Sugammadex

Forms and Dose

Sugammadex is both available and administered as a single bolus injection. For reversing the neurotransmission blockage by rocuronium and vecuronium, the standard adult dose is 4 mg per kilo of body weight. If spontaneous recovery of the twitch response has reached 1 to 2 post-tetanic counts and there are no twitch responses to train-of-four stimulation, the recommended adult dose is 2 mg per kilo of body weight is recommended if spontaneous recovery has reached the reappearance of the second twitch in response to TOF stimulation. For reversing Rocuronium effects only, the recommended adult dose is 16 mg per kilo if there is a clinical need to reverse neuromuscular blockade soon within 3 minutes of administration of a single dose of 1.2 mg per kilo.

The price of Sugammadex

In the USA, consumers have to pay around $1,103 for a supply of 20 milliliters for an intravenous solution (100 mg/mL). and in Australia, the cost of a 200mg vial of Sugammadex varies from A$45 to 195, depending on the brand.

How does Sugammadex work?

Sugammadex actions in the body deactivate rocuronium. It does this encapsulating the free molecule to form a stable complex. Sugammadex exerts its effect by forming very tight complexes at a 1:1 ratio with aminosteroid muscle relaxants creating intermolecular forces, thermodynamic bonds, and hydrophobic interactions. To make a tight sugammadex–rocuronium complex. This complex has a very high association rate and a very low dissociation rate. This results in a reduction in free rocuronium plasma concentration. So it creates a gradient between the tissue compartment and plasma so that the free rocuronium moves from tissue to plasma, with a reduction in nicotinic receptor occupancy at the Neuro-Muscular Junction.

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