Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 10mg/mL (5 & 10mL vials)
Rapid Sequence Intubation
Tracheal Intubation
Maintenance: 0.1-0.2 mg/kg IV repeat PRN OR
Continuous infusion: 0.01-0.012 mg/kg/min IV
Administration
Dose should be calculated based on ideal body weight
Dosage Forms & Strengths
injectable solution
- 10mg/mL (5 & 10mL vials)
Tracheal Intubation
< 3 months
- Safety and efficacy not established
3 months to 14 years
- Initial: 0.6 mg/kg IV
- Maintenance: 0.075-0.125 mg/kg IV OR
- Continuous infusion: 0.012 mcg/kg/min (IV)
> 14 years
- 0.45-0.6 mg/kg IV
- Maintenance: 0.1-0.2 mg/kg IV repeat PRN OR
- Continuous infusion: 0.01-0.012 mg/kg/min IV
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (29)
- amikacin
amikacin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- amphotericin B deoxycholate
amphotericin B deoxycholate increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, rocuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- capreomycin
capreomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- clindamycin
clindamycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- colistin
rocuronium increases effects of colistin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potentiation of neuromuscular blockade; risk of respiratory arrest.
- demeclocycline
demeclocycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- doxycycline
doxycycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- fentanyl
fentanyl, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl intranasal
fentanyl intranasal, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transdermal
fentanyl transdermal, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transmucosal
fentanyl transmucosal, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- gentamicin
gentamicin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- hydrocodone
hydrocodone, rocuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- lincomycin
lincomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- minocycline
minocycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- neomycin PO
neomycin PO increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- omadacycline
omadacycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- oxytetracycline
oxytetracycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- paromomycin
paromomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- polymyxin B
polymyxin B increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- pramlintide
pramlintide, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- quinine
quinine increases effects of rocuronium by pharmacodynamic synergism. Contraindicated. Risk of resp. depression.
- sarecycline
sarecycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- streptomycin
streptomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- sufentanil SL
sufentanil SL, rocuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tetracycline
tetracycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- tobramycin
tobramycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- valerian
valerian and rocuronium both increase sedation. Avoid or Use Alternate Drug.
Monitor Closely (112)
- abobotulinumtoxinA
rocuronium increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- aclidinium
rocuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amitriptyline
rocuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
rocuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- aripiprazole
rocuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atracurium
atracurium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
rocuronium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - betamethasone
rocuronium, betamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- bethanechol
bethanechol increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- buprenorphine, long-acting injection
rocuronium increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- carbachol
carbachol increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cevimeline
cevimeline increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
rocuronium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cisatracurium
cisatracurium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clomipramine
rocuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clozapine
rocuronium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - corticotropin
rocuronium, corticotropin. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cortisone
rocuronium, cortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cyclizine
cyclizine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- darifenacin
darifenacin and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- deflazacort
rocuronium, deflazacort. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- desipramine
rocuronium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dexamethasone
rocuronium, dexamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- dicyclomine
dicyclomine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- donepezil
donepezil increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal and rocuronium both increase pharmacodynamic synergism. Use Caution/Monitor. Donepezil transdermal, a cholinesterase inhibitor, may potentiate the effects on muscle relacation during anesthesia.
- dosulepin
rocuronium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxapram
doxapram decreases effects of rocuronium by pharmacodynamic antagonism. Use Caution/Monitor.
- doxepin
rocuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- droperidol
rocuronium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
fesoterodine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
flavoxate and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fludrocortisone
rocuronium, fludrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- fluphenazine
rocuronium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - fosphenytoin
fosphenytoin decreases effects of rocuronium by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Monitor closely for more rapid recovery from neuromuscular blockade than expected; infusion rate requirements may be higher.
- galantamine
galantamine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
rocuronium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
henbane and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
rocuronium, hydrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- hyoscyamine
hyoscyamine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
rocuronium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
rocuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ipratropium
ipratropium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- lofepramine
rocuronium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- loxapine
rocuronium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
rocuronium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - magnesium sulfate
magnesium sulfate increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Interaction occurs with parenteral magnesium.
- magnesium supplement
magnesium supplement, rocuronium. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Each enhance the neuromuscular blocking effect of the other; may have negative respiratory effects.
- maprotiline
rocuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclizine
meclizine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methscopolamine
methscopolamine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylprednisolone
rocuronium, methylprednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- neostigmine
neostigmine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
rocuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- olanzapine
rocuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oliceridine
oliceridine, rocuronium. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- onabotulinumtoxinA
onabotulinumtoxinA and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- orphenadrine
rocuronium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin
oxybutynin and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone increases effects of rocuronium by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Oxycodone may enhance the neuromuscular blocking action of true skeletal muscle relaxants and produce an increased degree of respiratory depression.
- paliperidone
rocuronium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
pancuronium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- perphenazine
rocuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - phenytoin
phenytoin decreases effects of rocuronium by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Monitor closely for more rapid recovery from neuromuscular blockade than expected; infusion rate requirements may be higher.
