Products
Rocuronium bromide is commercially available as a solution for injection (esmeron, generic). It was approved in the United States in 1994 and in many countries in 1995.
Structure and properties
Rocuronium bromide (C32H53BrN2O4, Mr = 609.7 g/mol) exists as a nearly white to pale yellow, slightly hygroscopic powder that is readily soluble in water. Structurally, it is an amino-substituted steroid.
Effects
Rocuronium bromide (ATC M03AC09) has muscle relaxant properties. It is a nondepolarizing neuromuscular blocker with a rapid onset of action and a medium-length duration of action. The effects are due to competitive antagonism at nicotinic acetylcholine receptors at the motor endplate. This results in paralysis and flaccidity of the muscles. Indirect parasympathomimetics (acetylcholinesterase inhibitors such as neostigmine and pyridostigmine) abolish the effects of rocuronium bromide.
Indications
For general anesthesia to facilitate tracheal intubation and maintain skeletal muscle relaxation for the duration of the surgical procedure. Off-Label Use:
- For physician-assisted euthanasia, after induction of coma, for example, with thiopental.
Dosage
According to the professional information. The drug is administered as an intravenous injection or infusion.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Several agents may potentiate or attenuate the effects of rocuronium bromide. These include, for example, local anesthetics such as lidocaine, anesthetics, suxamethonium, glucocorticoids, antibiotics, and diuretics (selection). Rocuronium bromide is incompatible with a number of substances. If the same infusion line is used, it must first be carefully flushed with a 0.9% sodium chloride solution.
Adverse effects
The most common potential adverse effects include injection site reactions, changes in vital function, and prolonged neuromuscular blockade.
