Succinylcholine

What it is used for

Succinylcholine chloride injection is indicated in adults and pediatric patients:

• as an adjunct to general anesthesia
• to facilitate tracheal intubation
• to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Side effects, and when to stop

The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling:

• Ventricular Dysrhythmias, Cardiac Arrest, and Death from Hyperkalemic Rhabdomyolysis in Pediatric Patients
• Anaphylaxis
• Hyperkalemia
• Malignant Hyperthermia
• Bradycardia
• Increase in Intraocular Pressure
• Prolonged Neuromuscular Block due to Phase II Block and Tachyphylaxis

The following adverse reactions associated with the use of succinylcholine were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure:

Cardiovascular disorders: Cardiac arrest, arrhythmias, bradycardia, tachycardia, hypertension, hypotension

Electrolyte disorders: Hyperkalemia

Eye disorders: Increased intraocular pressure

Gastrointestinal disorders: Excessive salivation

Immune system disorders: Hypersensitivity reactions including anaphylaxis (in some cases life-threatening and fatal)

Musculoskeletal disorders: Malignant hyperthermia, rhabdomyolysis with possible myoglobinuric acute renal failure, muscle fasciculation, jaw rigidity, postoperative muscle pain

Respiratory disorders: Prolonged respiratory depression or apnea

Skin disorders: Rash

Who should not take it

Succinylcholine chloride injection is contraindicated:

• in patients with skeletal muscle myopathies.
• in patients with known hypersensitivity to succinylcholine. Severe anaphylactic reactions to succinylcholine have been reported.
• after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury, which may result in severe hyperkalemia and cardiac arrest.
• in patients with known or suspected genetic susceptibility to malignant hyperthermia.