Vecuronium bromide

Vecuronium bromide
Clinical data
Trade namesNorcuron, others
AHFS/Drugs.comMonograph
License data
Routes of
administration
Intravenous
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability100% (IV)
Metabolismliver 30%
Onset of action< 1 min[1]
Elimination half-life51–80 minutes (longer with kidney failure)
Duration of action15–30 min[2]
ExcretionFecal (40–75%) and kidney (30% as unchanged drug and metabolites)
Identifiers
IUPAC name
  • [(2S,3S,5S,8R,9S,10S,13S,14S,16S,17S)-17-Acetyloxy-10,13-dimethyl-16-(1-methyl-3,4,5,6-tetrahydro-2H-pyridin-1-yl)-2-(1-piperidyl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-3-yl] acetate bromide
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.051.549
Chemical and physical data
FormulaC34H57BrN2O4
Molar mass637.744 g·mol−1
3D model (JSmol)
SMILES
  • CC(=O)O[C@H]1C[C@@H]2CC[C@@H]3[C@@H]([C@]2(C[C@@H]1N4CCCCC4)C)CC[C@]5([C@H]3C[C@@H]([C@@H]5OC(=O)C)[N+]6(CCCCC6)C)C.[Br-]
InChI
  • InChI=1S/C34H57N2O4.BrH/c1-23(37)39-31-20-25-12-13-26-27(34(25,4)22-29(31)35-16-8-6-9-17-35)14-15-33(3)28(26)21-30(32(33)40-24(2)38)36(5)18-10-7-11-19-36;/h25-32H,6-22H2,1-5H3;1H/q+1;/p-1/t25-,26+,27-,28-,29-,30-,31-,32-,33-,34-;/m0./s1 N
  • Key:VEPSYABRBFXYIB-PWXDFCLTSA-M N
 NY (what is this?)  (verify)

Vecuronium bromide, sold under the brand name Norcuron among others, is a medication used as part of general anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation.[1] It is also used to help with endotracheal intubation; however, agents such as suxamethonium (succinylcholine) or rocuronium are generally preferred if this needs to be done quickly.[1] It is given by injection into a vein.[1] Effects are greatest at about 4 minutes and last for up to an hour.[1]

Side effects may include low blood pressure and prolonged paralysis.[3] Allergic reactions are rare.[4] It is unclear if use in pregnancy is safe for the baby.[1]

Vecuronium is in the aminosteroid neuromuscular-blocker family of medications and is of the non-depolarizing type.[1] It works by competitively blocking the action of acetylcholine on skeletal muscles.[1] The effects may be reversed with sugammadex or a combination of neostigmine and glycopyrrolate. To minimize residual blockade, reversal should only be attempted if some degree of spontaneous recovery has been achieved.[1]

Vecuronium was approved for medical use in the United States in 1984[1] and is available as a generic medication.[1] It is on the World Health Organization's List of Essential Medicines.[5]

  1. ^ a b c d e f g h i j k "Vecuronium Bromide". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
  2. ^ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 23. ISBN 9781284057560.
  3. ^ "NORCURON 10mg - Summary of Product Characteristics (SPC) - (eMC)". www.medicines.org.uk. 4 August 2000. Archived from the original on 20 December 2016. Retrieved 16 December 2016.
  4. ^ World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 431. hdl:10665/44053. ISBN 9789241547659.
  5. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.