Indications & Uses
Survec is an adjunct to general anaesthesia, used to aid endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.
Pharmacology
Vecuronium Bromide is supplied as a lyophilized powder for injection. It belongs to the non-depolarising class of neuromuscular blocking agents. It works by competitively binding to the nicotinic receptors at the motor end-plate of striated muscle, thereby blocking transmission between the motor nerve-ending and the muscle.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Dosage
The recommended initial dose of Vecuronium is 0.08 to 0.10 mg per kg body weight, given as an intravenous bolus injection. This dose can be expected to produce good or excellent conditions for non emergency intubation within 2.5 to 3.0 minutes after injection. In caesarean section and neonatal surgery the dose should not exceed 0.1 mg/kg.
Like other neuromuscular blocking agents, Vecuronium Bromide should only be given by, or under the supervision of, experienced clinicians who are familiar with the action and use of these agents, and the dose should be individualized for each patient. Accordingly, adjustments should be made by giving smaller maintenance doses at less frequent intervals, or by using lower infusion rates, during long lasting procedures of more than one hour under inhalational anaesthesia.
In adult patients the following dosage recommendations may serve as a general guideline for tracheal intubation and muscle relaxation in surgical procedures of short to long duration.
Tracheal intubation. The standard intubating dose during routine anaesthesia is 0.08 to 0.1 mg Vecuronium Bromide per kg body weight, after which adequate intubation conditions are established within 90 to 120 seconds in nearly all patients.
Dosage for surgical procedures after intubation with suxamethonium. If suxamethonium is used for intubation, the administration of Vecuronium should be delayed until the patient has clinically recovered from the neuromuscular block caused by suxamethonium. The recommended dose is 0.03 to 0.05 mg Vecuronium Bromide per kg body weight.
Maintenance dosing. The recommended maintenance dose is 0.02 to 0.03 mg Vecuronium Bromide per kg body weight. These maintenance doses are best given when twitch height has recovered to 25 percent of the control twitch height.
Dose requirements for continuous infusion. If Vecuronium is given by continuous infusion, it is recommended to give a loading dose of 0.08 to 0.1 mg Vecuronium Bromide per kg body weight first, and to start the infusion once the neuromuscular block begins to recover. The infusion rate should be adjusted to maintain the twitch response at 10 percent of the control twitch height, or to maintain 1 to 2 responses to train of four stimulation. In adults, the infusion rate needed to maintain neuromuscular block at this level ranges from 0.8 to 1.4 microgram Vecuronium Bromide per kg per minute. Repeat monitoring of the neuromuscular block is recommended, since infusion rate requirements vary from patient to patient and with the anaesthetic method used.
Dosing in elderly patients. The same intubation and maintenance doses used in younger adults, 0.08 to 0.1 mg/kg and 0.02 to 0.03 mg/kg respectively, can be used. The onset time in elderly patients is similar to that in younger adults.
Dosing in paediatric patients. In neonates up to 4 weeks and children up to 4 months, an initial test dose of 0.01 to 0.02 mg/kg is recommended, followed by incremental doses until 90 to 95 percent depression of the twitch response is achieved. In neonatal surgery the dose should not exceed 0.1 mg/kg. In children from 5 months to 10 years, the dose is 0.08 to 0.1 mg/kg, though children under 12 months tend to have a more rapid onset and may not need the full intubating dose. Maintenance in this age group is 0.02 to 0.03 mg/kg, adjusted according to response. Because the duration of action is shorter in children, maintenance doses are needed more frequently.
Dosing in overweight and obese patients. Doses in overweight or obese patients should be reduced, taking ideal body weight into account. Initial doses ranging from 0.15 mg up to 0.30 mg Vecuronium Bromide per kg body weight have been given during surgery under both halothane and neurolept anaesthesia.
Side Effects
Survec belongs to the non-depolarising group of muscle relaxants and works over an intermediate duration. It does not typically trigger histamine release and has little effect on the cardiovascular system. As with other non-depolarising muscle relaxants, common side effects include flushing of the skin, low blood pressure, a fast heart rate, and bronchospasm, with anaphylactoid reactions occurring only very rarely. Acute myopathy has also been reported following prolonged use in intensive care settings.
