Vecuronium is a muscle relaxant used during anaesthesia and intubations: temporary muscle paralysis to allow the surgeon to operate safely while the patient is asleep and ventilated.
Also known as: Norcuron
Magnesium sulphate prolongs and intensifies the non-depolarising neuromuscular blockade of vecuronium.
Mg2+ reduces acetylcholine release and plate sensitivity, increasing curare-blockade duration (labels; obstetric practice with MgSO4).
Tremography/adductor pollicis, ventilation, serum Mg2+.
Prolonged paralysis, failed extubation.
Reduce the initial vecuronium dose in patients on MgSO4; use blockade monitoring (tremography); reversal with neostigmine under supervision.
DailyMed — Vecuronium Bromide Injection and Magnesium Sulfate Injection labels: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=582c7f44-b614-18df-e063-6294a90a74b6
No documented food or drink interactions.
Non-depolarising neuromuscular blockers are extremely potentiated in myasthenia — greatly reduced doses or avoidance.
Neuromuscular monitoring mandatory; 50–90% dose reduction.
EMC-UK — vecuronium SmPC 4.4 (myasthenia).
Vecuronium has an active metabolite (3-desacetyl) renally excreted — prolonged block in severe renal impairment.
Prefer rocuronium/cisatracurium in severe renal impairment if available.
EMC-UK — vecuronium SmPC 4.4 (renal impairment).
No specific Annex 1 entry; vecuronium is used for intubation in caesarean sections with safety experience (it does not cross the placenta in clinically relevant amounts). It is a paralytic — administer only with sedation and a secured airway; elimination is slower in newborns.
Compatible for anaesthetic use (intubation in caesarean section); administer only with adequate sedation — isolated paralysis is contraindicated.
Does not significantly cross the placenta and passes little into milk — compatible.
EMC-UK (MHRA) — Vecuronium bromide SmPC: https://www.medicines.org.uk/emc/product/3112/smpc (section 4.6).
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Complete flaccid muscle paralysis (intubation in 2–3 min; duration 25–40 min).
Competitive antagonist at the motor end-plate nicotinic receptor; reversible by neostigmine (↑ acetylcholine) or sugammadex (chemical encapsulation).
IV exclusive; not applicable orally.
Hepatic deacetylation to 3-hydroxyvecuronium (active metabolite ~ 50% potency); biliary and renal excretion.
~ 60–90 min (prolonged in advanced liver/kidney disease).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
