Rocuronium

See critical care quick reference for drug doses by weight.

General

• Type: Neuromuscular blocker, Non-Depolarizing, Fast Onset, Intermediate Lasting
• Dosage Forms: IV
• Common Trade Names: Zemuron

Adult Dosing

RSI

• 0.6 to 1.2mg/kg IV (actual body weight)

Maintenance Bolus Dosing

• 0.1 to 0.2mg/kg IV

Infusion

• 10 to 12 mcg/kg/min

Pediatric Dosing

See critical care quick reference for drug doses by weight.

RSI

• 0.6 to 1.2mg/kg IV (actual body weight)

Maintenance Bolus Dosing

• 0.1 to 0.2mg/kg IV

Infusion

• 10 to 12 mcg/kg/min

Special Populations

• Pregnancy Rating: C
• Lactation: Infant risk cannot be ruled out
• Renal Dosing (half life approximately 1 hour longer if renal transplant patient)
  • Adult
  • Pediatric
• Hepatic Dosing (half life approximately 3 hours longer with liver dysfunction)
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Anaphylaxis

Common

• Cardiovascular: hypertension (0.1% to 2%)
• Hypotension (0.1% to 2%)
• Tachycardia (1% to 5.3%)
• Dermatologic: Pain at injection site
• Respiratory: Increased pulmonary vascular resistance (24%)

Pharmacology

• Half-life: Variable by age, but anywhere from 30 minutes to 2 hours.
• Metabolism: Metabolite is 17-desacetyl-rocuronium
• Excretion: Primary route is fecal. Renal also.
• Mechanism of Action: Non-depolarizing neuromuscular blocking agent. Intermediate duration with dose dependant rapid to intermediate onset. Competes for cholinergic receptors at the motor end-plate. Acetylcholinesterase inhibitors like those found in organophosphates antagonize this action

See Also

• Critical care quick reference
• Reversal agent: Sugammadex

References

Authors

John E. Hipskind, Ross Donaldson, Andrew Mason, Neil Young, Daniel Ostermayer, Claire