Cautions & Contraindications
Warnings & Precautions
Allergic cross-reactivity between neuromuscular blocking agents has been reported, so be cautious if someone has had a hypersensitivity reaction to these drugs. Their effect lasts longer in patients with myasthenia gravis and in hypothermia, so lower doses are needed. Non-depolarising muscle relaxants should be used with great care in people with other neuromuscular disorders and in those with fluid and electrolyte disturbances, because the response can be unpredictable. Patients with burns may develop resistance and may need higher doses. In these patients, low plasma cholinesterase activity means the dose must be adjusted carefully for mivacurium. General Survec should be given in carefully adjusted doses, by or under the supervision of experienced clinicians who know its actions and the complications that can follow its use. Do not give the drug unless intubation equipment, artificial respiration, oxygen therapy and reversal agents are immediately available. The clinician must be ready to help with or take over breathing. A peripheral nerve stimulator should be used to monitor how the patient responds, whether more relaxant is needed, and whether spontaneous recovery or anticholinesterase reversal is adequate. Intensive Care Unit Survec, or any other neuromuscular blocking agent, should be given in carefully adjusted doses by or under the supervision of experienced clinicians. They should know the drug well and use proper peripheral nerve stimulator muscle monitoring. This helps reduce the chance of prolonged neuromuscular blockade and other complications after long-term use in the ICU. Neuromuscular Disease In patients known to have myasthenia gravis or myasthenic syndrome, small doses of Survec may have a strong effect. In these patients, a peripheral nerve stimulator and a small test dose can be especially useful for judging and monitoring the dose needed.
Contraindications
Hypersensitivity to vecuronium bromide, the bromide ion, or any of its excipients is a contraindication to its use.
Pregnancy & Breastfeeding
Pregnancy: There isn't enough evidence from animal or human studies to know whether Vecuronium could harm an unborn baby. It should only be used in pregnancy if the treating physician judges that the benefits outweigh the potential risks.
Breastfeeding: No human data exist on the use of Vecuronium while breastfeeding. It should only be given to a breastfeeding mother if the treating physician judges that the benefits outweigh the potential risks.
Caesarean section: Studies using Vecuronium at doses up to 0.1 mg/kg have found it safe for use during caesarean section, and the dose given for this purpose should not exceed 0.1 mg/kg. Across several clinical studies, Vecuronium did not affect the baby's Apgar score, muscle tone, or heart and breathing adaptation after birth. Testing of umbilical cord blood shows that only a very small amount of the drug crosses the placenta, and this has not been linked to any observed harm in newborns.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
If a patient has taken too much Vecuronium Bromide and the neuromuscular block lasts longer than expected, ventilatory support and sedation must carry on. Once the patient starts to recover on their own, give an acetylcholinesterase inhibitor (for example neostigmine, edrophonium or pyridostigmine) in adequate doses.
Sometimes the acetylcholinesterase inhibitor fails to reverse the effects of Vecuronium Bromide. When that happens, keep ventilating the patient until spontaneous breathing returns. Repeating the dose of an acetylcholinesterase inhibitor can be dangerous.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store in a cool and dry place. Protect from light. Keep out of the reach of children.
Drug Interactions
Common questions about Vencuron 10 IV Inj 10 mg/ml
What is Vencuron 10 IV Inj 10 mg/ml Injection?
Vencuron 10 IV Inj 10 mg/ml Injection is a medicine that contains Vecuronium Bromide. It is made by Techno Drugs Ltd., Gazipur. It belongs to the Non depolarizing muscle relaxants group of medicines.
What is Vencuron 10 IV Inj used for?
Survec is an adjunct to general anaesthesia, used to aid endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.
What are the side effects of Vencuron 10 IV Inj?
Survec belongs to the non-depolarising group of muscle relaxants and works over an intermediate duration. It does not typically trigger histamine release and has little effect on the cardiovascular system.
Can I take Vencuron 10 IV Inj during pregnancy or while breastfeeding?
Pregnancy: There isn't enough evidence from animal or human studies to know whether Vecuronium could harm an unborn baby. It should only be used in pregnancy if the treating physician judges that the benefits outweigh the potential risks. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Vencuron 10 IV Inj?
If a patient has taken too much Vecuronium Bromide and the neuromuscular block lasts longer than expected, ventilatory support and sedation must carry on. Once the patient starts to recover on their own, give an acetylcholinesterase inhibitor (for example neostigmine, edrophonium or pyridostigmine) in adequate doses. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Vencuron 10 IV Inj?
Store in a cool and dry place. Protect from light.
Can I take other medicines with Vencuron 10 IV Inj?
Some medicines can interact with Vecuronium Bromide, for example: Gentamicin, Halothane, Streptomycin, Isoflurane, Colistin, Magnesium. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Vencuron 10 IV Inj?
Vencuron 10 IV Inj is a prescription (Rx) medicine. Take it as your doctor advises.