Quelicin (Intramuscular, Intravenous)

Succinylcholine injection is used before and during surgery to relax muscles and make it easier to insert a breathing tube.

This medicine must be given only by or under the direct supervision of your doctor.

Your doctor will monitor you closely after you receive this medicine. This will help your doctor see if the medicine is working properly. Blood and urine tests may be needed to check for side effects.

This medicine may cause heart rhythm problems (for example, ventricular dysrhythmias) in children with rhabdomyolysis (a serious muscle issue) along with hyperkalemia. Contact your doctor immediately if you experience dizziness, fainting, or a fast, slow, or irregular heartbeat.

This medicine may cause a serious allergic reaction, including anaphylaxis, which can be life-threatening and needs immediate medical help. Contact your doctor right away if you experience chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, or unusual tiredness or weakness.

Hyperkalemia may occur rarely after you receive this medicine. Inform your doctor immediately if you have confusion, an irregular heartbeat, nausea or vomiting, numbness or tingling in your hands, feet, or legs, or trouble breathing after receiving this medicine.

This medicine may cause malignant hyperthermia (high body temperature). Contact your doctor right away if you experience a fast heartbeat, high fever, or rigid muscles.

This medicine may cause bradycardia (slow heartbeat). Contact your doctor immediately if you or your child experiences chest pain or discomfort, lightheadedness, dizziness, fainting, a slow or irregular heartbeat, trouble breathing, or unusual tiredness.

Contact your doctor right away if you experience blurred vision, changes in vision, or loss of vision. These may be signs of increased intraocular pressure.

Do not take other medicines unless you have talked about them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor should carefully consider the risks of taking the medicine compared to the benefits it may provide. For this medicine, keep the following points in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients thoroughly.

Pediatric

Studies so far have not shown any specific problems in children that would limit the use of succinylcholine injection in this age group. However, children may be more likely to experience unwanted side effects, including heart rhythm issues and heart disease from hyperkalemic rhabdomyolysis.

Geriatric

Studies conducted so far have not shown any specific problems in elderly patients that would limit the effectiveness of succinylcholine injection in older adults. However, older patients are more likely to have age-related issues with their liver, kidneys, or heart, which may require careful monitoring and possible dose adjustments for those taking this medicine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits and risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. In these situations, your doctor may need to adjust the dose, or other precautions may be necessary. When taking this medicine, it is very important for your healthcare professional to know if you are using any of the medicines listed below. The following interactions are significant but may not include all possible interactions.

Using this medicine with any of the following medicines is usually not recommended but may be necessary in some cases. If both medicines are prescribed, your doctor may adjust the dose or how often you take one or both medicines.

• Acetyldigoxin
• Amikacin
• Deslanoside
• Dibekacin
• Digitoxin
• Digoxin
• Donepezil
• Gentamicin
• Kanamycin
• Lidocaine
• Metildigoxin
• Netilmicin
• Pancuronium
• Procainamide
• Promazine
• Quinidine
• Quinine
• St John's Wort
• Streptomycin
• Thiopental
• Tobramycin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both may be the best treatment for you. If both are prescribed, your doctor may adjust the dose or frequency of one or both medicines.

• Atracurium
• Bambuterol
• Distigmine
• Echothiophate
• Fospropofol
• Lithium
• Magnesium
• Metoclopramide
• Mivacurium
• Neostigmine
• Physostigmine
• Propofol
• Pyridostigmine
• Vancomycin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be taken around mealtime or with specific foods due to potential interactions. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect how this medicine is used. Make sure to inform your doctor if you have any other medical conditions, especially:

• Bleeding problems or
• Nerve problems or
• Stomach infection—Use with caution. May increase the risk of severe hyperkalemia.

• Fracture or
• Heart or blood vessel disease or
• Heart rhythm problems or
• Hyperkalemia (high potassium in the blood) or
• Hypocalcemia (low calcium in the blood) or
• Hypokalemia (low potassium in the blood) or
• Hypotension (low blood pressure) or
• Hypovolemia (low blood volume) or
• Increased intraocular pressure or
• Kidney disease or
• Liver disease—Use with caution. May worsen these conditions.

• Hereditary problems (e.g., high risk for malignant hyperthermia) or
• Injury (e.g., major burns, multiple trauma, muscle or nerve injury) or
• Muscle problems—Should not be used in patients with these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

• Blurred vision
• change in vision
• chest pain, discomfort, or tightness
• confusion
• cough
• dark-colored urine
• difficulty swallowing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dizziness
• fainting
• fast, slow, pounding, or irregular heartbeat or pulse
• headache
• high fever
• hives, itching, or skin rash
• lightheadedness
• loss of vision
• muscle twitches, pain, stiffness, cramps, or spasms
• nausea or vomiting
• nervousness
• no blood pressure or pulse
• numbness or tingling in the hands, feet, or lips
• pale or blue lips, fingernails, or skin
• pounding in the ears
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rigid muscles
• stopping of the heart
• sweating
• trouble breathing
• unconsciousness
• unusual tiredness or weakness
• weakness or heaviness of the legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Watering of the mouth and drooling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Anectine
• Quelicin

Available Dosage Forms:

• Solution

Therapeutic Class: Musculoskeletal Agent

Pharmacologic Class: Succinylcholine

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is usually given as a shot into a muscle or into a vein.