ROCURONIUM BROMIDE

Aminosteroid non-depolarising neuromuscular blocker medicine with quick onset and intermediate duration of action

Dosage Forms

Injection

10 mg/ml

Uses

  • Neuromuscular blockade of intermediate duration for surgery or during intensive care

Dose and Duration

Dose should be individualised for each patient.

Neuromuscular blockade in surgery

Adult and child over 1 month: by IV injection, 0.6 mg/kg, then maintenance dose of 0.15 mg/kg. By IV infusion, give a loading dose of 0.6 mg/kg, then 0.3–0.6 mg/kg/hour adjusted according to response.

Elderly: loading dose of 0.6 mg, then maintenance dose 0.075–0.1 mg/kg by IV injection or 0.3–0.4 mg/kg/hour by IV infusion.

Neuromuscular blockade in intensive care

Adult and child over 1 month: by IV injection 0.6 mg/kg, then maintenance by IV infusion, 0.3–0.6 mg/kg/hour for the first hour, then adjusted according to response.

Contra-indications

  • Hypersensitivity

Side Effects

  • Injection site reactions
  • Tachycardia, hypotension
  • Prolonged neuromuscular block
  • Anaphylaxis

Interactions

  • Aminoglycosides (increased effect of rocuronium)
  • Clindamycin (increased effect of rocuronium)
  • Vancomycin (increased effect of rocuronium)
  • Polymixins (increased effect of rocuronium)
  • Phenytoin (long term use reduces effect of rocuronium)

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Reduce dose in hepatic failure
  • Reduce maintenance dose in renal failure
  • To avoid excessive dosage in obese patients, calculate doses on the basis of ideal bodyweight
  • Use with caution in patients with sensitivity to other neuromuscular blocking medicines due to cross-sensitivity
  • Use with caution in patients with neuromuscular disease or after poliomyelitis
  • In people with burns, titrate dose with response since they often develop resistance