Identification

Name
Rocuronium
Accession Number
DB00728  (APRD01221)
Type
Small Molecule
Groups
Approved
Description

Rocuronium (rapid onset-curonium) is a desacetoxy analogue of vecuronium with a more rapid onset of action. It is an aminosteroid non-depolarizing neuromuscular blocker or muscle relaxant used in modern anaesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Introduced in 1994, rocuronium has rapid onset, and intermediate duration of action. It is marketed under the trade name of Zemuron in the United States and Esmeron in most other countries. There is considered to be a risk of allergic reaction to the drug in some patients (particularly those with asthma), but a similar incidence of allergic reactions has been observed by using other members of the same drug class (non-depolarizing neuromuscular blocking drugs). The γ-cyclodextrin derivative sugammadex (trade name Bridion) has been recently introduced as a novel agent to reverse the action of rocuronium.

Structure
Thumb
Synonyms
  • Rocuronium
Product Ingredients
IngredientUNIICASInChI Key
Rocuronium bromideI65MW4OFHZ119302-91-9OYTJKRAYGYRUJK-FMCCZJBLSA-M
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Rocuronium Bromide InjectionSolution10 mgIntravenousOmega Laboratories Ltd2012-08-02Not applicableCanada
Rocuronium Bromide InjectionLiquid10 mgIntravenousHospira, Inc.2009-02-10Not applicableCanada
Rocuronium Bromide InjectionSolution10 mgIntravenousSandoz Canada Incorporated2008-10-24Not applicableCanada
Rocuronium Bromide InjectionSolution10 mgIntravenousMylan PharmaceuticalsNot applicableNot applicableCanada
Rocuronium Bromide Injection SdzSolution10 mgIntravenousSandoz Canada IncorporatedNot applicableNot applicableCanada
ZemuronSolution10 mgIntravenousMerck Ltd.1995-12-31Not applicableCanada
ZemuronInjection, solution10 mg/mLIntravenousOrganon1994-03-17Not applicableUs
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
RocuroniumInjection, solution10 mg/mLIntravenousThe Medicines Company2009-12-13Not applicableUs
RocuroniumInjection, solution10 mg/mLIntravenousThe Medicines Company2009-12-13Not applicableUs
RocuroniumInjection, solution10 mg/mLIntravenousFresenius Kabi2009-12-13Not applicableUs
Rocuronium BromideSolution10 mg/mLIntravenousX Gen Pharmaceuticals, Inc.2012-12-01Not applicableUs
Rocuronium BromideInjection10 mg/mLIntravenousMylan Institutional2014-09-29Not applicableUs
Rocuronium BromideInjection, solution50 mg/5mLIntravenousAurobindo Pharma2017-04-12Not applicableUs
Rocuronium BromideInjection, solution10 mg/mLIntravenousTeva Parenteral Medicines, Inc.2008-12-01Not applicableUs
Rocuronium BromideInjection10 mg/mLIntravenousMylan Institutional2014-09-29Not applicableUs
Rocuronium BromideInjection, solution50 mg/5mLIntravenousAuro Medics Pharma Llc2017-04-12Not applicableUs
Rocuronium BromideInjection10 mg/mLIntravenousWest Ward Pharmaceutical2017-04-30Not applicableUs
Unapproved/Other Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Rocuronium BromideInjection, solution10 mg/mLIntravenousCantrell Drug Company2015-01-29Not applicableUs
International/Other Brands
Esmeron
Categories
UNII
WRE554RFEZ
CAS number
143558-00-3
Weight
Average: 529.7742
Monoisotopic: 529.400533194
Chemical Formula
C32H53N2O4
InChI Key
YXRDKMPIGHSVRX-OOJCLDBCSA-N
InChI
InChI=1S/C32H53N2O4/c1-5-14-34(15-6-7-16-34)28-20-26-24-9-8-23-19-29(36)27(33-12-17-37-18-13-33)21-32(23,4)25(24)10-11-31(26,3)30(28)38-22(2)35/h5,23-30,36H,1,6-21H2,2-4H3/q+1/t23-,24+,25-,26-,27-,28-,29-,30-,31-,32-/m0/s1
IUPAC Name
1-[(1S,2S,4S,5S,7S,10R,11S,13S,14R,15S)-14-(acetyloxy)-5-hydroxy-2,15-dimethyl-4-(morpholin-4-yl)tetracyclo[8.7.0.0²,⁷.0¹¹,¹⁵]heptadecan-13-yl]-1-(prop-2-en-1-yl)pyrrolidin-1-ium
SMILES

