vecuronium (Rx)

Brand and Other Names:Norcuron
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 10mg
  • 20mg

General Anesthesia

Adjunct to general anesthesia-induced muscle relaxation for endotracheal intubation, mechanical ventilation

Dose should be calculated based on ideal body weight

Injection

  • Load: 0.08-0.1 mg/kg IVP over 60 sec OR  
  • 0.04-0.06 mg/kg IVP if following succinylcholine, PLUS
  • Maintenance: 0.01-0.015 mg/kg IVP 20-45min post initial PRN

Continuous Infusion

  • Load: 0.001 mg/kg/min IV starting 20 min post bolus recovery
  • Maintenance: 0.0008-0.0012 mg/kg/min

Dosage Forms & Strengths

powder for injection

  • 10mg
  • 20mg

General Anesthesia

Adjunct to general anesthesia-induce muscle relaxation for endotracheal intubation, mechanical ventilation

1-10 years old

  • 0.1 mg/kg IVP; repeat q1hour PRN; OR  
  • Continuous Infusion: 0.05-0.07 mg/kg/hour IV

Neonates; <28 days old (off-label)

  • Load: 0.1 mg/kg IV x1 dose
  • Maintenance: 0.03-0.15 mg/kg IV q1-2hours PRN

7 weeks-1 year old (off-label)

  • Load: 0.08-0.1 mg/kg IV x1 dose
  • Maintenance: 0.05-0.1 mg/kg IV q1hour PRN
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Interactions

Interaction Checker

and vecuronium

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            Contraindicated (1)

            • dantrolene

              dantrolene, vecuronium. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. May potentiate vecuronium-induced neuromuscular block.

            Serious - Use Alternative (29)

            • amikacin

              amikacin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • amphotericin B deoxycholate

              amphotericin B deoxycholate increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • clindamycin

              clindamycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • colistin

              vecuronium 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • doxycycline

              doxycycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • fentanyl

              fentanyl, vecuronium. 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, vecuronium. 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, vecuronium. 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, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • hydrocodone

              hydrocodone, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • minocycline

              minocycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • neomycin PO

              neomycin PO increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • omadacycline

              omadacycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • oxytetracycline

              oxytetracycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • paromomycin

              paromomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • polymyxin B

              polymyxin B increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.

            • pramlintide

              pramlintide, vecuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

            • quinine

              quinine increases effects of vecuronium by pharmacodynamic synergism. Contraindicated. Risk of resp. depression.

            • sarecycline

              sarecycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • streptomycin

              streptomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • sufentanil SL

              sufentanil SL, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • tobramycin

              tobramycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

            • valerian

              valerian and vecuronium both increase sedation. Avoid or Use Alternate Drug.

            Monitor Closely (112)

            • abobotulinumtoxinA

              vecuronium increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

            • aclidinium

              aclidinium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • amitriptyline

              vecuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • amoxapine

              vecuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • anticholinergic/sedative combos

              anticholinergic/sedative combos and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • aripiprazole

              vecuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

              aripiprazole increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • atracurium

              atracurium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine

              atropine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine IV/IM

              atropine IV/IM and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna alkaloids

              belladonna alkaloids and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • benperidol

              vecuronium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              benperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • betamethasone

              vecuronium, 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • buprenorphine, long-acting injection

              vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cevimeline

              cevimeline increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              vecuronium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

              chlorpromazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • cisatracurium

              cisatracurium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clomipramine

              vecuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clozapine

              vecuronium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

              clozapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • corticotropin

              vecuronium, corticotropin. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • cortisone

              vecuronium, cortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • cyclizine

              cyclizine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • darifenacin

              darifenacin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • deflazacort

              vecuronium, deflazacort. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • desipramine

              vecuronium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • dexamethasone

              vecuronium, dexamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • dicyclomine

              dicyclomine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • donepezil

              donepezil increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dosulepin

              vecuronium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • doxapram

              doxapram decreases effects of vecuronium by pharmacodynamic antagonism. Use Caution/Monitor.

