • a history of kidney disease;
  • heart disease, circulation problems; or
  • a nerve-muscle disorder such as ALS (Lou Gehrig’s disease), MS (multiple sclerosis), or muscular dystrophy.

It is not known whether rocuronium will harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether rocuronium passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Rocuronium during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Rocuronium. Rocuronium is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Rocuronium?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You will remain under constant supervision during treatment with rocuronium. Your caregivers will watch for any serious side effects. Tell your caregivers right away if you have:

  • ongoing muscle weakness; or
  • loss of movement in any part of your body (especially in adults who are 65 and older).

Common side effects may include:

  • a light-headed feeling, like you might pass out; or
  • high blood pressure (severe headache, blurred vision, pounding in your neck or ears, anxiety, confusion).

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Rocuronium?

Before receiving rocuronium, tell your doctor if you are using any of the following drugs:

  • lithium (Eskalith, Lithobid);
  • procainamide (Procan, Procanbid, Pronestyl);
  • seizure medication;
  • an antacid or mineral supplement that contains magnesium;
  • steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others;
  • a tetracycline antibiotic such as Brodspec, Panmycin, Sumycin, Tetracap, demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), or minocycline (Dynacin, Minocin, Solodyn, Vectrin); or
  • an antibiotic such as amikacin (Amikin), bacitracin (Baci-IM), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo-Fradin, Neo-Tab), netilmicin (Netromycin), polymyxin (Colistin), colistimethate (Coly-Mycin), streptomycin, tobramycin (Nebcin, Tobi), or vancomycin (Vancocin, Vancoled).

Rocuronium may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Rocuronium?

Rocuronium may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Rocuronium?

Rocuronium may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Rocuronium.

What is the dose of Rocuronium for an adult?

Usual Adult Dose for Anesthesia

TRACHEAL INTUBATION: Recommended initial dose is 0.6 mg/kg IV

RAPID SEQUENCE INTUBATION: 0.6 to 1.2 mg/kg IV

Maintenance doses: Guided by response to prior dose, not administered until recovery is evident.

Continuous infusion: Initial rate of 10 to 12 mcg/kg/min IV. Start only after early evidence of spontaneous recovery from an intubating dose.

Comments:

-Dosing information is derived from studies based upon units of drug per unit of body weight. It is intended to serve as an initial guide to clinicians familiar with other neuromuscular blocking agents to acquire experience with this drug. More information may be obtained by consulting the manufacturer product information.

-As with other neuromuscular blocking agents, the dosage of this drug should be individualized in each patient. The method of anesthesia, expected duration of surgery, method of sedation, expected duration of mechanical ventilation, possible interaction with other drugs that are administered concomitantly, and the condition of the patient should be taken into account when determining the dose.

-The use of an appropriate neuromuscular monitoring technique is recommended for the evaluation of neuromuscular block and recovery.

Use: For inpatients and outpatients as an adjunct to general anesthesia to facilitate both rapid sequence and routine tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

The manufacturer recommends caution

What is the dose of Rocuronium for a child?

Usual Pediatric Dose for Anesthesia

Infants and children:

TRACHEAL INTUBATION: 0.45 to 0.6 mg/kg IV

Maintenance for continued surgical relaxation, bolus: 0.075 to 0.125 mg/kg IV

Maintenance for continued surgical relaxation, continuous infusion: 7 to 12 mcg/kg/min IV

Comments:

-Dosing information is derived from studies based upon units of drug per unit of body weight. It is intended to serve as an initial guide to clinicians familiar with other neuromuscular blocking agents to acquire experience with this drug. More information may be obtained by consulting the manufacturer product information.

-As with other neuromuscular blocking agents, the dosage of this drug should be individualized in each patient. The method of anesthesia, expected duration of surgery, method of sedation, expected duration of mechanical ventilation, possible interaction with other drugs that are administered concomitantly, and the condition of the patient should be taken into account when determining the dose.

-The use of an appropriate neuromuscular monitoring technique is recommended for the evaluation of neuromuscular block and recovery.

-The experience with this drug in rapid sequence induction in pediatric patients is limited. This drug is therefore not recommended for facilitating tracheal intubation conditions during rapid sequence induction in pediatric patients.

Use: For tracheal intubation during routine sequence induction

Precautions

This drug is not recommended for use in children for rapid sequence tracheal intubation.

How is Rocuronium available?

Rocuronium is available in the following dosage forms and strengths:

  • Injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Rocuronium, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 10, 2018 | Last Modified: August 10, 2018

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