Succinylcholine

Pronunciation

Generic Name: succinylcholine (SUX-i-nil-KOE-leen)
Brand Name: Examples include Anectine and Quelicin

Succinylcholine has been associated with rapid muscle breakdown resulting in life-threatening heart rhythms, cardiac arrest, and death in children. These children appeared to be healthy, but were later found to have certain undiagnosed muscle problems (eg, Duchenne muscular dystrophy). Male children and children younger than 8 years old seem to be at a higher risk. Cases have also been reported in adolescents. Because it is hard to determine which children may be at risk, succinylcholine should only be used in an emergency situation.


Succinylcholine is used for:

Relaxing muscles during surgery or when using a breathing machine (ventilator). It is also used to induce anesthesia or when a tube must be inserted in the windpipe. It may also be used for other conditions as determined by your doctor.

Succinylcholine is a depolarizing muscle relaxant. It works by keeping muscles from contracting, which causes paralysis of the muscles in the face and those used to breathe and move.

Do NOT use succinylcholine if:

  • you are allergic to any ingredient in succinylcholine
  • you have recently had a severe burn, trauma, nerve damage, or an upper body movement injury
  • you have a personal or family history of muscle disease or malignant hyperthermia (a life-threatening state that includes high body temperatures)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using succinylcholine:

Some medical conditions may interact with succinylcholine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to another neuromuscular blocking agent (eg, pancuronium)
  • if you have glaucoma, blood electrolyte problems (eg, high or low potassium levels, low calcium levels), liver or kidney problems, a tumor that has spread, an infection, anemia, a certain thyroid problem (myxedema), stomach or intestinal ulcers, decompensated heart problems, decreased activity or deficiency of plasma cholinesterase, a bone fracture, or muscle spasms
  • if you are dehydrated or have recently had eye surgery or an eye injury
  • if you have or have a history of stomach infections or bleeding in the brain

Some MEDICINES MAY INTERACT with succinylcholine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Digoxin because the risk of abnormal heart rhythms may be increased
  • Aminoglycosides (eg, gentamicin), aprotinin, beta-adrenergic blockers (eg, propranolol), chloroquine, clindamycin, cyclophosphamide, glucocorticoids (eg, prednisone), lidocaine, lithium, magnesium salts, metoclopramide, oral contraceptives (eg, birth control pills), oxytocin, procainamide, promazine, quinidine, quinine, terbutaline, or trimethaphan because they may increase the risk of succinylcholine's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if succinylcholine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use succinylcholine:

Use succinylcholine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Succinylcholine is given as an injection at your doctor's office, hospital, or clinic.
  • Do not use succinylcholine if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of succinylcholine, contact your doctor right away.

Ask your health care provider any questions you may have about how to use succinylcholine.

Important safety information:

  • Malignant hyperthermia is a possibly fatal syndrome that can be caused by succinylcholine. Symptoms may include fast heartbeat, fast breathing, high body temperature, or spasm or stiffness of the jaw or other muscles. Contact your doctor at once if you have any of these symptoms.
  • Tell your doctor or dentist that you take succinylcholine before you receive any medical or dental care, emergency care, or surgery.
  • Succinylcholine should only be used in CHILDREN in emergency situations. Rare, serious side effects have occurred in children who have received succinylcholine.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using succinylcholine while you are pregnant. If you are or will be breast-feeding while you use succinylcholine, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of succinylcholine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Increased saliva; muscle pain following surgery; muscle twitching.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast breathing; fast, slow, or irregular heartbeat; flushing; high body temperature; increased pressure in the eye; pauses in breathing; pounding in the chest; severe muscle pain with or without decreased urination; severe or persistent dizziness or headache; slowed or shallow breathing; tightening of the jaw or other muscles.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include muscle weakness; slowed breathing or pauses in breathing.

Proper storage of succinylcholine:

Succinylcholine is usually handled and stored by a health care provider. If you are using succinylcholine at home, store succinylcholine as directed by your pharmacist or health care provider. Keep succinylcholine out of the reach of children and away from pets.

General information:

  • If you have any questions about succinylcholine, please talk with your doctor, pharmacist, or other health care provider.
  • Succinylcholine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take succinylcholine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about succinylcholine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to succinylcholine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using succinylcholine.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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