rocuronium bromide

CLINICAL USE

Muscle relaxant in general anaesthesia, medium duration

DOSE IN NORMAL RENAL FUNCTION

IV injection: intubation dose: 0.6 mg/kg; maintenance: 0.15 mg/kg

IV infusion

: 0.6 mg/kg loading dose, followed by 0.3–0.6 mg/kg/hour

PHARMACOKINETICS

Molecular weight :609.7

%Protein binding :25–30

%Excreted unchanged in urine : 40

Volume of distribution (L/kg) :0.2

half-life – normal/ESRD (hrs) :1.2–1.4 /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. See ‘Other Information’

<10 : Dose as in normal renal function. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR< 10 mL/min

HD :Unknown dialysability. Dose as in GFR< 10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR< 10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR=

10 to 20 : mL/min

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 piperacillinBotulinum toxin: neuromuscular block enhanced (risk of toxicity)

ADMINISTRATION

Reconstition

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Route

Rate of Administration

Slow bolus or continuous infusion

Comments

Compatible with sodium chloride 0.9% and glucose 5%

OTHER INFORMATION

Use with caution in renal failure: variable duration of action (range: 22–90 minutes)Use the lowest possible dose in patients with GFR<20 mL/min, as at risk of prolonged paralysis

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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