ICU Drugs · Modified γ-cyclodextrin
Sugammadex
Dose
Routine reversal 2–4 mg/kg; immediate (after RSI dose) 16 mg/kg
Mechanism
Encapsulates aminosteroid NMBs (rocuronium, vecuronium) → reversal
Indications
- • Reversal of rocuronium / vecuronium block
- • Can't intubate can't oxygenate scenario after rocuronium
Use
Rapid, complete reversal regardless of block depth.
Monitoring
TOF, recurrence of block, anaphylaxis.
Side effects
- • Anaphylaxis (rare)
- • Bradycardia
- • Renders hormonal contraception ineffective 7 days
Always confirm dose against your local formulary / BNF before prescribing.
