patient information leaflet esmeron

Information for the patient

What you should know about Esmeron

Before you receive your medicine please read this leaflet carefully.

If you have any questions or worries, ask your anaesthetist.

What is in this medicine

Active substance

The active substance of Esmeron is rocuronium bromide.

Other substances:

Sodium acetate, sodium chloride, acetic acid and water for injections. Each millilitre (ml) of Esmeron contains 1.72 mg of sodium.

Esmeron is a solution for intravenous injection or infusion containing 10 mg/ml rocuronium bromide. It is available in vials containing 50 mg or 100 mg of rocuronium bromide.

How this medicine works and what it is used for

Esmeron is one of a group of drugs called muscle relaxants. Muscle relaxants are used during an operation as part of the general anaesthetic. When you have an operation your muscles must be completely relaxed. This makes it easier for the surgeon to perform the operation. Normally the nerves send messages to the muscles by impulses. Esmeron acts by blocking these impulses so that the muscles are relaxed. Because the muscles needed for breathing also become relaxed you will need help with your breathing (artificial respiration) during and after your operation until you can breathe on your own. During the operation the effect of the muscle relaxant is constantly checked and if necessary some more drug is given. At the end of surgery the effects of the drug are allowed to wear off and you can start breathing on you own. Sometimes another drug is given to help speed this up. Esmeron may also be used in Intensive Care Units to keep your muscles relaxed.

When Esmeron should not be given

This medicine should not be given:

if you are allergic to rocuronium or the bromide ion

Precautions and possible problems

Before you receive this medicine you must tell your anaesthetist if you have now or have ever had one of the following conditions:

kidney, heart or liver disease
diseases affecting nerves and muscles, (poliomyelitis, myasthenia gravis, Eaton-Lambert syndrome)
allergy to rocuronium, the bromide ion or other muscle relaxants
A serious condition called malignant hyperthermia where you have a very severe fever

When you are ill you may suffer from certain conditions which may influence the effects of Esmeron for example:

low calcium levels in the blood (hypocalcaemia)
low potassium levels in the blood (hypokalaemia)
high magnesium levels in the blood (hypermagnesaemia)
low levels of protein in the blood (hypoproteinaemia)
too much carbon dioxide in the blood (acidosis)
loss of too much water from the body, eg by being sick, diarrhoea or sweating (dehydration)
overbreathing (hyperventilation) leading to too little carbon dioxide in the blood (alkalosis)
general ill-health (cachexia)

If you are suffering from any of these conditions your anaesthetist will take it into account when deciding the correct dose of Esmeron for you.

If you are pregnant, or suspect that you are pregnant, or if you are breast-feeding, then you must tell your anaesthetist.

However Esmeron may be given to you if you undergo a Caesarean section.

Other medicines may influence the effects of Esmeron or vice versa.

You must tell your anaesthetist if you are taking (or intend to take) other medicines, such as:

antibiotics
diuretics (water pills)
medicines for heart disease or high blood pressure
acetylcholinesterase inhibitors (medicines for the treatment of myasthenia gravis)
corticosteroids
medicines for epilepsy
thiamine (vitamin B1)
some antidepressants such as carbamazepine, phenelzine, isocarboxazid
some laxatives such as magnesium salts, pyridostigmine
theophylline (medicine for asthma)
azathioprine (a medicine used to slow rejection of organ transplants)

You may be given other medicines during surgery which can alter the effects of Esmeron. These include certain anaesthetics, other muscle relaxants, protamine, agents which reverse the effects of Esmeron and calcium chloride. Your anaesthetist will take this into account when he is deciding the correct dose of Esmeron for you.

Ability to drive vehicles or to operate machinery

You should not use potentially dangerous machinery or drive a car within 24 hours after the full recovery from the effects of Esmeron.

Using this medicine properly

How much

The normal dose is 0.6 mg per kg body weight and the effect will last 30–40 minutes. The dose is adjusted to your needs by your anaesthetist. Your anaesthetist will take into account the anaesthetic, the expected duration of surgery, other drugs you have been given and your state of health.

How it is administered

Esmeron will be given to you by your anaesthetist.
Esmeron is given intravenously, either as single
injections or as a continuous infusion.

Overdose

As your anaesthetist will be monitoring your condition during the procedure it is unlikely that you will be given too much Esmeron. However if this happens and your lungs are not working your anaesthetist will make sure that you continue breathing artificially until you can breathe on your own. You may need to be kept asleep while recovery takes place however this is not unusual.

Side-effects this medicine may have

Possibly:

itching or rash near the site of injection
hypotension (lowering of blood pressure), tachycardia (increase in heart rate)
broncospasm (wheezing)

Rarely:

allergic reactions

If these side effects occur during treatment they will be seen and treated by your anaesthetist.

If you have any other unpleasant effects which you think may be due to this medicine you should tell your anaesthetist.

Storing Esmeron

This drug should not be used after the ‘Use by’ date.

The hospital will keep Esmeron according to the correct storage conditions.

Medicine: esmeron