Classifications: acetylcholine antagonist; nondepolarizing skeletal muscle relaxant; Therapeutic: skeletal muscle relaxant, nondepolarizing
Pregnancy Category: C
4 mg, 10 mg, 20 mg vials
Intermediate-acting nondepolarizing skeletal muscle relaxant structurally similar to pancuronium. Inhibits neuromuscular
transmission by competitively binding with acetylcholine to motor endplate receptors.
Inhibits neuromuscular transmission by competitively binding with acetylcholine to motor endplate receptors resulting in
skeletal muscular relaxation.
Adjunct for general anesthesia to produce skeletal muscle relaxation during surgery. Especially useful for patients with
severe kidney disease, limited cardiac reserve, and history of asthma or allergy. Also to facilitate endotracheal intubation.
Continuous infusion for facilitation of mechanical ventilation.
Hypersensitivity to bromide; pregnancy (category C).
Severe liver disease; impaired acidbase, fluid and electrolyte balance; severe obesity; adrenal or neuromuscular disease
(myasthenia gravis, Eaton-Lambert syndrome); patients with slow circulation time (cardiovascular disease, old age, edematous
states); malignant hyperthermia; lactation.
Route & Dosage
|Skeletal Muscle Relaxation
Adult/Child (≥1 y): IV 0.040.1 mg/kg initially, then after 2540 min, 0.010.15 mg/kg q1215min or 0.001 mg/kg/min by continuous
Infant: IV 0.080.1 mg/kg, then 0.050.1 mg/kg q1h prn
Neonate: IV 0.1 mg/kg, followed by 0.030.15 mg/kg q12h prn
Dose based on IBW.
Note: Vecuronium is administered only by qualified clinicians.
PREPARE: Direct: Dilute 1020 mg with 50 mL sterile water for injection (supplied). Continuous: Further dilute with up to 100 mL D5W, NS, or RL to yield 0.10.2 mg/mL.
ADMINISTER: Direct: Give a bolus dose over 30 sec. Continuous: Give at the required rate.
INCOMPATIBILITIES Y-site: Amphotericin B cholesteryl complex, diazepam, etomidate, furosemide, thiopental.
- Refrigerate after reconstitution below 30° C (86° F), unless otherwise directed. Discard solution after 24 h.
Adverse Effects (≥1%) Body as a Whole:
Skeletal muscle weakness, malignant hyperthermia. Respiratory: Respiratory depression.
InteractionsDrug: general anesthetics
increase neuromuscular blockade and duration of action; aminoglycosides
, bacitracin, polymyxin B, clindamycin, lidocaine, parenteral magnesium, quinidine, quinine, trimethaphan, verapamil
increase neuromuscular blockade; diuretics
may increase or decrease neuromuscular blockade; lithium
prolongs duration of neuromuscular blockade; narcotic analgesics
increase possibility of additive respiratory depression; succinylcholine
increases onset and depth of neuromuscular blockade; phenytoin
may cause resistance to or reversal of neuromuscular blockade.
<1 min. Peak:
35 min. Duration:
2540 min. Distribution:
Well distributed to tissues and extracellular fluids; crosses placenta; distribution into breast milk unknown. Metabolism:
Rapid nonenzymatic degradation in bloodstream. Elimination:
3035% in urine, 3035% in bile. Half-Life:
Assessment & Drug Effects
- Lab tests: Baseline serum electrolytes, acidbase balance, and kidney & liver functions.
- Use peripheral nerve stimulator during and following drug administration to avoid risk of overdosage and to identify residual
paralysis during recovery period. This is especially indicated when cautious use of drug is specified.
- Monitor vital signs at least q15min until stable, then every 30 min for the next 2 h. Also monitor airway patency until
assured that patient has fully recovered from drug effects. Note rate, depth, and pattern of respirations. Obese patients
and patients with myasthenia gravis or other neuromuscular disease may have ventilation problems.
- Evaluate patients for recovery from neuromuscular blocking (curare-like) effects as evidenced by ability to breathe naturally
or take deep breaths and cough, to keep eyes open, and to lift head keeping mouth closed and by adequacy of hand grip strength.
Notify physician if recovery is delayed.
- Note: Recovery time may be delayed in patients with cardiovascular disease, edematous states, and in older adults.