Succinylcholine
Generic Name: succinylcholine
Brand Names:
Succinylcholine
11 DESCRIPTION Succinylcholine Chloride Injection, USP is a sterile, nonpyrogenic solution to be used as a short-acting, depolarizing neuromuscular blocker for intravenous or intramuscular use. Succinylcholine chloride injection contains succinylcholine chloride as the active pharmaceutical ingredient. Succinylcholine Chloride, USP is chemically designated C 14 H 30 C l2 N 2 O 4 .2H 2 O and its molecular weight is 397.34.
Overview
11 DESCRIPTION Succinylcholine Chloride Injection, USP is a sterile, nonpyrogenic solution to be used as a short-acting, depolarizing neuromuscular blocker for intravenous or intramuscular use. Succinylcholine chloride injection contains succinylcholine chloride as the active pharmaceutical ingredient. Succinylcholine Chloride, USP is chemically designated C 14 H 30 C l2 N 2 O 4 .2H 2 O and its molecular weight is 397.34.
Uses
1 INDICATIONS AND USAGE Succinylcholine chloride injection is indicated in adults and pediatric patients: as an adjunct to general anesthesia to facilitate tracheal intubation to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine chloride is a depolarizing neuromuscular blocker indicated in adults and pediatric patients: as an adjunct to general anesthesia ( 1 ) to facilitate tracheal intubation (1 ) to provide skeletal muscle relaxation during surgery or mechanical ventilation. (1 )
Dosage
2 DOSAGE AND ADMINISTRATION For intravenous or intramuscular use only. ( 2.1 ) Individualize dosage after careful assessment of the patient. (2.1 ) Accidental administration of neuromuscular blocking agents may be fatal. Store succinylcholine chloride injection with the cap and ferrule intact and in a manner that minimizes the possibility of selecting the wrong product. (2.1 ) See full prescribing information for succinylcholine chloride injection dosage recommendations, preparation instructions, and administration information. ( 2.2, 2.3 , 2.4 , 2.5, 2.6) 2.1 Important Dosage and Administration Information Succinylcholine chloride injection is for intravenous or intramuscular use only.
Side Effects
6 ADVERSE REACTIONS The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling: Ventricular Dysrhythmias, Cardiac Arrest, and Death from Hyperkalemic Rhabdomyolysis in Pediatric Patients [see Warnings and Precautions ( 5.1 )] Anaphylaxis [see Warnings and Precautions ( 5.2 )] Hyperkalemia [see Warnings and Precautions ( 5.4 )] Malignant Hyperthermia [see Warnings and Precautions ( 5.5 )] Bradycardia [see Warnings and Precautions ( 5.6 )] Increase in Intraocular Pressure [see Warnings and Precautions ( 5.7) ] Prolonged Neuromuscular Block due to Phase II Block and Tachyphylaxis [see Warnings and Precautions ( 5.8 )] The following adverse reactions associated with the use of succinylcholine were identified in clinical studies or p...
Interactions
7 DRUG INTERACTIONS Drugs that May Enhance the Neuromuscular Blocking Action of Succinylcholine: promazine, oxytocin, aprotinin, certain non-penicillin antibiotics, quinidine, β-adrenergic blockers, procainamide, lidocaine, trimethaphan, lithium carbonate, magnesium salts, quinine, chloroquine, isoflurane, desflurane, metoclopramide, terbutaline, and drugs that reduce plasma cholinesterase activity.
Warnings
WARNING: VENTRICULAR DYSRHYTHMIAS, CARDIAC ARREST, AND DEATH FROM HYPERKALEMIC RHABDOMYOLYSIS IN PEDIATRIC PATIENTS Acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death has occurred after the administration of succinylcholine to apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy [see Warnings and Precautions ( 5.1 )] . 5 WARNINGS AND PRECAUTIONS Anaphylaxis: Severe anaphylactic reactions to neuromuscular blocking agents, including succinylcholine, have been reported. Some cases have been life-threatening and fatal. Take necessary precautions, such as the immediate availability of appropriate emergency treatment. ( 5.2 ) Risk of Death due to Medication Errors: Unintended administration of succinylcholine chloride injection may result in paralysis, respiratory arrest and death. Confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings. ( 5.3) Hyperkalemia: Succinylcholine chloride injection may induce serious cardiac arrhythmias or cardiac arrest due to hyperkalemia. 4 CONTRAINDICATIONS Succinylcholine chloride injection is contraindicated: in patients with skeletal muscle myopathies [see Warnings and Precautions ( 5.1 )] in patients with known hypersensitivity to succinylcholine.