Pharmacology

Indication

For inpatients and outpatients as an adjunct to general anesthesia to facilitate both rapid sequence and routine tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Structured Indications
Pharmacodynamics

Neuromuscular blocking agents are drugs that cause skeletal muscle relaxation primarily by causing a decreased response to the neurotransmitter acetylcholine (ACh) at the myoneural (neuromuscular) junction of skeletal muscle. At that site, ACh normally produces electrical depolarization of the postjunctional membrane of motor end-plate, which leads to conduction of muscle action potential and subsequently induces skeletal muscle contraction. Neuromuscular agents are classified as depolarizing or nondepolarizing. Rocuronium is a nondepolarizing neuromuscular blocking agent with a rapid to intermediate onset depending on dose and intermediate duration. Rocuronium, like vecuronium is longer acting in infants than in children. However, unlike vecuronium, rocuronium retains the characteristics of an intermediate-acting NMBD in infants.

Mechanism of action

Rocuronium acts by competing for cholinergic receptors at the motor end-plate. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine and edrophonium. Rocuronium acts by competitively binding to nicotinic cholinergic receptors. The binding of vecuronium decreases the opportunity for acetylcholine to bind to the nicotinic receptor at the postjunctional membrane of the myoneural junction. As a result, depolarization is prevented, calcium ions are not released and muscle contraction does not occur. Evidence also suggests that nondepolarizing agents can affect ACh release. It has been hypothesized that nondepolarzing agents bind to postjunctional ("curare") receptors and may therefore interfere with the sodium and potassium flux, which is responsible for depolarization and repolarization of the membranes involved in muscle contraction.

TargetActionsOrganism
ANeuronal acetylcholine receptor subunit alpha-2
antagonist
Human
AMuscarinic acetylcholine receptor M2
antagonist
Human
U5-hydroxytryptamine receptor 3A
antagonist
Human
Absorption

Poorly absorbed from the GI tract.

Volume of distribution
  • 0.3 L/kg [3 to <12 mos]
  • 0.26 L/kg [1 to <3 yrs]
  • 0.21 L/kg [3 to <8 yrs]
Protein binding

Approximately 30% bound to human plasma proteins.

Metabolism

Rocuronium is metabolized to a less active metabolite, 17-desacetyl-rocuronium, and is eliminated primarily by the liver.

Route of elimination

Studies of distribution, metabolism, and excretion in cats and dogs indicate that rocuronium is eliminated primarily by the liver.

Half life

The rapid distribution half-life is 1-2 minutes and the slower distribution half-life is 14-18 minutes. Renal impairment has no net effect on half-life, however, half-life is almost doubled in patients with impaired liver function.

Clearance
  • 0.25 L/kg/hr [Adults (Ages 27 to 58 years)]
  • 0.21 L/kg/hr [Geriatrics (>=65 yrs)]
  • 0.16 L/kg/hr [Normal ewnal and hepatice function]
  • 0.13 L/kg/hr [Renal transplant patients]
  • 0.13 L/kg/hr [Hepatic dysfunction patients]
  • 0.35 +/- 0.08 L/kg/hr [Pediatric Patients 3 to <12 mos]
  • 0.32 +/- 0.07 L/kg/hr [Pediatric Patients 1 to 3 yrs]
  • 0.44 +/- 0.16 L/kg/hr [Pediatric Patients 3 to 8 yrs]
Toxicity

