Brand and Other Names:Pavulon
Dosing & Uses
Dosage Forms & Strengths
General Anesthesia Adjunct/Cesarean Section
Maintenance: 0.015-0.1 mg/kg IV q30-60min OR
Continuous infusion: 0.1 mg/kg/hr IV
Dose should be calculated based on ideal body weight
Monitoring of muscle twitch response to a peripheral nerve stimulator is advised
Other Indications & Uses
Skeletal muscle relaxation during surgery, endotracheal intubation, mechanical ventilation
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Slight elevation in pulse rate
Elevations in blood pressure
Excessive sweating (in children)
Histamine release (bronchospasm/hypotension)
CAUTION: adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience incr sensitivity w/electrolyte disorders (hyperMg, hypoK, hypoCa)
Black Box Warnings
The drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards
Lack of ventilatory support, neuromuscular disease
Hypersensitive to drug &/or bromides
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
In pts with poor renal perfusion or severe renal disease, preexisting tachycardia
Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk; effect on nursing infant not known
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
2 hr (terminal phase)
Renal dysfunction may incr half-life 50%
Onset: 1-2 min
Duration: 60 min
Protein Bound: 87% (range: 77-91%)
Metabolism: primarily none, some hepatic transformation to weakly active metabolite
Excretion: unchanged in urine
Little effect on intraocular/intracranial pressure
Very rarely causes release of histamine (and hypotension, bronchospasm, flushing); more commonly causes dose-related tachycardia by blocking cardiac ACh receptors
Mechanism of Action
Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist
Additive: ciprofloxacin, verapamil
Syringe: caffeine, heparin
Y-site: aminophylline, cefazolin, cefuroxime, cimetidine, dobutamine, dopamine, epinephrine, esmolol, etomidate, fenoldopam, fentanyl, fluconazole, gentamicin, heparin, Hextend, hydrocortisone, isoproterenol, levofloxacin, lorazepam, midazolam, milrinone, morphine, nitroglycerin, propofol (1 mg/mL), ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin
Y-site: diazepam, thiopental
Solution: add to an empty Viaflex bag & infuse undiluted (2 mg/mL); however, if necessary, may be diluted in D5W, NS, or LR
Continuous infusions may be given by using undiluted drug
Use controlled microinfusion device
Store at 2-8 C; stable at RT x 6mth
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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