vecuronium bromide

CLINICAL USE

Non-depolarising muscle relaxant

DOSE IN NORMAL RENAL FUNCTION

Intubation: 80–100 micrograms/kg, with maintenance of 20–30 micrograms/kg

IV infusion

: 40–100 micrograms/kg bolus, followed by 48–84 micrograms/kg/hour

PHARMACOKINETICS

Molecular weight : 637.7

%Protein binding : 30

%Excreted unchanged in urine : 25

Volume of distribution (L/kg) : 0.18–0.27

half-life – normal/ESRD (hrs) : 0.5–1.3/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unlikely to be dialysed. Dose as in normal renal function

HD : Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux : Unknown dialysability. Dose as in normal renal function

CAV/VVHD : Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anaesthetics: enhanced muscle relaxant effect

Anti-arrhythmics: procainamide enhances muscle relaxant effect

Antibacterials: effect enhanced by aminoglycosides, clindamycin, polymyxins and piperacillin Botulinum toxin: neuromuscular block enhanced (risk of toxicity)

ADMINISTRATION

Reconstition

5 mL water for injection to reconstitute 10 mg vial; up to 10 mL sodium chloride 0.9% or glucose 5% may be used

Route

Rate of Administration

See dose

Comments

May be added to sodium chloride 0.9%, glucose 5% or Ringer’s solution to give a final concentration of 40 mg/L

OTHER INFORMATION

Vecuronium is largely excreted via the liver. Use normal doses with caution in renal failure as has active metabolites which may accumulate Vecuronium bromide .

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