No cases of significant accidental or intentional overdose have been reported. Overdosage with neuromuscular blocking agents may result in neuromuscular block beyond the time needed for surgery and anesthesia.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
AcetyldigitoxinRocuronium may increase the arrhythmogenic activities of Acetyldigitoxin.Approved
AcetyldigoxinRocuronium may increase the arrhythmogenic activities of Acetyldigoxin.Experimental
AclarubicinAclarubicin may increase the respiratory depressant activities of Rocuronium.Investigational
AmikacinAmikacin may increase the respiratory depressant activities of Rocuronium.Approved, Vet Approved
AmrubicinAmrubicin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
annamycinannamycin may increase the respiratory depressant activities of Rocuronium.Investigational
ApramycinApramycin may increase the respiratory depressant activities of Rocuronium.Experimental, Vet Approved
ArbekacinArbekacin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
BekanamycinBekanamycin may increase the respiratory depressant activities of Rocuronium.Experimental
Botulinum Toxin Type ABotulinum Toxin Type A may increase the neuromuscular blocking activities of Rocuronium.Approved, Investigational
Botulinum Toxin Type BRocuronium may increase the neuromuscular blocking activities of Botulinum Toxin Type B.Approved
BumetanideBumetanide may decrease the neuromuscular blocking activities of Rocuronium.Approved
CapreomycinCapreomycin may increase the neuromuscular blocking activities of Rocuronium.Approved
ChlortetracyclineChlortetracycline may increase the neuromuscular blocking activities of Rocuronium.Approved, Investigational, Vet Approved
ClindamycinClindamycin may increase the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
ColistimethateColistimethate may increase the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
CyclosporineCyclosporine may increase the neuromuscular blocking activities of Rocuronium.Approved, Investigational, Vet Approved
CymarinRocuronium may increase the arrhythmogenic activities of Cymarin.Experimental
DaunorubicinDaunorubicin may increase the respiratory depressant activities of Rocuronium.Approved
DemeclocyclineDemeclocycline may increase the neuromuscular blocking activities of Rocuronium.Approved
DeslanosideRocuronium may increase the arrhythmogenic activities of Deslanoside.Approved
DibekacinDibekacin may increase the respiratory depressant activities of Rocuronium.Experimental
DigitoxinRocuronium may increase the arrhythmogenic activities of Digitoxin.Approved, Investigational
DigoxinRocuronium may increase the arrhythmogenic activities of Digoxin.Approved
Digoxin Immune Fab (Ovine)Rocuronium may increase the arrhythmogenic activities of Digoxin Immune Fab (Ovine).Approved
DihydrostreptomycinDihydrostreptomycin may increase the respiratory depressant activities of Rocuronium.Investigational, Vet Approved
DoxorubicinDoxorubicin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
DoxycyclineDoxycycline may increase the neuromuscular blocking activities of Rocuronium.Approved, Investigational, Vet Approved
EpirubicinEpirubicin may increase the respiratory depressant activities of Rocuronium.Approved
Etacrynic acidEtacrynic acid may decrease the neuromuscular blocking activities of Rocuronium.Approved
FramycetinFramycetin may increase the respiratory depressant activities of Rocuronium.Approved
FurosemideFurosemide may decrease the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
GeneticinGeneticin may increase the respiratory depressant activities of Rocuronium.Experimental
GentamicinGentamicin may increase the respiratory depressant activities of Rocuronium.Approved, Vet Approved
GENTAMICIN C1AGENTAMICIN C1A may increase the respiratory depressant activities of Rocuronium.Experimental
GitoformateRocuronium may increase the arrhythmogenic activities of Gitoformate.Experimental
GPX-150GPX-150 may increase the respiratory depressant activities of Rocuronium.Investigational
Hygromycin BHygromycin B may increase the respiratory depressant activities of Rocuronium.Vet Approved
IdarubicinIdarubicin may increase the respiratory depressant activities of Rocuronium.Approved
INNO-206INNO-206 may increase the respiratory depressant activities of Rocuronium.Investigational