            • doxepin

              vecuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • droperidol

              vecuronium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              droperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • echothiophate iodide

              echothiophate iodide increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fesoterodine

              fesoterodine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • flavoxate

              flavoxate and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • fludrocortisone

              vecuronium, fludrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • fluphenazine

              vecuronium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              fluphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • fosphenytoin

              fosphenytoin decreases effects of vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • glycopyrrolate

              glycopyrrolate and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • glycopyrrolate inhaled

              glycopyrrolate inhaled and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • haloperidol

              vecuronium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              haloperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • henbane

              henbane and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • homatropine

              homatropine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • huperzine A

              huperzine A increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydrocortisone

              vecuronium, hydrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • hyoscyamine

              hyoscyamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • hyoscyamine spray

              hyoscyamine spray and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • iloperidone

              vecuronium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              iloperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • imipramine

              vecuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • ipratropium

              ipratropium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

            • lofepramine

              vecuronium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • loxapine

              vecuronium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

              loxapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • loxapine inhaled

              loxapine inhaled increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              vecuronium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

            • magnesium sulfate

              magnesium sulfate increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Interaction occurs with parenteral magnesium.

            • magnesium supplement

              magnesium supplement, vecuronium. 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

              vecuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • meclizine

              meclizine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methscopolamine

              methscopolamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methylprednisolone

              vecuronium, 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              vecuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • olanzapine

              vecuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

              olanzapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • oliceridine

              oliceridine, vecuronium. 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 vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • orphenadrine

              vecuronium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin

              oxybutynin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin topical

              oxybutynin topical and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin transdermal

              oxybutynin transdermal and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxycodone

              oxycodone increases effects of vecuronium 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

              vecuronium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              paliperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • pancuronium

              pancuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • perphenazine

              vecuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              perphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • phenytoin

              phenytoin decreases effects of vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pilocarpine

              pilocarpine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              vecuronium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

              pimozide increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • piperacillin

              piperacillin increases toxicity of vecuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Neuromuscular blockade may be prolonged.

            • pralidoxime

              pralidoxime and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • prednisolone

              vecuronium, prednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • prednisone

              vecuronium, prednisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

            • prochlorperazine

              vecuronium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              prochlorperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • promethazine

              vecuronium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

              promethazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • propantheline

              propantheline and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • protriptyline

              vecuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • pyridostigmine

              pyridostigmine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              vecuronium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

              quetiapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • rapacuronium

              rapacuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • risperidone

              vecuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              risperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • rocuronium

              rocuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • scopolamine

              scopolamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • sevoflurane

              sevoflurane increases levels of vecuronium by pharmacodynamic synergism. Use Caution/Monitor.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases effects of vecuronium 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 vecuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

            • solifenacin

              solifenacin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • succinylcholine

              succinylcholine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thioridazine

              vecuronium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

              thioridazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • thiothixene

              vecuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

              thiothixene increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • tiotropium

              tiotropium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • tobramycin inhaled

              tobramycin inhaled increases effects of vecuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Aminoglycosides may aggravate muscle weakness because of a curare-like effect.

            • tolterodine

              tolterodine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trazodone

              vecuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • triamcinolone acetonide injectable suspension

              vecuronium, 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

              vecuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • trimipramine

              vecuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trospium chloride

              trospium chloride and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • ziprasidone

              vecuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

              ziprasidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • zotepine

              vecuronium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

            Minor (37)

            • acetazolamide

              acetazolamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • amlodipine

              amlodipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • carbamazepine

              carbamazepine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • clevidipine

              clevidipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • clonazepam

              clonazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • diazepam

              diazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • diltiazem

              diltiazem increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • dimenhydrinate

              dimenhydrinate increases toxicity of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • donepezil

              donepezil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • eslicarbazepine acetate

              eslicarbazepine acetate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • ethosuximide

              ethosuximide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • felbamate

              felbamate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • felodipine

              felodipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • gabapentin

              gabapentin decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • gabapentin enacarbil

              gabapentin enacarbil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • galantamine

              galantamine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • isradipine

              isradipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • lacosamide

              lacosamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • lamotrigine

              lamotrigine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • levetiracetam

              levetiracetam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • lithium

              lithium increases effects of vecuronium by unknown mechanism. Minor/Significance Unknown.

