Indications & Uses
Suxalax IM/IV is indicated for:
Pharmacology
Suxamethonium is a muscle relaxant. It acts as a depolarizing neuromuscular blocker by imitating the action of acetylcholine at the neuromuscular junction. Suxamethonium acts on muscle type nicotinic receptors. When it binds to the nicotinic acetylcholine receptor, the receptor's nicotinic sodium channel opens; sodium moves into the cell, a disorganized depolarization of the motor-end plate occurs, and calcium is released from the sarcoplasmic reticulum. This results in fasciculation. In a normal muscle, following depolarization, acetylcholine is rapidly hydrolyzed by acetylcholinesterase, allowing the muscle cell to 'reset' and ready itself for the next signal. Suxamethonium, however, is degraded not by acetylcholinesterase but by butyrylcholinesterase, a plasma cholinesterase, and this hydrolysis is much slower than that of acetylcholine by acetylcholinesterase. As a result, Suxamethonium has a longer duration of effect than acetylcholine; it does not allow the muscle cell to 'reset' and keeps the 'new' resting membrane potential below threshold. When acetylcholine then binds to an already depolarized receptor, it cannot cause further depolarization. Calcium is removed from the muscle cell cytosol independent of repolarization, and as it is taken up by the sarcoplasmic reticulum, the muscle relaxes. This explains why flaccidity, rather than tetany, follows the fasciculation.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Suxamethonium Chloride is usually given by bolus intravenous or intramuscular injection.
Adults: The dose of Suxamethonium depends on body weight, the degree of muscle relaxation required, the route of administration, and how the individual patient responds. To achieve endotracheal intubation, Suxamethonium is usually given intravenously at a dose of 1 mg/kg. This dose usually produces muscle relaxation within about 30 to 60 seconds and lasts about 2 to 6 minutes. Supplementary doses of 50% to 100% of the initial dose, given at intervals of 5 to 10 minutes, will maintain muscle relaxation during short surgical procedures performed under general anesthesia. For prolonged surgical procedures, Suxamethonium may instead be given by intravenous infusion as a 0.1% to 0.2% solution, diluted in 5% glucose solution or sterile isotonic saline solution, at a rate of 2.5 to 4 mg per minute. The infusion rate should be adjusted according to how the individual patient responds. The total dose given by repeated intravenous injection or continuous infusion should not exceed 500 mg per hour.
Children: Infants and young children are more resistant to Suxamethonium than adults. The recommended intravenous dose for infants is 2 mg/kg. A dose of 1 mg/kg is recommended for older children. When given as an intravenous infusion in children, the dosage follows the adult regimen, with a proportionately lower initial infusion rate based on body weight. Suxamethonium may be given intramuscularly to infants at doses of up to 4 to 5 mg/kg, and to older children at doses of up to 4 mg/kg. These doses produce muscle relaxation within about 3 minutes. A total dose of 150 mg should not be exceeded.
Side Effects
Cardiovascular effects can include a slower or faster heart rate, high or low blood pressure, and irregular heart rhythms. Breathing-related effects may include bronchospasm and prolonged breathing difficulty or apnea. Muscle-related effects can include muscle twitching, post-operative muscle aches, and myoglobinemia. Other effects may include high body temperature, increased pressure in the eyes or stomach, skin rash, and excessive salivation.
Cautions & Contraindications
Warnings & Precautions
Suxonium should be given only by, or under the close supervision of, an anesthetist who is familiar with its actions, characteristics, and hazards, and who is skilled in managing artificial respiration. It should be used only where facilities for immediate endotracheal intubation and oxygen delivery by intermittent positive pressure ventilation are readily available. Elderly patients may be more prone to cardiac arrhythmias, particularly when digitalis-like drugs are being taken concurrently.
Contraindications
Suxamethonium does not affect a person's level of consciousness, so it should never be given to someone who is not fully anaesthetised. It should also not be given to anyone known to be hypersensitive (allergic) to the drug. Suxamethonium is contraindicated in people known to have an inherited atypical plasma cholinesterase activity. In normal people, serum potassium often rises briefly after suxamethonium is given, usually by about 0.5 mmol/Litre. In certain disease states, though, the rise can be excessive, and that can lead to serious heart rhythm problems (arrhythmias) and cardiac arrest. For this reason, suxamethonium must not be used in patients recovering from major trauma or severe burns, in patients with neurological deficits involving acute major muscle wasting, or in patients who already have hyperkalaemia. Suxamethonium also causes a slight, temporary rise in intra-ocular pressure, so it should not be used when a person has an open eye injury. The injection is contraindicated in newborn babies, especially premature neonates.
Pregnancy & Breastfeeding
Suxamethonium doesn't cross the placenta easily, but it's still best avoided during pregnancy unless the doctor feels the benefits clearly outweigh the risks.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Storage
Keep Suxamethonium Chloride in a refrigerator, between 2° and 8° C. Don't let it freeze.
Drug Interactions
Common questions about Suxalax IM/IV 100 mg
What is Suxalax IM/IV 100 mg Injection?
Suxalax IM/IV 100 mg Injection is a medicine that contains Suxamethonium Chloride. It is made by Square Pharmaceuticals PLC, Gazipur. It belongs to the Depolarizing muscle relaxants group of medicines.
What is Suxalax IM/IV used for?
Suxalax IM/IV is used for: Muscle Spasm.
What are the side effects of Suxalax IM/IV?
Cardiovascular effects can include a slower or faster heart rate, high or low blood pressure, and irregular heart rhythms. Breathing-related effects may include bronchospasm and prolonged breathing difficulty or apnea.
Can I take Suxalax IM/IV during pregnancy or while breastfeeding?
Suxamethonium doesn't cross the placenta easily, but it's still best avoided during pregnancy unless the doctor feels the benefits clearly outweigh the risks. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Suxalax IM/IV?
Keep Suxamethonium Chloride in a refrigerator, between 2° and 8° C. Don't let it freeze.
Can I take other medicines with Suxalax IM/IV?
Some medicines can interact with Suxamethonium Chloride, for example: Cyclophosphamide, Ketamine, Pyridostigmine, Pethidine, Morphine Sulphate, Chlorpromazine Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Suxalax IM/IV?
Suxalax IM/IV is a prescription (Rx) medicine. Take it as your doctor advises.