IsepamicinIsepamicin may increase the respiratory depressant activities of Rocuronium.Experimental
KanamycinKanamycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational, Vet Approved
Lanatoside CRocuronium may increase the arrhythmogenic activities of Lanatoside C.Experimental
LincomycinLincomycin may increase the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
LithiumLithium may increase the neuromuscular blocking activities of Rocuronium.Approved
Magnesium HydroxideMagnesium Hydroxide may increase the neuromuscular blocking activities of Rocuronium.Approved
Magnesium oxideMagnesium oxide may increase the neuromuscular blocking activities of Rocuronium.Approved
Magnesium salicylateMagnesium salicylate may increase the neuromuscular blocking activities of Rocuronium.Approved
Magnesium SulfateMagnesium Sulfate may increase the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
MetildigoxinRocuronium may increase the arrhythmogenic activities of Metildigoxin.Experimental
MetrizamideMetrizamide may increase the respiratory depressant activities of Rocuronium.Approved
MicronomicinMicronomicin may increase the respiratory depressant activities of Rocuronium.Experimental
MinocyclineMinocycline may increase the neuromuscular blocking activities of Rocuronium.Approved, Investigational
NeamineNeamine may increase the respiratory depressant activities of Rocuronium.Experimental
NeomycinNeomycin may increase the respiratory depressant activities of Rocuronium.Approved, Vet Approved
NetilmicinNetilmicin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
OleandrinRocuronium may increase the arrhythmogenic activities of Oleandrin.Experimental, Investigational
OuabainRocuronium may increase the arrhythmogenic activities of Ouabain.Approved
ParomomycinParomomycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
PeruvosideRocuronium may increase the arrhythmogenic activities of Peruvoside.Experimental
PirarubicinPirarubicin may increase the respiratory depressant activities of Rocuronium.Investigational
PiretanidePiretanide may decrease the neuromuscular blocking activities of Rocuronium.Experimental
PirlimycinPirlimycin may increase the neuromuscular blocking activities of Rocuronium.Vet Approved
PlazomicinPlazomicin may increase the respiratory depressant activities of Rocuronium.Investigational
PlicamycinPlicamycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational, Withdrawn
Polymyxin B SulfatePolymyxin B Sulfate may increase the neuromuscular blocking activities of Rocuronium.Approved, Vet Approved
ProcainamideProcainamide may increase the neuromuscular blocking activities of Rocuronium.Approved
ProscillaridinRocuronium may increase the arrhythmogenic activities of Proscillaridin.Experimental
PuromycinPuromycin may increase the respiratory depressant activities of Rocuronium.Experimental
QuinidineQuinidine may increase the neuromuscular blocking activities of Rocuronium.Approved
QuinineQuinine may increase the neuromuscular blocking activities of Rocuronium.Approved
RibostamycinRibostamycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
SabarubicinSabarubicin may increase the respiratory depressant activities of Rocuronium.Investigational
SisomicinSisomicin may increase the respiratory depressant activities of Rocuronium.Investigational
SP1049CSP1049C may increase the respiratory depressant activities of Rocuronium.Investigational
SpectinomycinSpectinomycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational, Vet Approved
StreptomycinStreptomycin may increase the respiratory depressant activities of Rocuronium.Approved, Vet Approved
StreptozocinStreptozocin may increase the respiratory depressant activities of Rocuronium.Approved
TobramycinTobramycin may increase the respiratory depressant activities of Rocuronium.Approved, Investigational
TorasemideTorasemide may decrease the neuromuscular blocking activities of Rocuronium.Approved
ValrubicinValrubicin may increase the respiratory depressant activities of Rocuronium.Approved
VancomycinVancomycin may increase the neuromuscular blocking activities of Rocuronium.Approved
Zoptarelin doxorubicinZoptarelin doxorubicin may increase the respiratory depressant activities of Rocuronium.Investigational
ZorubicinZorubicin may increase the respiratory depressant activities of Rocuronium.Experimental
Food Interactions
Not Available

