Pharmacokinetics in children
It does not bind to plasma proteins or erythrocytes. It is not metabolized. It is excreted almost entirely in unchanged form in the urine.
| |
Clearance (mL/min)
|
Vd (L)
|
T1/2 (h) |
| Neonate (15 days; 3,8 kg) |
13 |
1,1 |
1,3 |
| Infant (6 months; 7,9 kg) |
12 |
1,8 |
2,2 |
| Toddler (1,5 yr; 11 kg) |
16 |
2,5 |
2,1 |
| Young child (3,5 yr; 15 kg) |
22 |
3,4 |
2,1 |
Older child (9 yr; 29 kg)
|
39 |
5,8 |
2,1 |
Adolescent (15 yr; 56 kg)
|
71 |
10 |
2,0 |
| Adult (40 yr; 75 kg) |
84 |
13 |
2,2 |
[SmPC Bridion]
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
| Standard relief of neuromuscular blockade induced by rocuronium |
- Intravenous
-
1 month
up to
18 years
On return of T2: 2 mg/kg/dose For recovery of at least 1-2 PTC: 4 mg/kg/dose
In emergency situations (without presentation of T2) higher doses – of up to 16 mg/kg – may be needed to lift the block urgently.
-
Term neonate
On return of T2: 2 mg/kg/dose For recovery of at least 1-2 PTC: 4 mg/kg/dose
In emergency situations (without presentation of T2) higher doses – of up to 16 mg/kg – may be needed to lift the block urgently.
|
Renal impaiment in children > 3 months
No information available on dose adjustment in renal impairment.
The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects
No information is present at this moment.
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
No information available on specific warnings and precautions in children.
Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
ALL OTHER THERAPEUTIC PRODUCTS
This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.
| Antidotes |
|
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V03AB27
|
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V03AB16
|
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V03AB24
|
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V03AB25
|
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V03AB33
|
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V03AB17
|
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V03AB15
|
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V03AB13
|
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V03AB19
|
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V03AB14
|
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V03AB06
|
| Iron chelating agents |
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V03AC03
|
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V03AC02
|
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V03AC01
|
| Drugs for treatment of hyperkalemia and hyperphosphatemia |
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V03AE07
|
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V03AE01
|
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V03AE02
|
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V03AE01
|
| Detoxifying agents for antineoplastic treatment |
|
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V03AF03
|
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V03AF01
|
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V03AF07
|
| Drugs for treatment of hypoglycemia |
|
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V03AH01
|
| Other therapeutic products |
|
|
|
V03AX03
|
| DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT |
|
|
|
V03AF03
|
|
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V03AF01
|
|
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|
V03AF07
|
| OTHER THERAPEUTIC PRODUCTS |
|
|
|
V03AX03
|
References
-
Merck Sharp & Dohme B.V. , SmPC Bridion (EU/1/08/466/001) Rev 20, 14-02-2022, www.emea.europa.eu
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Mirakhur RK, Sugammadex in clinical practice, Anaesthesia, 2009, 64 (0), 45-54
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Sparr HJ et al, Sugammadex Neues pharmakologisches Konzept zur Antagonisierung von Rocuronium und Vecuronium, Anaesthesist, 2009, 58, 6680
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Buchanan CCR et al, The transversus abdominis plane (TAP) block in neonates and infants results of an audit, Pediatric Anesthesia 21, 2011, 21, 10731088
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Plaud B, et al, Reversal of Rocuronium-induced Neuromuscular Blockade with Sugammadex in Pediatric and Adult Surgical Patients, Anesthesiology, 2009, 110, 28494
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Werkgroep Neonatale Farmacologie NVK sectie Neonatologie., Expert opinion, 8 May 2024
-
Franz AM, et al., Case series of 331 cases of sugammadex compared to neostigmine in patients under 2 years of age., Paediatr Anaesth., 2019, 29(6), 591-6
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Alonso A, et al, Reversal of rocuronium-induced neuromuscular block by sugammadex in neonates: 10AP1-3, European Journal of Anaesthesiology, 2014, 31, 163
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Langley RJ, et al, The presumed central nervous system effects of rocuronium in a neonate and its reversal with sugammadex. , Paediatr Anaesth., 2016, 26(1), 109-11
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Langley RJ, et al, The presumed central nervous system effects of rocuronium in a neonate and its reversal with sugammadex., Paediatr Anaesth., 2016, 26(1), 109-11
-
Merck Sharp & Dohme B.V., SmPC Bridion (EU/1/08/466/001) Rev 24, 10-02-2025, www.ema.europa.eu
Therapeutic Drug Monitoring
Overdose