Succinylcholine (Intramuscular, Intravenous)

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

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 any unwanted effects.

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

This medicine may lead to a serious allergic reaction, including anaphylaxis, which can be life-threatening and needs immediate medical attention. Contact your doctor right away if you have chest tightness, cough, trouble 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 this medicine is given. Inform your doctor immediately if you experience confusion, irregular heartbeat, nausea or vomiting, numbness or tingling in your hands, feet, or legs, or difficulty breathing after receiving this medicine.

This medicine may cause malignant hyperthermia (high body temperature). Contact your doctor right away if you have a fast heartbeat, high fever, or stiff 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, slow or irregular heartbeat, difficulty breathing, or unusual tiredness.

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

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

In deciding to use a medicine, the risks of taking it must be compared to the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, you should consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your health care professional about any other allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

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

Geriatric

Studies done so far have not shown any specific problems in older adults that would limit the use of succinylcholine injection in this age group. However, elderly patients are more likely to have age-related liver, kidney, or heart issues, which may require caution and a dose adjustment for those receiving 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 against the possible risks before taking this medication while breastfeeding.

Interactions with Medicines

Certain 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 want to change the dose or take other precautions. When you receive this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

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 together, your doctor may change the dose or how often you use one or both of the 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 using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the 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 used at or around mealtimes or with certain types of food, as interactions may occur. Using alcohol or tobacco with some medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect the use of this medicine. Make sure to tell 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 issues (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 happen, if they do, they may need medical attention.

Check with your doctor or nurse right away 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 happen 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.