References

Synthesis Reference

Eliezer Adar, David Sondack, Oded Friedman, Iosef Manascu, Tamir Fizitzki, Boris Freger, Oded Arad, Alexander Weisman, Joseph Kaspi, "Processes for the preparation of rocuronium bromide and intermediates thereof." U.S. Patent US20050159398, issued July 21, 2005.

US20050159398
General References
  1. Agoston S, Vandenbrom RH, Wierda JM: Clinical pharmacokinetics of neuromuscular blocking drugs. Clin Pharmacokinet. 1992 Feb;22(2):94-115. [PubMed:1551294]
  2. Khuenl-Brady KS, Sparr H: Clinical pharmacokinetics of rocuronium bromide. Clin Pharmacokinet. 1996 Sep;31(3):174-83. [PubMed:8877248]
  3. Alvarez-Gomez JA: [Rocuronium]. Rev Esp Anestesiol Reanim. 1997 Oct;44(8):310-4. [PubMed:9424684]
  4. Wicks TC: The pharmacology of rocuronium bromide (ORG 9426). AANA J. 1994 Feb;62(1):33-8. [PubMed:8122487]
  5. Sparr HJ, Beaufort TM, Fuchs-Buder T: Newer neuromuscular blocking agents: how do they compare with established agents? Drugs. 2001;61(7):919-42. [PubMed:11434449]
  6. Hemmerling TM, Russo G, Bracco D: Neuromuscular blockade in cardiac surgery: an update for clinicians. Ann Card Anaesth. 2008 Jul-Dec;11(2):80-90. [PubMed:18603747]
External Links
Human Metabolome Database
HMDB14866
KEGG Drug
D00765
KEGG Compound
C07556
PubChem Compound
441290
PubChem Substance
46506855
ChemSpider
390053
ChEBI
8884
ChEMBL
CHEMBL1201244
Therapeutic Targets Database
DAP000349
PharmGKB
PA164754992
IUPHAR
4003
Guide to Pharmacology
GtP Drug Page
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Rocuronium
ATC Codes
M03AC09 — Rocuronium bromide
AHFS Codes
  • 12:20.20 — Neuromuscular Blocking Agents
MSDS
Download (46.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1RecruitingTreatmentHigh-Frequency Jet Ventilation / Vocal Cord Resection1
2Active Not RecruitingTreatmentMuscle Relaxation1
2CompletedTreatmentIntubation Conditions1
2CompletedTreatmentLaparoscopic Cholecystectomy1
2CompletedTreatmentOut-Of-Hospital Cardiac Arrest1
2CompletedTreatmentAdjunct to general anesthesia therapy1
2RecruitingOtherCardiac Arrest1
2, 3CompletedTreatmentOrganophosphate Poisoning1
2, 3RecruitingTreatmentNeoplasms, Lung1
3CompletedSupportive CareMuscle Relaxation1
3CompletedTreatmentAnaesthesia therapy5
3CompletedTreatmentCardiac Arrest With Successful Resuscitation / Hypothermia / Skeletal Muscle Relaxant Overdose1
3CompletedTreatmentMuscle Relaxation1
3CompletedTreatmentNeuromuscular Blockade2
3CompletedTreatmentAdjunct to general anesthesia therapy1
3Not Yet RecruitingTreatmentAcute Appendicitis / Inguinal Hernias1
4Active Not RecruitingHealth Services ResearchObesity, Morbid1
4CompletedNot AvailableLaparoscopy / Neuromuscular Blockade / Pneumoperitoneum / Rating Scales / Surgical Conditions1
4CompletedOtherNeuromuscular Blockade1
4CompletedPreventionLaparoscopic Cholecystectomy1
4CompletedPreventionOrotracheal Intubation1
4CompletedPreventionPostoperative Confusion1
4CompletedPreventionPostoperative Residual Curarization / Residual Neuromuscular Block1
4CompletedPreventionPostoperative pain1
4CompletedPreventionProstate Hypertrophy / Renal Diseases1
4CompletedPreventionPost-gastrointestinal bypass surgery1
4CompletedScreeningAnaesthesia therapy / Neuromuscular Blockade1
4CompletedSupportive CareEsophageal Cancers / General Surgery / Neuromuscular Block1
4CompletedSupportive CareHysterectomy (MeSH nr: E04.950.300.399)1
4CompletedSupportive CareLaparoscopic Renal Surgery / Laparoscopy / Muscle Relaxation1
4CompletedTreatmentAirway Reflexes, Protective / Anesthetic Recovery / Recovery After Neuromuscular Block1
4CompletedTreatmentAnaesthesia1
4CompletedTreatmentAnaesthesia therapy1
4CompletedTreatmentCaesarean Sections / Pregnancy1
4CompletedTreatmentCirrhosis and Chronic Liver Disease1
4CompletedTreatmentGallbladder disorders1
4CompletedTreatmentIntubation, Endotracheal1
4CompletedTreatmentIntubations1
4CompletedTreatmentLaparoscopic Herniotomy1
4CompletedTreatmentLaparoscopy / Neuromuscular Blockade / Pain1
4CompletedTreatmentMuscle Relaxation1
4CompletedTreatmentMuscle Relaxation Caused by Sevoflurane1
4CompletedTreatmentNeuromuscular Blockade1
4CompletedTreatmentRespiratory Distress Syndrome (RDS)1
4CompletedTreatmentSepsis / Shock, Septic / Systemic Inflammatory Response Syndrome (SIRS)1
4CompletedTreatmentSurgical Conditions1
4Enrolling by InvitationSupportive CareHemodynamics Instability1
4Enrolling by InvitationTreatmentAnesthesia Complication / Hemodynamics Instability / Ileus paralytic / Nausea / Postoperative pain / Vomiting1
4Not Yet RecruitingNot AvailableInguinal Hernias1
4Not Yet RecruitingSupportive CareAnaesthesia therapy1
4Not Yet RecruitingTreatmentGynecology / Surgery, Laparoscopic1
4Not Yet RecruitingTreatmentIntubation Complications1
