 Molecular structure of rocuronium | |
 3D representation of a rocuronium molecule | |
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| Trade names | Esmeron, Zemuron |
| Other names | [3-hydroxy-10,13-dimethyl-2-morpholin-4-yl-16-(1-prop-2-enyl-2,3,4,5-tetrahydropyrrol-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl] acetate |
| AHFS/Drugs.com | Monograph |
| Routes of administration | Intravenous |
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| Pharmacokinetic data | |
| Bioavailability | NA |
| Protein binding | ~30% |
| Metabolism | some de-acetylation |
| Eliminationhalf-life | 66–80 minutes |
| Excretion | Unchanged, inbile andurine |
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| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.122.235 |
| Chemical and physical data | |
| Formula | C32H53BrN2O4 |
| Molar mass | 609.690 g·mol−1 |
| 3D model (JSmol) | |
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 N Y (what is this?) (verify) | |
Rocuronium bromide (brand namesZemuron,Esmeron), also referred to as "roc",[2] is anaminosteroidnon-depolarizingneuromuscular blocker ormuscle relaxant used in modernanaesthesia to facilitatetracheal intubation by providingskeletal muscle relaxation forsurgery ormechanical ventilation. It is used for standardendotracheal intubation, as well as forrapid sequence induction. It can also be used with other drugs formedical assistance in dying.[3]
Rocuronium bromide is acompetitive antagonist for thenicotinic acetylcholine receptors at the neuromuscular junction. Of theneuromuscular-blocking drugs it is considered to be a non-depolarizing neuromuscular junction blocker, because it acts by dampening the receptor action causing muscle relaxation, instead of continual depolarisation which is the mechanism of action of the depolarizing neuromuscular junction blockers, likesuccinylcholine.
It was designed to be a weaker antagonist at the neuromuscular junction thanpancuronium; hence its monoquaternary structure and its having anallyl group and a pyrrolidine group attached to the D ring quaternary nitrogen atom. Rocuronium has a rapid onset and intermediate duration of action.[4]
There is considered to be a risk of allergic reaction to the drug in some patients (particularly those withasthma), but a similar incidence of allergic reactions has been observed by using other members of the same drug class (non-depolarizing neuromuscular blocking drugs).[5]
The γ-cyclodextrin derivativesugammadex (trade name Bridion) is an agent to reverse the action of rocuronium by binding to it with high affinity.[6] Sugammadex has been in use since 2009 in many European countries; however, it was turned down for approval twice by the US FDA due to concerns over allergic reactions and bleeding,[7] but finally approved the medication for use during surgical procedures in the United States on December 15, 2015.[8] The acetylcholinesterase inhibitorneostigmine can also be used as a reversal agent of rocuronium but is not as effective as sugammadex. Neostigmine is often still used due to its low cost compared with sugammadex.[9]
It was introduced in 1994.
Since 2016, rocuronium bromide has been the standard drug, along withpropofol, administered to patients foreuthanasia in Canada.[10]
Rocuronium bromide is marketed under the brand name Zemuron in the United States and Esmeron in most other countries.[citation needed]
