Pronunciation:

sux-i-nil-KOE-leen KLOR-ide

Brand Names:

• Anectine
• Quelicin

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Musculoskeletal Agent

Pharmacologic—

Succinylcholine

Uses of This Medicine:

Succinylcholine injection is used before and during surgery to provide muscle relaxation and make intubation easier.

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

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

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

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of succinylcholine injection in the pediatric population. However, children are more likely to have unwanted side effects, including heart rhythm problems, heart disease from hyperkalemic rhabdomyolysis.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of succinylcholine injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of 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 required 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 cause an increased 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

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems or
• Nerve problems or
• Stomach infection—Use with caution. May increased risk of having 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
• Increase intraocular pressure or
• Kidney disease or
• Liver disease—Use with caution. May make these conditions worse.

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

Proper Use of This Medicine:

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.

Precautions While Using This Medicine:

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

This medicine may cause heart rhythm problems (eg, ventricular dysrhythmias) in children with rhabdomyolysis (serious muscle problem) with hyperkalemia. Check with your doctor right away if you have dizziness, fainting, or fast, slow, or irregular heartbeat.

This medicine may cause serious allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, or 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 receiving this medicine. Tell your doctor right away if you have confusion, irregular heartbeat, nausea or vomiting, numbness or tingling in the hands, feet, or legs, or trouble breathing after receiving this medicine.

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

This medicine may cause bradycardia (slow heartbeat). Check with your doctor right away if you or your child has chest pain or discomfort, lightheadedness, dizziness, or fainting, slow or irregular heartbeat, trouble breathing, or unusual tiredness.

Check with your doctor right away if you have blurred vision, change in vision, or loss of vision. These may be symptoms of increase intraocular pressure.

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

Side Effects of This Medicine:

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.