4Not Yet RecruitingTreatmentLaryngoscopic Surgical Procedures1
4Not Yet RecruitingTreatmentNeuromuscular Block1
4Not Yet RecruitingTreatmentNeuromuscular Blockade1
4RecruitingOtherAnaesthesia therapy / Muscle Relaxation1
4RecruitingPreventionHypoxemia1
4RecruitingSupportive CareBladder Cancers / Malignant Neoplasms of Urinary Tract1
4RecruitingSupportive CareBypass, Gastric / Laparoscopic Bariatric Surgery / Obesity, Morbid / Post-gastrointestinal bypass surgery / Robotic Bariatric Surgery1
4RecruitingTreatmentChronic Kidney Disease (CKD) / Endometriosis / Gallbladder Inflammation / Intestinal Obstruction / Leiomyomas / Prostate Cancer / Uterine Prolapse1
4RecruitingTreatmentComatose / Major Trauma / Respiratory Distress / Shock1
4RecruitingTreatmentAdjunct to general anesthesia therapy / Hip Fractures / Neuromuscular Blockade / Spinal Anaesthesia1
4RecruitingTreatmentNeuromuscular Block1
4RecruitingTreatmentNeuromuscular Blockade1
4RecruitingTreatmentPost-operative Residual Curarization1
4TerminatedTreatmentAnaesthesia therapy1
4Unknown StatusNot AvailablePain1
4Unknown StatusPreventionPostoperative Confusion1
4Unknown StatusSupportive CareInjection Site Irritation1
4Unknown StatusTreatmentCesarean Section1
4Unknown StatusTreatmentPerioperative/Postoperative Complications / PORC (Postoperative Residual Curarization)1
4Unknown StatusTreatmentAdjunct to general anesthesia therapy1
4WithdrawnNot AvailableNeuromuscular Blockade1
Not AvailableCompletedNot AvailableAnaesthesia therapy2
Not AvailableCompletedNot AvailableAnaesthesia therapy / Effects of Dexmedetomidine / Elderly Patients / Emergence From Anesthesia / Recovery From Anesthesia1
Not AvailableCompletedNot AvailableHepatic Failure1
Not AvailableCompletedNot AvailableInguinal Hernias / Intubation, Endotracheal / Laryngeal Masks / Smooth muscle relaxation prior to radiological procedures1
Not AvailableCompletedNot AvailableIntubating Conditions1
Not AvailableCompletedNot AvailableNeuromuscular Blockade2
Not AvailableCompletedNot AvailableNeuromuscular Monitoring1
Not AvailableCompletedBasic ScienceIntraoperative Complications / Laparoscopy / Postoperative Complications / Surgical Complications From General Anesthesia / Ventilator-Induced Lung Injury1
Not AvailableCompletedPreventionAcute Respiratory Distress Syndrome (ARDS) / Tidal Volume / Ventilations, Mechanical1
Not AvailableCompletedPreventionAdjunct to general anesthesia therapy / Breast Diseases1
Not AvailableCompletedPreventionFentanyl-induced Coughing1
Not AvailableCompletedPreventionIschemia, Cerebral1
Not AvailableCompletedPreventionLaryngeal Injuries1
Not AvailableCompletedPreventionAdjunct to general anesthesia therapy1
Not AvailableCompletedSupportive CareCardiac Arrest / Critical Illness1
Not AvailableCompletedSupportive CareContinuous Positive Airway Pressure (CPAP) / Hypoxic Ventilatory Response / Neuromuscular Blockade / OSA / Rocuronium1
Not AvailableCompletedSupportive CareRobot-Assisted Laparoscopic Radical Prostatectomy1
Not AvailableCompletedTreatmentAdverse Effect of Other General Anesthetics1
Not AvailableCompletedTreatmentAnaesthesia therapy / Neuromuscular Blockade1
Not AvailableCompletedTreatmentComplication of Ventilation Therapy / Observation of Neuromuscular Block1
Not AvailableCompletedTreatmentElectroconvulsive Therapy / Neuromuscular Blockade1
Not AvailableCompletedTreatmentFasciculations / Intubating Conditions / Patients Satisfaction / Postoperative Myalgia / Throat Pain1
Not AvailableNot Yet RecruitingDiagnosticMuscle Weakness / Neuromuscular Block / Orthopedic Disorder of Spine1
Not AvailableNot Yet RecruitingTreatmentGeneral Surgery / Neuromuscular Block1
Not AvailableNot Yet RecruitingTreatmentNeuromuscular Blockade1
Not AvailableNot Yet RecruitingTreatmentObesity, Morbid1
Not AvailableRecruitingNot AvailableEffect of a Neuromuscular Block on Ventilation1
Not AvailableRecruitingNot AvailablePregnancy1
Not AvailableRecruitingBasic ScienceCancer of Bladder1
Not AvailableRecruitingBasic ScienceEnd Stage Renal Disease (ESRD) / Transplantations1
Not AvailableRecruitingDiagnosticCurarisation / Neuromuscular Monitoring1
Not AvailableRecruitingDiagnosticLaparoscopic Cholecystectomy1
Not AvailableRecruitingDiagnosticPain, Menstrual1
Not AvailableRecruitingOtherAdjunct to general anesthesia therapy1
Not AvailableRecruitingPreventionIntubation; Difficult or Failed1
Not AvailableRecruitingSupportive CareAnaesthesia therapy1
Not AvailableRecruitingTreatmentAnaesthesia therapy / General Surgery / Pain1
Not AvailableRecruitingTreatmentNeuromuscular Blockade1
Not AvailableUnknown StatusNot AvailableC.Delivery; Surgery (Previous), Gynecological1
Not AvailableUnknown StatusTreatmentObesity, Morbid1

