• Muscle relaxant


  • Nondepolarizing skeletal muscle relaxant


  • Adjunct to general anesthesia to facilitate intubation and skeletal muscle relaxation



  • Pregnancy category C

  • Only used by skilled personnel in airway management and respiratory support.

  • Must have anticholinesterase reversal agents immediately available during use.

  • Will cause histamine release.  Use with caution in patients susceptible to histamine, such as cardiovascular disease and asthma.

  • Contains benzyl alcohol that may cause “gasping syndrome” in premature infants.

  • May cause bradycardia during anesthesia.

  • Use with caution in patients with neuromuscular disease.

  • May cause malignant hyperthermia in susceptible patients.

  • Use a peripheral nerve stimulator to monitor twitch suppression and recovery.

  • IM injection may cause tissue irritation.

Adverse Reactions (Side Effects):

  • Cardiovascular: hypotension (up to 14%), vasodilation (up to 9%), tachycardia (up to 5%), bradycardia

  • Dermatologic: rash, urticaria, injection-site reactions

  • Respiratory: dyspnea, broncho- and laryngospasm



  • Administered via IV injection (IM may cause tissue irritation)

  • Bolus:

    • Initial adult dose: 0.4-0.5mg/kg IV bolus

    • Maintenance adult dose: 0.08-0.1mg/kg every 15-25 minutes to maintain blockade

  • Pediatric dose:

    • Children > 2 years old: no adjustments needed

    • Children 1 month – 2 years old: 0.3-0.4mg/kg

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