Pregnancy
8.1 Pregnancy Risk Summary Available data from published literature from case reports and case series over decades of use with succinylcholine during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Succinylcholine is used commonly during delivery by caesarean section to provide muscle relaxation. If succinylcholine is used during labor and delivery, there is a risk for prolonged apnea in some pregnant women (see Clinical Considerations).
Storage
16 HOW SUPPLIED/STORAGE AND HANDLING Succinylcholine chloride injection, USP is supplied as a clear, colorless solution in the following concentrations and packages: Unit of Sale Concentration NDC 43598-666-25 Tray containing 25 Multiple-dose Vials 200 mg/10 mL(20 mg/mL) Refrigeration of undiluted succinylcholine chloride injection will assure full potency until expiration date.
Frequently Asked Questions
What is Succinylcholine used for?▼
1 INDICATIONS AND USAGE Succinylcholine chloride injection is indicated in adults and pediatric patients: as an adjunct to general anesthesia to facilitate tracheal intubation to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine chloride is a depolarizing neuromuscular blocker indicated in adults and pediatric patients: as an adjunct to general anesthesia ( 1 ) to facilitate tracheal intubation (1 ) to provide skeletal muscle relaxation during surgery or mechanical ventilation. (1 )
What are the side effects of Succinylcholine?▼
6 ADVERSE REACTIONS The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling: Ventricular Dysrhythmias, Cardiac Arrest, and Death from Hyperkalemic Rhabdomyolysis in Pediatric Patients [see Warnings and Precautions ( 5.1 )] Anaphylaxis [see Warnings and Precautions ( 5.2 )] Hyperkalemia [see Warnings and Precautions ( 5.4 )] Malignant Hyperthermia [see Warnings and Precautions ( 5.5 )] Bradycardia [see Warnings and Precautions ( 5.6 )] Increase in Intraocular Pressure [see Warnings and Precautions ( 5.7) ] Prolonged Neuromuscular Block due to Phase II Block and Tachyphylaxis [see Warnings and Precautions ( 5.8 )] The following adverse reactions associated with the use of succinylcholine were identified in clinical studies or p...
Can I take Succinylcholine during pregnancy?▼
8.1 Pregnancy Risk Summary Available data from published literature from case reports and case series over decades of use with succinylcholine during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Succinylcholine is used commonly during delivery by caesarean section to provide muscle relaxation. If succinylcholine is used during labor and delivery, there is a risk for prolonged apnea in some pregnant women (see Clinical Considerations).
What are the important warnings for Succinylcholine?▼
WARNING: VENTRICULAR DYSRHYTHMIAS, CARDIAC ARREST, AND DEATH FROM HYPERKALEMIC RHABDOMYOLYSIS IN PEDIATRIC PATIENTS Acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death has occurred after the administration of succinylcholine to apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy [see Warnings and Precautions ( 5.1 )] . 5 WARNINGS AND PRECAUTIONS Anaphylaxis: Severe anaphylactic reactions to neuromuscular blocking agents, including succinylcholine, have been reported. Some cases have been life-threatening and fatal. Take necessary precautions, such as the immediate availability of appropriate emergency treatment. ( 5.2 ) Risk of Death due to Medication Errors: Unintended administration of succinylcholine chloride injection may result in paralysis, respiratory arrest and death. Confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings. ( 5.3) Hyperkalemia: Succinylcholine chloride injection may induce serious cardiac arrhythmias or cardiac arrest due to hyperkalemia. 4 CONTRAINDICATIONS Succinylcholine chloride injection is contraindicated: in patients with skeletal muscle myopathies [see Warnings and Precautions ( 5.1 )] in patients with known hypersensitivity to succinylcholine.
Related Medications
10% Methyl Salicylate
10% methyl salicylate
Purpose Topical Anesthetic
Oxygen-nitrogen Mixture
oxygen-nitrogen mixture
Astragalus Membranaceus, Angelica Sinensis, Myrrha, Aconitum Napellus, Ephedra Vulgaris
astragalus membranaceus, angelica sinensis, myrrha, aconitum napellus, ephedra vulgaris
PURPOSE: Aids in degenerative conditions of the lymph.† †Claims based on traditional homeopathic practice, not accepted medical evidence. Not FDA evaluated.
Medical Disclaimer
This drug information is for educational purposes only and should not replace professional medical advice. Drug information is sourced from the FDA National Drug Code Directory and Structured Product Labeling. Always consult with a healthcare provider before starting, stopping, or changing any medication.