Pharmacoeconomics

Manufacturers
  • App pharmaceuticals llc
  • Bioniche pharma usa llc
  • Hospira inc
  • Sagent pharmaceuticals inc
  • Sandoz canada inc
  • Teva parenteral medicines inc
  • Schering corp
Packagers
Dosage forms
FormRouteStrength
InjectionIntravenous10 mg/mL
Injection, solutionIntravenous10 mg/mL
Injection, solutionIntravenous100 mg/10mL
Injection, solutionIntravenous50 mg/5mL
SolutionIntravenous10 mg/mL
LiquidIntravenous10 mg
SolutionIntravenous10 mg
Prices
Unit descriptionCostUnit
Zemuron 10 mg/ml vial4.62USD ml
Rocuronium 100 mg/10 ml vial2.66USD ml
Rocuronium 50 mg/5 ml vial1.08USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubilityCompleteNot Available
Predicted Properties
PropertyValueSource
Water Solubility2.84e-05 mg/mLALOGPS
logP2.71ALOGPS
logP-0.33ChemAxon
logS-7.3ALOGPS
pKa (Strongest Acidic)14.59ChemAxon
pKa (Strongest Basic)7.96ChemAxon
Physiological Charge2ChemAxon
Hydrogen Acceptor Count4ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area59 Å2ChemAxon
Rotatable Bond Count6ChemAxon
Refractivity161.65 m3·mol-1ChemAxon
Polarizability62.87 Å3ChemAxon
Number of Rings6ChemAxon
Bioavailability1ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption-0.9444
Blood Brain Barrier+0.8569
Caco-2 permeable-0.5336
P-glycoprotein substrateSubstrate0.8559
P-glycoprotein inhibitor IInhibitor0.7889
P-glycoprotein inhibitor IIInhibitor0.9009
Renal organic cation transporterNon-inhibitor0.7222
CYP450 2C9 substrateNon-substrate0.8008
CYP450 2D6 substrateNon-substrate0.7534
CYP450 3A4 substrateSubstrate0.7272
CYP450 1A2 substrateNon-inhibitor0.9103
CYP450 2C9 inhibitorNon-inhibitor0.8856
CYP450 2D6 inhibitorNon-inhibitor0.8763
CYP450 2C19 inhibitorNon-inhibitor0.8423
CYP450 3A4 inhibitorNon-inhibitor0.8582
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9119
Ames testNon AMES toxic0.7601
CarcinogenicityNon-carcinogens0.9353
BiodegradationNot ready biodegradable0.946
Rat acute toxicity2.9310 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.8607
hERG inhibition (predictor II)Non-inhibitor0.8146
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as steroid esters. These are compounds containing a steroid moiety which bears a carboxylic acid ester group.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Steroids and steroid derivatives
Sub Class
Steroid esters
Direct Parent
Steroid esters
Alternative Parents
Androgens and derivatives / 3-alpha-hydroxysteroids / N-alkylpyrrolidines / Morpholines / Tetraalkylammonium salts / Trialkylamines / Secondary alcohols / 1,2-aminoalcohols / Amino acids and derivatives / Cyclic alcohols and derivatives
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Substituents
Steroid ester / Androgen-skeleton / Androstane-skeleton / 3-hydroxysteroid / 3-alpha-hydroxysteroid / Hydroxysteroid / N-alkylpyrrolidine / Oxazinane / Morpholine / Quaternary ammonium salt
show 29 more
Molecular Framework
Aliphatic heteropolycyclic compounds
External Descriptors
quaternary ammonium ion, androstane, 3alpha-hydroxy steroid (CHEBI:8884)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Drug binding
Specific Function
After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.
Gene Name
CHRNA2
Uniprot ID
Q15822
Uniprot Name
Neuronal acetylcholine receptor subunit alpha-2
Molecular Weight
59764.82 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
