Suxamethonium

Generic name
Suxamethonium
Brand name
ATC Code
M03AB01

Suxamethonium

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No information

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Relaxation of the skeletal muscles
  • Intravenous
    • 1 month up to 1 year
      • (Suxamethoniumchloride) In intubation: 2 mg/kg/dose, once only.
    • Term neonate
      • (Suxamethoniumchloride) In intubation: 2 mg/kg/dose, once only.
    • 1 year up to 12 years
      • (Suxamethoniumchloride) In intubation: 1 - 2 mg/kg/dose, once only.
    • 12 years up to 18 years
      • (Suxamethoniumchloride) In intubation: 1 mg/kg/dose, once only.
        • Additional dose may be required at 50-100% of initial dose to maintain muscle relaxation. Max (cumulative) 500 mg/hour
        • Alternative: continuous infusion 2.5-4 mg/min

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

a single dose may be administered provided there is no hyperkalemia. Do not give multiple or high doses as this may cause a clinically significant increase in serum potassium. (SmPC)

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Very common (>10%): Myoglobinaemia, arrhythmias (bradycardia, AV node arrhythmias, ectopic heartbeats)

Rare (0.01-0.1 %): Myoglobinuria and subsequent renal failure or acute heart failure (especially in children and adolescents treated with suxamethonium chloride and halothane due to leakage of potassium, creatinine phosphokinase and myoglobin from the muscle cell after administration of Lysthenon 2%)

Very rare (<0.01%): Cardiac arrest (especially in children with unrecognised skeletal muscle diseases such as Duchenne muscular dystrophy)

[GER_SmPC Lysthenon® 2 %, Injektionslösung (6428407.01.00), Takeda GmbH, 01/2022]

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Bradycardia is observed more frequently in children and with repeated administration of suxamethonium (in both children and adults). Prior treatment with intravenous atropine or glycopyrronium significantly reduces the incidence and severity of bradycardia. Intramuscular atropine is not effective. Nontreatable cases of cardiac arrest have been described in children in whom neuromuscular disease had not been previously diagnosed. Use extreme caution and monitor extra in infants and children receiving suxamethonium because of increased risk of application in previously undiagnosed muscular disorders or propensity for malignant hyperthermia previously unknown.

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Other quaternary ammonium compounds
M03AC04
M03AC11
M03AC10
M03AC01
M03AC09
M03AC03
Other muscle relaxants, peripherally acting agents
M03AX01

References

  1. Ethypharm, SmPC Suxamethoniumchloride Ethypharm - 50 mg/ ml (RVG 123872) - 20-03-2020, www.geneesmiddeleninformatiebank.nl
  2. Takeda GmbH, SmPC Lysthenon® 2 %, Injektionslösung (6428407.01.00), 01/2022

Changes

Therapeutic Drug Monitoring


Overdose