Source: Medicines & Healthcare Products Regulatory Agency (GB) Revision Year: 2019 Publisher: Mercury Pharmaceuticals Limited, Capital House, 85 King William Street, London EC4N 7BL, UK
Suxamethonium is a short acting depolarising neuromuscular blocking agent for producing muscular relaxation during anaesthesia. It is used in anaesthesia as a muscle relaxant to facilitate endotracheal intubation, mechanical ventilation and a wide range of surgical and obstetric procedures.
It is also used to reduce the intensity of muscle contractions associated with Pharmacologically or electrically-induced convulsions.
The dosage for adults and children is dependent on body weight and the degree of muscular relaxation required. The usual single dose for an adult is in the range of 20 to 100mg intravenously, depending on the patient’s body weight and the degree of muscular relaxation required. Infants and young children are relatively resistant to suxamethonium.
A suggested dose for children is in the range of 1 to 2mg/kg body weight, intravenously.
If necessary, the intramuscular route may be used and a dose up to 2.5mg/kg body weight may be given intramuscularly to adults or children to a maximum total of 150mg. For administration by continuous intravenous infusion, a 0.1 to 0.2% Solution may be used and the adult dose ranges from 2 to 5mg per minute.
Dosage requirements of suxamethonium in older patients are comparable to those for younger adults.
The elderly may be more susceptible to cardiac arrhythmias, especially if digitalis-like drugs are also being taken. See also 'Special warnings and precautions for use.
Suxamethonium Chloride is usually administered by the intravenous route. It is given intravenously after anaesthesia has been induced and should not be administered to the conscious patient. Assisted respiration is necessary.
Apnoea and prolonged muscle paralysis are the main and serious effects of overdosage.
It is essential to maintain the airway and to ensure adequate ventilation until spontaneous respiration occurs.
Neostigmine and other anticholinesterase drugs are not antidotes to suxamethonium but would normally intensify the depolarisation effect. However, in some cases when the action of suxamethonium is prolonged, the characteristic depolarising (Phase I) block may change to one with characteristics of a non-depolarising (Phase II) block.
The decision to use neostigmine to reverse a Phase II suxamethonium-induced block depends on the judgement of the clinician in the individual case. Valuable information in regard to this decision will be gained by monitoring neuromuscular function.
To investigate this possibility, the short-acting anticholinesterase drug, edrophonium, may be given intravenously. If an obvious improvement is maintained for several minutes, neostigmine may be given with atropine. Subsequently, the patient should be observed carefully and if apnoea recurs, a further dose of neostigmine is indicated.
18 months.
Store in a refrigerator (2°-8°C).
Do not freeze.
Keep the ampoule in the outer carton in order to protect from light.
2m1, clear glass ampoules, glass type I Ph.Eur. borosilicate glass, packed in cardboard cartons to contain 10 × 2ml ampoules.
For IM and IV injection.
If only part used, discard the remaining solution immediately after first use.
Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
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