Contraindicated in:
- Hypersensitivity;
- Pedi: Products containing benzyl alcohol should be avoided in neonates.
Use Cautiously in:
- Dehydration or electrolyte abnormalities (should be corrected);
- Fractures or muscle spasm;
- Hyperthermia (↑ duration/intensity of paralysis);
- Shock;
- Extensive burns (may be more resistant to effects);
- Low plasma pseudocholinesterase levels (may be seen in association with anemia, dehydration, cholinesterase inhibitors/insecticides, severe liver disease, pregnancy, or hereditary predisposition);
- Obese patients ;
- OB: Safety not established (use only if benefit outweighs potential risk to fetus)
- Pedi: Children <1 mo (safety and effectiveness not established)
Exercise Extreme Caution in:
- Neuromuscular diseases such as myasthenia gravis (small test dose may be used to assess response).
Therapeutic Classification: neuromuscular blocking agents-nondepolarizing
Absorption: Following IV administration, absorption is essentially complete.
Distribution: Rapidly distributes into extracellular fluid;
Metabolism/Excretion: Undergoes pH-dependent breakdown, which is responsible for 80% of metabolism; remainder eliminated by liver and kidneys.
Half-Life: 22–31 min;
