This medicine suits most people, but there are a few people who should not be given it. Ask yourself these questions to help check whether it is right for you:

• Have you ever had an allergy (rash, itching, shortness of breath) or bad reaction to Anectine or suxamethonium?
• Have you ever reacted abnormally to muscle relaxants (for example an unexpectedly long action)? You may have been given a card stating that this has happened in the past
• Have you, or any of your close relatives, ever had a very high body temperature (malignant hyperthermia) during anaesthesia or after being given suxamethonium?
• Have you had a major accident, surgical operation or severe burn within the last three months?
• Do you have a muscle wasting disease, paralysis, motor neurone disease or cerebral palsy?
• Have you been immobilised for a long period, for example to allow a broken bone to mend or a long period of bed rest?
• Do you have a high level of potassium in your blood (hyperkalaemia)?
• Have you recently had an eye injury?
• Do you have, or are you being treated for, raised pressure of fluid in the eyes (glaucoma)?
• Do you or any of your family have any disease resulting in muscle weakness or abnormal muscle growth (e.g. Duchenne muscular dystrophy, myotonia congenita or dystrophy myotonia)?

If the answer to any of these questions is "YES", tell your doctor.

Anectine is given under carefully controlled (and often emergency) conditions by an experienced doctor. It must be used with special care in certain situations. Please tell your doctor if you know you are suffering from any of the following:

• A severe or long-standing infection such as tuberculosis
• Tetanus
• Liver or kidney disease
• Cancer
• Auto-immune disease
• Any long-standing illness which has left you weak
• Anaemia
• Malnutrition
• An under-active thyroid gland (myxoedema)
• Muscle weakness, tiredness or difficulty in co-ordinating your movements (myasthenia gravis)

Please also tell your doctor if;

• you have given birth in the last 6 weeks, are pregnant, trying to become pregnant or breast feeding

 

• you have recently had a blood transfusion or a heart-lung bypass

Are you taking other medicines?

Anectine Injection may interact with other medicines. It is important to let your doctor know if you are taking any of the following (please check with your doctor if you are not sure) :

• Ecothiopate eye drops
• The antihistamines diphenhydramine and promethazine contained in some cough and cold remedies, mild sleeping tablets and medicines used to treat allergic reactions
• Oestrogens, steroids and oral contraceptives
• Quinine and chloroquine, used to treat malaria
• Terbutaline, used in the treatment of asthma and other breathing conditions
• Medicines used to treat cancer (cytotoxic drugs): cyclophosphamide, mechlorethamine, triethylene-melamine and thiotepa
• Metoclopramide, used to treat and prevent feeling and being sick
• Medicines used in psychiatry: phenelzine, promazine, chlorpromazine, lithium
• Medicines containing magnesium
• Azathioprine used in auto-immune conditions and to prevent rejection of transplants
• Anaesthetic drugs and agents used during surgery: ketamine, morphine, morphine antagonists, pethidine, pancuronium, tacrine hydrochloride, halothane, enflurane, desflurane, isoflurane, diethylether and methoxyflurane. These medications are always given by highly trained health professionals
• Certain antibiotics (check with your doctor)
• Medicines used to treat disturbances in heartbeat rhythm (antiarrhythmic drugs): verapamil, betablockers, quinidine, procainamide, lignocaine and procaine
• Trimetaphan, used to control blood pressure during surgical operations
• Medicines used mainly in the treatment of the condition myasthenia gravis: neostigmine, pyridostigmine, physostigmine and edrophonium. Some of these medicines may also be used during surgery
• Have you been in contact with certain insecticides, called organophosphorus insecticides, or the insecticide metriphonate? If so, tell your doctor
• Please also tell your doctor if you are taking drugs to control your heart, such as digitalis or digoxin

Instructions to open the ampoule

Ampoules are equipped with the OPC (One Point Cut) opening system and must be opened using the following instructions:

• hold with the hand the bottom part of the ampoule as indicated in picture 1
• put the other hand on the top of the ampoule positioning the thumb above the coloured point and press as indicated in picture 2

Can an overdose with Anectine be given?

The effects of Anectine are monitored carefully throughout your operation and appropriate action can be taken promptly if you receive too much.

Side-effects which may happen during the operation:

• changes to the normal heartbeat or blood pressure
• interference with normal breathing, resulting in wheezing and shortness of breath; difficulty in drawing breath; a reduced breathing rate or shallow breathing
• muscle twitches or spasms
• a raised body temperature
• excessive production of saliva
• skin flushing

Side-effects which may happen after the operation:

• painful muscles
• a raised pressure of fluid in the eye which may result in headache or blurred vision
• abdominal cramps or pain and a feeling of nausea or "fullness"
• rash