sugammadex sodium: clinical use

Prescribing considerations

• Restrict use to reversal of blockade caused by rocuronium or vecuronium within the selected product’s licensed populations.
• Use by or under an anaesthetist, with appropriate neuromuscular monitoring.
• Not recommended in severe renal impairment, including patients requiring dialysis.
• Exercise particular caution with severe hepatic impairment, coagulopathy, therapeutic anticoagulation or previous pulmonary complications.
• Consider sodium content in patients requiring sodium restriction.

Contraindications and cautions

• Hypersensitivity to sugammadex or any excipient in the selected product.

Monitoring

• Neuromuscular monitoring until sustained recovery.
• Respiratory function and adequacy of spontaneous ventilation.
• Heart rate and haemodynamic changes during and after reversal.
• Signs of hypersensitivity, bronchospasm or recurrent neuromuscular blockade.
• Haemostasis and coagulation parameters when clinically indicated by bleeding risk.

Clinical pharmacology

Sugammadex is a modified gamma-cyclodextrin selective relaxant-binding agent. It forms circulating complexes with rocuronium or vecuronium, reducing their availability at nicotinic receptors and reversing neuromuscular blockade.

Formulation and product differences

• The selected product is a clear, colourless to slightly yellow intravenous solution supplied in 2 mL and 5 mL vials.
• It contains up to 9.7 mg sodium per mL.
• Physical incompatibility has been reported with verapamil, ondansetron and ranitidine; flush shared intravenous lines appropriately.

Injection

Route: Parenteral

Strengths: 100 mg/mL