- physostigmine
physostigmine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
rocuronium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pralidoxime
pralidoxime and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- prednisolone
rocuronium, prednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prednisone
rocuronium, prednisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prochlorperazine
rocuronium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
rocuronium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
propantheline and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- protriptyline
rocuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
rocuronium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rapacuronium
rapacuronium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- risperidone
rocuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - scopolamine
rocuronium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- sevoflurane
sevoflurane increases levels of rocuronium by pharmacodynamic synergism. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of rocuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of rocuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- solifenacin
rocuronium and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- succinylcholine
succinylcholine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Should not administer rocuronium until recovery from succinylcholine observed .
- thioridazine
rocuronium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
rocuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
rocuronium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tobramycin inhaled
tobramycin inhaled increases effects of rocuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Aminoglycosides may aggravate muscle weakness because of a curare-like effect.
- tolterodine
rocuronium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trazodone
rocuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
- triamcinolone acetonide injectable suspension
rocuronium, triamcinolone acetonide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- trifluoperazine
rocuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trimipramine
rocuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trospium chloride
rocuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- vecuronium
rocuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ziprasidone
rocuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
rocuronium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (37)
- acetazolamide
acetazolamide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- amlodipine
amlodipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- carbamazepine
carbamazepine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- clevidipine
clevidipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- clonazepam
clonazepam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- diazepam
diazepam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- diltiazem
diltiazem increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- dimenhydrinate
dimenhydrinate increases toxicity of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethosuximide
ethosuximide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felbamate
felbamate decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felodipine
felodipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- gabapentin
gabapentin decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- gabapentin enacarbil
gabapentin enacarbil decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- isradipine
isradipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- lacosamide
lacosamide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lamotrigine
lamotrigine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- levetiracetam
levetiracetam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lithium
lithium increases effects of rocuronium by unknown mechanism. Minor/Significance Unknown.
- lorazepam
lorazepam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- methsuximide
methsuximide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- nicardipine
nicardipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nifedipine
nifedipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nisoldipine
nisoldipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- oxcarbazepine
oxcarbazepine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- primidone
primidone decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown.
- rufinamide
rufinamide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- thiamine
thiamine increases effects of rocuronium by unspecified interaction mechanism. Minor/Significance Unknown.
- tiagabine
tiagabine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- topiramate
topiramate decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- valproic acid
valproic acid decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- verapamil
verapamil increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- zonisamide
zonisamide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
1-10%
Transient hypotension (1-2%)
Hypertension (1-2%)
<1%
Dose-related tachycardia
Apnea
Abnormal ECG
Injection site edema
Hiccups
Pruritus
Nausea
Wheezing
Residual muscle weakness
Allergic or idiosyncratic hypersensitivity reactions
Postmarketing Reports
Malignant hyperthermia
Warnings
Contraindications
Hypersensitivity
Lack of ventilatory support, neuromuscular disease
Other neuromuscular blocking agents
Cautions
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
Administer only by trained individuals familiar with its actions, characteristics, and hazard
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; neuromuscular cross-sensitivity with other nuromuscular blocking agents possible
Neuromuscular transmission should be monitored continuously during administration and recovery with the help of a nerve stimulator; additional doses of rocuronium or any other neuromuscular blocking agent should not be given until there is a definite response (one twitch of the train-of-four) to nerve stimulation
Use caution in patients with significant hepatic disease; if used for rapid sequence induction in patients with ascites, an increased initial dosage may be necessary to assure complete block
Some patients may experience prolonged recovery (paralysis) of neuromuscular function
Adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)
When used with other agents, occurrence of malignant hyperthermia during anesthesia is possible even in the absence of known triggering agents; clinicians should be familiar with early signs, confirmatory diagnosis and treatment of malignant hyperthermia prior to initiating any anesthetic
Conditions associated with slower circulation time, eg, cardiovascular disease or advanced age, may be associated with a delay in onset time; since higher doses of rocuronium bromide injection produce longer duration of action, initial dosage should not be increased in these patients to reduce onset time; instead, when feasible, more time should be allowed for the drug to achieve onset of effect; geriatric patients (65 years or older) may be at increased risk for residual neuromuscular block
Administration results in paralysis, which may lead to respiratory arrest and death, a progression that may be more likely to occur in a patient for whom drug is not intended; confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings; if another healthcare provider is administering product, ensure that the intended dose is clearly labeled and communicated
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk; effect on nursing infant not known
Pregnancy Categories
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.Pharmacology
Mechanism of Action
Nondepolarizing skeletal muscle relaxant; cholinergic receptor antagonist; inhibits depolarization
Other Information
Onset: 1-2 min
Half-Life: 60-70 min (elimination); About 2x as long in hepatic dysfunction
Duration: 30 min (0.6 mg/kg dose); 67 min (1.2 mg/kg dose)
Metabolism: Minimal hepatic metabolism
Protein binding: 30%
Vd: 0.25 L/kg
Excretion: Urine (30%); feces (70%) as active & inactive metabolites & small amounts of unchanged drug
Administration
IV Compatibilities
Solution: D5W, D5/NS, LR, NS
Y-site: dexmedetomidine, fenoldopam, Hextend, milrinone
IV Preparation
Dilute with D5W or LR to a final concentration of 0.5 or 1 mg/mL for infusion
IV Administration
Administer IV only
May be given undiluted as a rapid injection or via continuous infusion using an infusion pump
Storage
Refrigerate 2-8°C; do not freeze
Intact vials stored at room temp should be used within 60 d
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 50 mg/5 mL (10 mg/mL) solution |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  | |
| rocuronium intravenous - | 10 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
rocuronium intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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