Suxamethonium chloride
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]
Disclaimer
WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.
Black Box Warning
|
RISK OF CARDIAC ARREST FROM HYPERKALEMIC RHABDOMYOLYSIS
See full prescribing information for complete Boxed Warning.
There have been rare reports of acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death after the administration of succinylcholine to apparently healthy children who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne's muscular dystrophy.
This syndrome often presents as peaked T-waves and sudden cardiac arrest within minutes after the administration of the drug in healthy appearing children (usually, but not exclusively, males, and most frequently 8 years of age or younger). There have also been reports in adolescents. Therefore, when a healthy appearing infant or child develops cardiac arrest soon after administration of succinylcholine not felt to be due to inadequate ventilation, oxygenation, or anesthetic overdose, immediate treatment for hyperkalemia should be instituted. This should include administration of intravenous calcium, bicarbonate, and glucose with insulin, with hyperventilation. Due to the abrupt onset of this syndrome, routine resuscitative measures are likely to be unsuccessful. However, extraordinary and prolonged resuscitative efforts have resulted in successful resuscitation in some reported cases. In addition, in the presence of signs of malignant hyperthermia, appropriate treatment should be instituted concurrently. Since there may be no signs or symptoms to alert the practitioner to which patients are at risk, it is recommended that the use of succinylcholine in children should be reserved for emergency intubation or instances where immediate securing of the airway is necessary, e.g. laryngospasm, difficult airway, full stomach, or for intramuscular use when a suitable vein is inaccessible (see PRECAUTIONS: Pediatric Use and DOSAGE AND ADMINISTRATION). |
Overview
Suxamethonium chloride is a skeletal muscle relaxant, neuromuscular blocking drug that is FDA approved for the {{{indicationType}}} of induction of neuromuscular blockade, adjunct to general anesthesia, to facilitate endotracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation, rapid sequence intubation. There is a Black Box Warning for this drug as shown here. Common adverse reactions include ophthalmic: raised intraocular pressure.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
There is limited information regarding Suxamethonium chloride FDA-Labeled Indications and Dosage (Adult) in the drug label.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Suxamethonium chloride in adult patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Suxamethonium chloride in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
There is limited information regarding Suxamethonium chloride FDA-Labeled Indications and Dosage (Pediatric) in the drug label.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Suxamethonium chloride in pediatric patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Suxamethonium chloride in pediatric patients.
Contraindications
There is limited information regarding Suxamethonium chloride Contraindications in the drug label.
Warnings
|
RISK OF CARDIAC ARREST FROM HYPERKALEMIC RHABDOMYOLYSIS
See full prescribing information for complete Boxed Warning.
There have been rare reports of acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death after the administration of succinylcholine to apparently healthy children who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne's muscular dystrophy.
This syndrome often presents as peaked T-waves and sudden cardiac arrest within minutes after the administration of the drug in healthy appearing children (usually, but not exclusively, males, and most frequently 8 years of age or younger). There have also been reports in adolescents. Therefore, when a healthy appearing infant or child develops cardiac arrest soon after administration of succinylcholine not felt to be due to inadequate ventilation, oxygenation, or anesthetic overdose, immediate treatment for hyperkalemia should be instituted. This should include administration of intravenous calcium, bicarbonate, and glucose with insulin, with hyperventilation. Due to the abrupt onset of this syndrome, routine resuscitative measures are likely to be unsuccessful. However, extraordinary and prolonged resuscitative efforts have resulted in successful resuscitation in some reported cases. In addition, in the presence of signs of malignant hyperthermia, appropriate treatment should be instituted concurrently. Since there may be no signs or symptoms to alert the practitioner to which patients are at risk, it is recommended that the use of succinylcholine in children should be reserved for emergency intubation or instances where immediate securing of the airway is necessary, e.g. laryngospasm, difficult airway, full stomach, or for intramuscular use when a suitable vein is inaccessible (see PRECAUTIONS: Pediatric Use and DOSAGE AND ADMINISTRATION). |
There is limited information regarding Suxamethonium chloride Warnings' in the drug label.
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Suxamethonium chloride Clinical Trials Experience in the drug label.
Postmarketing Experience
There is limited information regarding Suxamethonium chloride Postmarketing Experience in the drug label.
Drug Interactions
There is limited information regarding Suxamethonium chloride Drug Interactions in the drug label.
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
There is no FDA guidance on usage of Suxamethonium chloride in women who are pregnant.
Pregnancy Category (AUS):
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Suxamethonium chloride in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Suxamethonium chloride during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Suxamethonium chloride in women who are nursing.
Pediatric Use
There is no FDA guidance on the use of Suxamethonium chloride in pediatric settings.
Geriatic Use
There is no FDA guidance on the use of Suxamethonium chloride in geriatric settings.
Gender
There is no FDA guidance on the use of Suxamethonium chloride with respect to specific gender populations.
Race
There is no FDA guidance on the use of Suxamethonium chloride with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Suxamethonium chloride in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Suxamethonium chloride in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Suxamethonium chloride in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Suxamethonium chloride in patients who are immunocompromised.
Administration and Monitoring
Administration
There is limited information regarding Suxamethonium chloride Administration in the drug label.
Monitoring
There is limited information regarding Suxamethonium chloride Monitoring in the drug label.
IV Compatibility
There is limited information regarding the compatibility of Suxamethonium chloride and IV administrations.
Overdosage
There is limited information regarding Suxamethonium chloride overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.
Pharmacology
There is limited information regarding Suxamethonium chloride Pharmacology in the drug label.
Mechanism of Action
There is limited information regarding Suxamethonium chloride Mechanism of Action in the drug label.
Structure
There is limited information regarding Suxamethonium chloride Structure in the drug label.
Pharmacodynamics
There is limited information regarding Suxamethonium chloride Pharmacodynamics in the drug label.
Pharmacokinetics
There is limited information regarding Suxamethonium chloride Pharmacokinetics in the drug label.
Nonclinical Toxicology
There is limited information regarding Suxamethonium chloride Nonclinical Toxicology in the drug label.
Clinical Studies
There is limited information regarding Suxamethonium chloride Clinical Studies in the drug label.
How Supplied
There is limited information regarding Suxamethonium chloride How Supplied in the drug label.
Storage
There is limited information regarding Suxamethonium chloride Storage in the drug label.
Images
Drug Images
{{#ask: Page Name::Suxamethonium chloride |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}
Package and Label Display Panel
{{#ask: Label Page::Suxamethonium chloride |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}
Patient Counseling Information
There is limited information regarding Suxamethonium chloride Patient Counseling Information in the drug label.
Precautions with Alcohol
Alcohol-Suxamethonium chloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
There is limited information regarding Suxamethonium chloride Brand Names in the drug label.
Look-Alike Drug Names
There is limited information regarding Suxamethonium chloride Look-Alike Drug Names in the drug label.
Drug Shortage Status
Price
References
The contents of this FDA label are provided by the National Library of Medicine.