Reverse Dosage/Direction for Use

SUGAMMADEX injection, for intravenous use, should be administered by trained healthcare providers familiar with the use, actions, characteristics, and complications of neuromuscular blocking agents (NMBA) and neuromuscular block reversal agents.
Doses and timing of SUGAMMADEX administration should be based on monitoring for twitch responses and the extent of spontaneous recovery that has occurred.
Administer SUGAMMADEX intravenously as a single bolus injection. The bolus injection may be given over 10 seconds, into an existing intravenous line. SUGAMMADEX has only been administered as a single bolus injection in clinical trials.
From the time of SUGAMMADEX administration until complete recovery of neuromuscular function, monitor the patient to assure adequate ventilation and maintenance of a patent airway. Satisfactory recovery should be determined through assessment of skeletal muscle tone and respiratory measurements in addition to the response to peripheral nerve stimulation.
The recommended dose of SUGAMMADEX does not depend on the anesthetic regimen.
Recommended Dosing: SUGAMMADEX can be used to reverse different levels of rocuronium- or vecuronium-induced neuromuscular blockade.
For Rocuronium and Vecuronium: A dose of 4 mg/kg SUGAMMADEX is recommended if spontaneous recovery of the twitch response has reached 1 to 2 post-tetanic counts (PTC) and there are no twitch responses to train-of-four (TOF) stimulation following rocuronium- or vecuronium-induced neuromuscular blockade [see Precautions].
A dose of 2 mg/kg SUGAMMADEX is recommended if spontaneous recovery has reached the reappearance of the second twitch (T2) in response to TOF stimulation following rocuronium- or vecuronium-induced neuromuscular blockade [see Precautions].
For Rocuronium only: A dose of 16 mg/kg SUGAMMADEX is recommended if there is a clinical need to reverse neuromuscular blockade soon (approximately 3 minutes) after administration of a single dose of 1.2 mg/kg of rocuronium. The efficacy of the 16 mg/kg dose of SUGAMMADEX following administration of vecuronium has not been studied.
SUGAMMADEX dosing is based on actual body weight.
Drug Compatibility: May inject SUGAMMADEX into the intravenous line of a running infusion with the following intravenous solutions: 0.9% sodium chloride; 5% dextrose; 0.45% sodium chloride and 2.5% dextrose; 5% dextrose in 0.9% sodium chloride isolyte P with 5% dextrose; Ringer's lactate solution.
Ringer's solution: Ensure the infusion line is adequately flushed (e.g., with 0.9% sodium chloride) between administration of SUGAMMADEX and other drugs.
Do not mix SUGAMMADEX with other products except those listed previously.
SUGAMMADEX is physically incompatible with verapamil, ondansetron, and ranitidine.
Visually inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever the solution and container permit.