Bridion

Sugammadex

Reversal of neuromuscular blockade induced by rocuronium Br & vecuronium Br in adults & ped patients ≥2 yr undergoing surgery.

May be administered over 10 sec into an existing IV line. For rocuronium & vecuronium 4 mg/kg IV as a single bolus inj if spontaneous recovery of the twitch response has reached 1-2 post-tetanic counts (PTC) & there are no twitch responses to train-of-four (TOF) stimulation following rocuronium- or vecuronium-induced neuromuscular blockade. 2 mg/kg IV as a single bolus inj if spontaneous recovery has reached the reappearance of the 2nd twitch (T₂) in response to TOF stimulation following rocuronium- or vecuronium-induced neuromuscular blockade. For rocuronium only Adult 16 mg/kg IV as a single bolus inj if there is a clinical need to reverse neuromuscular blockade soon (approx 3 min) after administration of a single dose of 1.2 mg/kg rocuronium.

Hypersensitivity.

Possibility of drug hypersensitivity reactions. Cases of marked bradycardia. Closely monitor patients for hemodynamic changes during & after reversal of neuromuscular blockade. Monitor resp function during recovery, & ventilation until recovery occurs. Observe waiting times for re-administration of neuromuscular blocking agents for intubation following reversal w/ Bridion. Risk of coagulopathy & bleeding. Monitor coagulation parameters in patients who received 16 mg/kg sugammadex dose & w/ known coagulopathies, being treated w/ therapeutic anticoagulation, receiving thromboprophylaxis drugs other than heparin & LMWH, or receiving thromboprophylaxis drugs. Signs of light anesth when neuromuscular blockade was reversed intentionally in the middle of anesth. Has not been studied for reversal following rocuronium or vecuronium administration in the ICU. Efficacy of 16 mg/kg Bridion dose following administration of vecuronium has not been studied. Physically incompatible w/ verapamil, ondansetron, & ranitidine. Potential interaction w/ hormonal contraceptives. Risk of recurrence of neuromuscular blockade due to displacement interactions by other drugs; use of lower than recommended Bridion doses; use of drugs that potentiate neuromuscular blockade in the post-op phase. Do not use to reverse blockade induced by nonsteroidal neuromuscular blocking agents eg, succinylcholine or benzylisoquinolinium compd & by steroidal neuromuscular blocking agents other than rocuronium or vecuronium. May interfere w/ serum progesterone assay. Not recommended in patients w/ severe renal impairment (CrCl <30 mL/min), including those requiring dialysis. Caution in patients w/ hepatic impairment accompanied by coagulopathy or severe edema. Advise female patients of reproductive potential using hormonal contraceptives to use additional non-hormonal contraceptive for the next 7 days following Bridion administration. Pregnancy & lactation. Elderly. Immediate reversal in ped patients has not been studied. Safety & effectiveness in patients <2 yr have not been established.

Adult: Vomiting, pain, nausea, hypotension, headache. Ped patient: Incision site pain, procedural nausea, pain, vomiting; nausea, vomiting; bradycardia; eye disorders.

Toremifene may cause some displacement of vecuronium or rocuronium from the complex w/ Bridion. Lowered efficacy of hormonal contraceptives.

Antidotes & Detoxifying Agents

V03AB35 - sugammadex ; Belongs to the class of antidotes. Used to reverse neuromuscular blockade caused by rocuronium or vecuronium.

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