Active Ingredient: Rocuronium
In adults rocuronium bromide is also indicated to facilitate tracheal intubation during rapid sequence induction and as an adjunct in the intensive care unit (ICU) to facilitate intubation and mechanical ventilation.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intravenous, 0.6 milligrams rocuronium per kilogram of body weight, one dose. Afterwards, intravenous, between 0.2 milligrams rocuronium per kilogram of body weight and 0.6 milligrams rocuronium per kilogram of body weight, one dose, over the duration of 6 hours.
For tracheal intubation, the same doses should be used as described above under surgical procedures.
The use of an initial loading dose of 0.6 mg/kg rocuronium bromide is recommended, followed by a continuous infusion as soon as twitch height recovers to 10% or upon reappearance of 1 to 2 twitches to train of four stimulation. Dosage should always be titrated to effect in the individual patient. The recommended initial infusion rate for the maintenance of a neuromuscular block of 80-90% (1 to 2 twitches to TOF stimulation) in adult patients is 0.3-0.6 mg/kg/h during the first hour of administration, which will need to be decreased during the following 6-12 hours, according to the individual response. Thereafter, individual dose requirements remain relatively constant.
A large between patient variability in hourly infusion rates has been found in controlled clinical studies, with mean hourly infusion rates ranging from 0.2-0.5 mg/kg/h depending on nature and extent of organ failure(s), concomitant medication and individual patient characteristics. To provide optimal individual patient control, monitoring of neuromuscular transmission is strongly recommended. Administration up to 7 days has been investigated.
Rocuronium bromide is administered intravenously either as a bolus injection or as a continuous infusion.
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