            • lorazepam

              lorazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • methsuximide

              methsuximide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • nicardipine

              nicardipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • nifedipine

              nifedipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • nisoldipine

              nisoldipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • oxcarbazepine

              oxcarbazepine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • phenobarbital

              phenobarbital decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • primidone

              primidone decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • quinidine

              quinidine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown.

            • rufinamide

              rufinamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • thiamine

              thiamine increases effects of vecuronium by unspecified interaction mechanism. Minor/Significance Unknown.

            • tiagabine

              tiagabine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • topiramate

              topiramate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • valproic acid

              valproic acid decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • verapamil

              verapamil increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

            • zonisamide

              zonisamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            Skeletal muscle weakness or paralysis

            Respiratory insufficiency or apnea

            Hypersensitivity reactions associated with histamine release (e.g., bronchospasm, flushing, erythema, acute urticaria, hypotension, tachycardia)

            Itching

            Myositis ossificans (prolonged use)

            Acute quadriplegic myopathy syndrome (prolonged use)

            Less cardiovascular effects than pancuronium or atracurium

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            Warnings

            Black Box Warnings

            The drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards

            Contraindications

            Hypersensitivity

            Lack of ventilatory support

            Neuromuscular disease

            Cautions

            Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent

            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

            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)

            CAUTION: Hepatobiliary obstruction, renal dysfunction will significantly prolong duration of action

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Not known if excreted in breast milk; effect on nursing infant not known; used during pregnancy only when clearly needed

            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.

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            Pharmacology

            Mechanism of Action

            Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist

            Pharmacokinetics

            Half-life: 3.3-9 min (distribution phase); 31-80 min (terminal phase); increased in hepatobiliary disease

            Clearance: 2.9-6.4 mL/min/kg (normal renal function); 2.5-4.5 mL/min/kg (renal dysfunction); 0.97-2.7 mL/min/kg (hepatic dysfunction)

            Vd: 50-120 mL/kg (central compartment, Vc); 179-400 mL/kg (steady-state, Vss)

            Metabolism: Not been fully characterized; aqueous solution in vitro has shown spontaneous deacetylation at the 3a- &/or 17ß-positions to form hydroxy derivatives

            Onset: 3-5 min

            Duration: 20-35 min

            Protein Bound: 60-90%

            Excretion: 30% excreted unchanged in urine, 45% excreted unchanged in bile/feces

            Less histamine release than pancuroniun or atracurium (and less effect on HR & MAP)

            Little effect on intraocular/intracranial pressure

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            Administration

            IV Incompatibilities

            Y-site: ampho B chol SO4, diazepam, etomidate, furosemide, thiopental

            IV Compatibilities

            Solution: NS, D5W, D5/NS, LR

            Additive: ciprofloxacin

            Y-site: aminophylline, amiodarone, cefazolin, cefuroxime, cimetidine, clarithromycin, diltiazem, dobutamine, dopamine, epinephrine, esmolol, fenoldopam, fentanyl, fluconazole, gatifloxacin, gentamicin, heparin, Hextend, hydrocortisone, hydromorphone, isoproterenol, labetalol, linezolid, lorazepam, midazolam, milrinone, morphine, nicardipine, nitroglycerin, norepinephrine, propofol, ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin

            IV Preparation

            Rapid direct injection: dilute vial to max of 2 mg/mL

            Infusion: dilute vial to max of 1 mg/mL

            Solution:

            • Rapid direct injection: dilute vial to max of 2 mg/mL
            • Infusion: dilute vial to max of 1 mg/mL

            IV Administration

            Give either as a rapid direct injection or as an infusion

            Storage

            Store at room temp

            Do not mix with alkaline drugs

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            vecuronium bromide intravenous
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            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            vecuronium bromide 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) 2021 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.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.