Sugammadex

Administration

• Type/Class: γ-cyclodextrin
• Dosage Forms:
  • 200mg/2mL (100mg/mL)
  • 500mg/5mL (100mg/mL)
• Routes of Administration: IV
• Common Trade Names: Bridion

Adult Dosing

IV bolus injection infused over 10 seconds via central or peripheral line with 16 mg/kg will reverse a single 1.2 mg/kg dose of rocuronium in approximately 3 minutes.

• 4 mg/kg if patient has no twitch responses to train-of-four and emergent reverse is not needed
• 2mg/kg if patient has a second twitch after train of four and no emergent reversal is needed

Pediatric Dosing

• No approved dosing or usage

Special Populations

• Pregnancy Rating: There are no data on use in pregnant women
• Lactation risk: Unknown

Renal Dosing

• Adult: Unknown
• Pediatric: Unknown

Hepatic Dosing

• Adult: Unknown
• Pediatric: Unknown

Contraindications

• Allergy to class/drug and or prior documentation of hypersensitivity

Adverse Reactions

Adverse affects are described in the anesthesia literature and the most serious side effect is in patients with a known hypersensitivity to Sugammadex

Serious

• Anaphylaxis (0.3%)
• Bradycardia (1-5%)

Minor

• Coughing
• Extremity pain
• Parosmia
• Hypoesthesia

Pharmacology

Sugammadex can encapsulates rocuronium and vecuronium preventing binding to acetylcholine receptors and can reverse paralysis in 3 minutes.

• Half-life:
• Metabolism:
• Excretion:

Mechanism of Action

Sugammadex is a reversal agent that can bind to rocuronium and reverse paralysis. The molecule encapsulates rocuronium rather than reversing paralysis via inhibition of acetylcholinesterase like neostigmine. The main use is in reversal of rocuronium or vecuronium induced paralysis after surgery

Comments

• Sugammadex is only FDA approved for reversal for patients undergoing surgery. The drug has been used in Europe since 2008