Sugammadex
Reversal of rocuronium/vecuronium neuromuscular blockade
Indications
- Reversal of rocuronium/vecuronium neuromuscular blockade
Adult dosing
- immediate reversal: dose: 16; unit: mg/kg; route: IV; weightBased: true; maxDose: 3200; maxDoseAbsolute: true; routine reversal: dose: 4; unit: mg/kg; route: IV; weightBased: true; maxDose: 800; maxDoseAbsolute: true
Pediatric dosing
- routine reversal: dose: 2; unit: mg/kg; route: IV; weightBased: true; maxDose: 200; maxDoseAbsolute: true; immediate reversal: dose: 16; unit: mg/kg; route: IV; weightBased: true; maxDose: 1120; maxDoseAbsolute: true
Contraindications
- Hypersensitivity to sugammadex
Clinical pearls
- Use 16 mg/kg for immediate "cannot intubate, cannot ventilate" reversal of rocuronium
- Encapsulates rocuronium — rendering it inactive; does not work for succinylcholine
- May reduce efficacy of hormonal contraceptives — counsel patients
- Onset faster and more predictable than neostigmine
Source and review
- Tintinalli's Emergency Medicine, 9th ed.. Last reviewed: 2024-11-01