Dose of sugammadex

Neither sugammadex nor the complex of sugammadex and rocuronium binds to plasma proteins or erythrocytes, as was shown in vitro using male human plasma and whole blood. Sugammadex exhibits linear kinetics in the dosage range of 1 to 16 mg/kg when administered as an IV bolus dose.

Options for endotracheal intubation include succinylcholine, intubation without an NMBA (eg, high dose remifentanil intubation, although this technique is associated with more trauma), or rocuronium or vecuronium if sugammadex is available for rapid reversal of block. (See 'Sugammadex' below.)

In this case, no AEs related to sugammadex were observed, despite the high dose of sugammadex. This may contribute to expanding the safety profile of sugammadex and its use in patients with renal failure. In addition, this case suggests that dose modification of sugammadex may be necessary for patients with ESRD.

Figure 2: Table showing dose of sugammadex required to reverse different levels of rocuronium neuromuscular blockade.4 For reversal of routine and moderate rocuronium and also vecuronium-induced blockade, similar doses of sugammadex are required.4,6 However, the dose of sugammadex for reversal of profound vecuronium induced block has not been

The mass of one molecule (or mole) of sugammadex is 3.6x that of rocuronium. If you've given 0.6mg/kg roc, the dose of sugammadex to give the

Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a

Five minutes after each sugammadex dose of 50 mg, the response to the train-of-four stimulus was determined. Sugammadex dosing was continued

16mg/kg sugammadex may affect serum progesterone assays, INR and APTT. Capturing interactions Hormonal contraceptives can be subject to capture by sugammadex. The administration of a dose of sugammadex is equivalent to one missed daily dose of oral contraceptive.

Since sugammadex was introduced in clinical anesthesia, several studies have reported administration of a lower-than-recommended dose of sugammadex. The decision to under-dose sugammadex is often motivated by cost reduction strategies, as the price of sugammadex is much higher than that of neostigmine outside the United States.