  3. Jonsson Fagerlund M, Dabrowski M, Eriksson LI: Pharmacological characteristics of the inhibition of nondepolarizing neuromuscular blocking agents at human adult muscle nicotinic acetylcholine receptor. Anesthesiology. 2009 Jun;110(6):1244-52. doi: 10.1097/ALN.0b013e31819fade3. [PubMed:19417616]
  4. Jonsson M, Gurley D, Dabrowski M, Larsson O, Johnson EC, Eriksson LI: Distinct pharmacologic properties of neuromuscular blocking agents on human neuronal nicotinic acetylcholine receptors: a possible explanation for the train-of-four fade. Anesthesiology. 2006 Sep;105(3):521-33. [PubMed:16931985]
  5. Liu M, Dilger JP: Synergy between pairs of competitive antagonists at adult human muscle acetylcholine receptors. Anesth Analg. 2008 Aug;107(2):525-33. doi: 10.1213/ane.0b013e31817b4469. [PubMed:18633030]
  6. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
G-protein coupled acetylcholine receptor activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM2
Uniprot ID
P08172
Uniprot Name
Muscarinic acetylcholine receptor M2
Molecular Weight
51714.605 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
  3. Milchert M, Spassov A, Meissner K, Nedeljkov V, Lehmann C, Wendt M, Loster BW, Mazurkiewicz-Janik M, Gedrange T, Pavlovic D: Skeletal muscle relaxants inhibit rat tracheal smooth muscle tone in vitro. J Physiol Pharmacol. 2009 Dec;60 Suppl 8:5-11. [PubMed:20400785]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
General Function
Voltage-gated potassium channel activity
Specific Function
This is one of the several different receptors for 5-hydroxytryptamine (serotonin), a biogenic hormone that functions as a neurotransmitter, a hormone, and a mitogen. This receptor is a ligand-gate...
Gene Name
HTR3A
Uniprot ID
P46098
Uniprot Name
5-hydroxytryptamine receptor 3A
Molecular Weight
55279.835 Da
References
  1. Min KT, Wu CL, Yang J: Nondepolarizing neuromuscular blockers inhibit the serotonin-type 3A receptor expressed in Xenopus oocytes. Anesth Analg. 2000 Feb;90(2):476-81. [PubMed:10648343]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Secondary active organic cation transmembrane transporter activity
Specific Function
Translocates a broad array of organic cations with various structures and molecular weights including the model compounds 1-methyl-4-phenylpyridinium (MPP), tetraethylammonium (TEA), N-1-methylnico...
Gene Name
SLC22A1
Uniprot ID
O15245
Uniprot Name
Solute carrier family 22 member 1
Molecular Weight
61153.345 Da
References
  1. van Montfoort JE, Muller M, Groothuis GM, Meijer DK, Koepsell H, Meier PJ: Comparison of "type I" and "type II" organic cation transport by organic cation transporters and organic anion-transporting polypeptides. J Pharmacol Exp Ther. 2001 Jul;298(1):110-5. [PubMed:11408531]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent transport of organic anions such as sulfobromophthalein (BSP) and conjugated (taurocholate) and unconjugated (cholate) bile acids (By similarity). Selectively inhibit...
Gene Name
SLCO1A2
Uniprot ID
P46721
Uniprot Name
Solute carrier organic anion transporter family member 1A2
Molecular Weight
74144.105 Da
References
  1. van Montfoort JE, Hagenbuch B, Fattinger KE, Muller M, Groothuis GM, Meijer DK, Meier PJ: Polyspecific organic anion transporting polypeptides mediate hepatic uptake of amphipathic type II organic cations. J Pharmacol Exp Ther. 1999 Oct;291(1):147-52. [PubMed:10490898]

Drug created on June 13, 2005 07:24 / Updated on November 19, 2017 20:33