Bridion Dosage/Direction for Use

Important Dosing and Administration Information: BRIDION dosing is based on actual body weight.
BRIDION (sugammadex) injection, for intravenous use, should be administered by trained healthcare providers familiar with the use, actions, characteristics, and complications of neuromuscular blocking agents (NMBA) and neuromuscular block reversal agents.
Doses and timing of BRIDION administration should be based on monitoring for twitch responses and the extent of spontaneous recovery that has occurred.
Administer BRIDION intravenously as a single bolus injection. The bolus injection may be given over 10 seconds, into an existing intravenous line. BRIDION has only been administered as a single bolus injection in clinical trials.
From the time of BRIDION administration until complete recovery of neuromuscular function, monitor the patient to assure adequate ventilation and maintenance of a patent airway. Satisfactory recovery should be determined through assessment of skeletal muscle tone and respiratory measurements in addition to the response to peripheral nerve stimulation.
The recommended dose of BRIDION does not depend on the anesthetic regimen.
Preparation of dilution for pediatric use: BRIDION 100 mg/mL may be diluted to a concentration of 10 mg/mL, using 0.9% sodium chloride injection, USP, to increase the accuracy of dosing in the pediatric population.
To prepare the required dose, aseptically transfer all the contents of the 2 mL vial of BRIDION 2-mL single-dose vials containing 200 mg sugammadex (100 mg/mL) to a bottle (or intravenous bag) containing 18 mL of 0.9% sodium chloride injection, to achieve a final concentration of 10 mg/mL sugammadex.
BRIDION injection is a single-dose sterile solution without preservatives. Discard any unused portion from the vial.
Recommended Dosing: BRIDION can be used to reverse different levels of rocuronium- or vecuronium-induced neuromuscular blockade.
For rocuronium and vecuronium: A dose of 4 mg/kg BRIDION is recommended if spontaneous recovery of the twitch response has reached 1 to 2 post-tetanic counts (PTC) and there are no twitch responses to train-of-four (TOF) stimulation following rocuronium- or vecuronium-induced neuromuscular blockade [see Risk of Recurrence of Neuromuscular Blockade with Lower Than Recommended Dosing under Precautions].
A dose of 2 mg/kg BRIDION is recommended if spontaneous recovery has reached the reappearance of the second twitch (T₂) in response to TOF stimulation following rocuronium- or vecuronium-induced neuromuscular blockade [see Risk of Recurrence of Neuromuscular Blockade with Lower Than Recommended Dosing under Precautions].
For rocuronium only: A dose of 16 mg/kg BRIDION is recommended if there is a clinical need to reverse neuromuscular blockade soon (approximately 3 minutes) after administration of a single dose of 1.2 mg/kg of rocuronium. The efficacy of the 16 mg/kg dose of BRIDION following administration of vecuronium has not been studied. Immediate reversal in pediatric patients has not been studied [see Pharmacology: Pharmacodynamics: Clinical Studies: Controlled Clinical Studies under Actions].