Sugammadex

Sugammadex

Trade names	Bridion
Clinical data
Uses	Reversal of neuromuscular blockade from rocuronium and vecuronium
Contraindications	Renal impairment
Routes of administration	Intravenous
Dosage	Based upon response to train-of-four stimulation: 2+ twitches: 2 mg/kg 1-2 posttetanic twitches: 4 mg/kg Reversal immediately after administration of rocuronium 1.2 mg/kg: 16 mg/kg
Pharmacodynamics
Mechanism of action	Encapsulation of rocuronium or vecuronium
Adverse effects	Bradycardia, may interfere with hormonal contraceptives
Pharmacokinetics
Physical and chemical data
Formula	C72H112O48S8
Molar mass	2002.12 g/mol

Sugammadex is used to reverse neuromuscular blockade from rocuronium and vecuronium.

Uses

If a patient requires reparaylsis after administration of sugammadex (up to 4 mg/kg), rocuronium or vecuronium can be re-administered after a minimum waiting time.

Drug and dose to be administered	Minimum waiting time
Rocuronium 1.2 mg/kg	5 minutes
Rocuronium 0.6 mg/kg or vecuronium 0.1 mg/kg	4 hours

Contraindications

Absolute contraindications

• Previous anaphylactic reaction to sugammadex

Precautions

• Sugammadex can also bind steroid-structured molecules such as estrogen and tamoxifen. Consideration to using other agents to reverse NMB should be given to those patients on tamoxifen or toremifene for breast cancer. Female patients of child-bearing age on oral birth control should be advised of the potential of a short-term decrease in the efficacy of this method of birth control following reversal with sugammadex.
• Renal disease is a relative contraindication to the use of sugammadex as it is mainly renally cleared. With decreased renal clearance, the drug will stay in the body longer and the safety profile of this kind of drug exposure has not been well studied.