Suxamethonium/Succinylcholinechloride (Suxamethonium chloride) is a Medicine belongs to Neuromuscular blocker group whose information about Brand can be referenced from   Book : Martindale    Page : 2076   Edition : 37  

  ►   Brandname : Midarine, Anectine, Quelicin, Scoline, Lysthenon, Pantolax
  ►  Strength : Injection with 20 mg/ml.  Injection with 50 mg/ml.  Injection with 100 mg/ml.  Injection with

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 481   Edition : 12  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : IV
Reference :-   Book : Martindale    Page : 2076   Edition : 37  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 After induction of general anaesthesia IV 100 mcg/kg Injection or 5 to 10 mg, of suxamethonium chloride may be given intravenously if increased sensitivity is suspected. The response to suxamethonium varies considerably and the usual single dose of suxamethonium chloride for an adult is 0.3 to 1.1 mg/kg by intravenous injection. Supplementary doses of 50 to 100% of the initial dose may be given at 5 to 10 minute intervals if required but the total dose given by repeated intravenous injection or continuous infusion should not exceed 500 mg/hour.

Ref :-  Book : Martindale    Page : 2076   Edition : 37  



Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 After induction of general anaesthesia IV 2 mg/kg Injection
2 After induction of general anaesthesia 1 Year 12 Year IV 1 mg/kg Injection

Ref :- Book : Martindale    Page : 2076   Edition : 37  
►  Side Effect : Apnoea, Tachyphylaxis, Transient fasciculations, Rhabdomyolysis, Myoglobinemia, Myoglobinuria, Postoperative muscle pain occurs in some patients but is not directly related to the degree of fasciculation., A transient rise in intra-gastric pressure may occur secondary to fasciculation of abdominal muscles., Transient increase in intra-ocular pressure, Depolarisation of skeletal muscle produces an immediate increase in plasma-potassium concentration and this can have serious consequences in some patients, Stimulation of the vagus nerve and parasympathetic ganglia by suxamethonium chloride may be followed by bradycardia, other arrhythmias, and hypotension, and may be exacerbated by the raised plasma-potassium concentration; cardiac arrest has been reported., Tachycardia and an increase in blood pressure due to stimulation of sympathetic ganglia have also been reported, Suxamethonium chloride may cause an increase in salivary, bronchial, and gastric secretion and other muscarinic effects. Salivary gland enlargement has occurred., Flushing, skin rash, bronchospasm, and shock have been reported, Other reported effects include prolonged respiratory depression and apnoea.
Ref :-   Book : Martindale    Page : 2073   Edition : 37.  

►  Drug Interaction : Drug interaction of Suxamethonium/Succinylcholinechloride (Suxamethonium chloride) is with AMINOGLYCOSIDES , , TETRACYCLINES ,  Lidocaine , Procainamide , Quinidine , Verapamil , Lincosamides , Clindamycin , Lincomycin
Ref :-   Book : Martindale    Page : 2067, 2075   Edition : 37.  


  ►    Mechanism of Drug Drug Interaction :  Some drugs may interact with depolarising neuromuscular blockers such as suxamethonium. The mechanisms of interaction can include a direct effect on neuromuscular transmission or an alteration of enzyme activity and may result in potentiation or antagonism of neuromuscular block. In general, such interactions are potentially more serious in patients with impaired neuromuscular function or reduced activity of plasma cholinesterase, who are more sensitive to suxamethonium’s effects. Lidocaine, procainamide, quinidine, and verapamil all have some neuromuscular blocking activity and may enhance the block produced by neuromuscular blockers. Some antibacterials in very high concentration can produce a muscle paralysis that may be additive to or synergistic with that produced by neuromuscular blockers. The neuromuscular block produced by antibacterials may be enhanced in patients with intracellular potassium deficiency, low plasma-calcium concentration, neuromuscular disease, or a tendency to a high plasma-antibacterial concentration, for example after large doses or in renal impairment. The interaction appears to be more important for competitive neuromuscular blockers. The antibacterials most commonly implicated are aminoglycosides, lincosamides, polymyxins, and, more rarely, tetracyclines. The lincosamides (clindamycin and lincomycin) can prolong the action of muscle relaxants producing a neuromuscular block that may be difficult to reverse with calcium or anticholinesterases. Patients should be monitored for prolonged paralysis. Vancomycin has been reported to increase neuromuscular blockade by vecuronium
Ref :-   Book : Martindale    Page : 2067,2075   Edition : 37.  


►  Contraindication : Suxamethonium chloride is contra-indicated in patients with atypical plasma cholinesterase and should be used with caution in patients with reduced plasma cholinesterase activity, Suxamethonium is contra-indicated in patients with burns, massive trauma, renal impairment with a raised plasma- potassium concentration, severe long-lasting sepsis, and severe hyperkalaemia, since suxamethoniuminduced rises in plasma-potassium concentration can have serious consequences in such patients patients who have been immobilised for prolonged periods may be at similar risk., It is contra-indicated in patients with a history of hypersensitivity to the drug and, because high rates of cross-sensitivity have been reported, should be used with caution when hypersensitivity to any neuromuscular blocker has previously occurred., Should be avoided in patients with a penetrating eye injury, raised intra-ocular pressure or glaucoma, or those about to undergo incision of the eyeball in eye surgery, because of the risks from increased intra-ocular pressure, It is contra-indicated in patients with a personal or family history of malignant hyperthermia, Caution is also needed if it is given to a patient with cardiac or respiratory disease
Ref :-   Book : Martindale    Page : 2074   Edition : 37.  
  ►  Mechanism of Action :   It combines with cholinergic receptors of the motor end-plate to produce depolarization but is resistant to breakdown by acetylcholinesterase. This prevents repolarization and subsequent depolarization, and a flaccid muscle paralysis occurs.
Ref :-   Book : Martindale    Page : 2075   Edition : 37.  

Pathway of DIETARY Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- NA


DIETARY Substance Interactions


​   ► This Medicine interact with :- NA



ContraIndication DIETARY Substance


​   ► This Medicine contraindicate with :- NA

►   Route of Elimination :   Renal
Ref :-   Book : Martindale    Page : 2075   Edition : 37.  

►    Plasma Half-life :   Min value :-   10 minute,    Max value :-   NA
Ref :-   Book : Clinical Pharmacology    Page : 357   Edition : 9.  

►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA