Literature DB >> 20825252

Safety, tolerability and pharmacokinetics of sugammadex using single high doses (up to 96 mg/kg) in healthy adult subjects: a randomized, double-blind, crossover, placebo-controlled, single-centre study.

Pierre A M Peeters1, Michiel W van den Heuvel, Emiel van Heumen, Paul C C M Passier, Jean M W Smeets, Thijs van Iersel, Alex Zwiers.   

Abstract

BACKGROUND AND
OBJECTIVE: Sugammadex facilitates rapid reversal of rocuronium- and vecuronium-induced neuromuscular blockade. This study aimed to evaluate the safety, tolerability and pharmacokinetics of high doses of sugammadex (up to 96 mg/kg) in healthy subjects.
METHODS: In this randomized, double-blind, crossover, placebo-controlled, single-centre study, 13 healthy adults were scheduled to receive three single intravenous doses of sugammadex in ascending order (32, 64 and 96 mg/kg) and placebo (interspersed between sugammadex doses), each separated by a 1-week washout period. Subjects were randomized to one of four treatment sequences, receiving doses as constant rate infusions over 5 minutes. Safety was assessed by adverse events, 12-lead ECGs, vital signs, and blood and urine laboratory parameters; pharmacokinetics were evaluated from blood and urine sugammadex concentrations.
RESULTS: Sugammadex was well tolerated in 12 of the 13 subjects, with adverse events being generally mild, of limited duration and more frequent at higher doses. The most common adverse event was dysgeusia; there were no serious adverse events. One subject was withdrawn from the study after experiencing several adverse events following first exposure to sugammadex, related to a probable hypersensitivity reaction to sugammadex. Pharmacokinetics were dose linear over the dose range studied (32-96 mg/kg), and 90-93% of the sugammadex dose was excreted unchanged in urine within 48 hours.
CONCLUSION: High doses of sugammadex (up to 96 mg/kg) were well tolerated in 12 of the 13 subjects. One male subject experienced several adverse events associated with a probable hypersensitivity reaction to sugammadex. Pharmacokinetics were dose linear over the range 32-96 mg/kg, with elimination predominantly via the renal route.

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Year:  2010        PMID: 20825252     DOI: 10.1007/bf03256915

Source DB:  PubMed          Journal:  Clin Drug Investig        ISSN: 1173-2563            Impact factor:   2.859


  17 in total

1.  A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host.

Authors:  Anton Bom; Mark Bradley; Ken Cameron; John K Clark; Jan Van Egmond; Helen Feilden; Elizabeth J MacLean; Alan W Muir; Ronald Palin; David C Rees; Ming-Qiang Zhang
Journal:  Angew Chem Int Ed Engl       Date:  2002-01-18       Impact factor: 15.336

Review 2.  Residual neuromuscular blockade: incidence, assessment, and relevance in the postoperative period.

Authors:  G S Murphy
Journal:  Minerva Anestesiol       Date:  2006-03       Impact factor: 3.051

3.  First human exposure of Org 25969, a novel agent to reverse the action of rocuronium bromide.

Authors:  Francois Gijsenbergh; Steven Ramael; Natalie Houwing; Thijs van Iersel
Journal:  Anesthesiology       Date:  2005-10       Impact factor: 7.892

4.  Effective reversal of moderate rocuronium- or vecuronium-induced neuromuscular block with sugammadex, a selective relaxant binding agent.

Authors:  Koen Suy; Karl Morias; Guy Cammu; Pol Hans; Wilbert G F van Duijnhoven; Marten Heeringa; Ignace Demeyer
Journal:  Anesthesiology       Date:  2007-02       Impact factor: 7.892

5.  Sugammadex reversal of rocuronium-induced neuromuscular blockade: a comparison with neostigmine-glycopyrrolate and edrophonium-atropine.

Authors:  Ozlem Sacan; Paul F White; Burcu Tufanogullari; Kevin Klein
Journal:  Anesth Analg       Date:  2007-03       Impact factor: 5.108

6.  Reversal of rocuronium-induced neuromuscular block with the novel drug sugammadex is equally effective under maintenance anesthesia with propofol or sevoflurane.

Authors:  Bernard F Vanacker; Karel M Vermeyen; Michel M R F Struys; Henk Rietbergen; Eugene Vandermeersch; Vera Saldien; Alain F Kalmar; Martine E Prins
Journal:  Anesth Analg       Date:  2007-03       Impact factor: 5.108

7.  Reversal of neuromuscular blockade and simultaneous increase in plasma rocuronium concentration after the intravenous infusion of the novel reversal agent Org 25969.

Authors:  Ola Epemolu; Anton Bom; Frank Hope; Rona Mason
Journal:  Anesthesiology       Date:  2003-09       Impact factor: 7.892

8.  Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers.

Authors:  G Cammu; P J De Kam; I Demeyer; M Decoopman; P A M Peeters; J M W Smeets; L Foubert
Journal:  Br J Anaesth       Date:  2008-01-31       Impact factor: 9.166

Review 9.  Cyclodextrins.

Authors:  Valentino J Stella; Quanren He
Journal:  Toxicol Pathol       Date:  2008-01       Impact factor: 1.902

10.  Reversal of rocuronium-induced (1.2 mg kg-1) profound neuromuscular block by accidental high dose of sugammadex (40 mg kg-1).

Authors:  A L Molina; H D de Boer; M Klimek; M Heeringa; J Klein
Journal:  Br J Anaesth       Date:  2007-03-08       Impact factor: 9.166

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  16 in total

1.  Effects of sugammadex on immunoreactivity of calcineurin in rat testes cells after neuromuscular block: a pilot study.

Authors:  Yıldıray Kalkan; Levent Tümkaya; Habib Bostan; Yakup Tomak; Adnan Yılmaz
Journal:  J Mol Histol       Date:  2011-12-29       Impact factor: 2.611

2.  Effects of sugammadex doses up to 32 mg/kg alone or in combination with rocuronium or vecuronium on QTc prolongation: a thorough QTc study.

Authors:  Pieter-Jan de Kam; Jacqueline van Kuijk; Marita Prohn; Torben Thomsen; Pierre Peeters
Journal:  Clin Drug Investig       Date:  2010       Impact factor: 2.859

3.  Population pharmacokinetic-pharmacodynamic analysis for sugammadex-mediated reversal of rocuronium-induced neuromuscular blockade.

Authors:  Huub J Kleijn; Daniel P Zollinger; Michiel W van den Heuvel; Thomas Kerbusch
Journal:  Br J Clin Pharmacol       Date:  2011-09       Impact factor: 4.335

4.  The effect of rocuronium, sugammadex, and their combination on cardiac muscle and diaphragmatic skeletal muscle cells.

Authors:  Yildiray Kalkan; Habib Bostan; Levent Tumkaya; Yakup Tomak; Mehmet Bostan; Adnan Yilmaz; Hasan Turut; Ahmet Temiz; Alper Yalçin; Alparslan Turan
Journal:  J Anesth       Date:  2012-07-14       Impact factor: 2.078

5.  Prediction of optimal reversal dose of sugammadex after rocuronium administration in adult surgical patients.

Authors:  Shigeaki Otomo; Hajime Iwasaki; Kenichi Takahoko; Yoshiko Onodera; Tomoki Sasakawa; Takayuki Kunisawa; Hiroshi Iwasaki
Journal:  Anesthesiol Res Pract       Date:  2014-02-11

6.  Three suspected cases of sugammadex-induced anaphylactic shock.

Authors:  Tomonori Takazawa; Yukinari Tomita; Nagahide Yoshida; Akihiro Tomioka; Tatsuo Horiuchi; Chie Nagata; Masaki Orihara; Makiko Hardy Yamada; Shigeru Saito
Journal:  BMC Anesthesiol       Date:  2014-10-17       Impact factor: 2.217

7.  In the hour of Sugammadex.

Authors:  Jin Young Chon
Journal:  Korean J Anesthesiol       Date:  2013-01-21

8.  Comparative study between sugammadex and neostigmine in neurosurgical anesthesia in pediatric patients.

Authors:  Ayman A Ghoneim; Mohammed A El Beltagy
Journal:  Saudi J Anaesth       Date:  2015 Jul-Sep

9.  The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade.

Authors:  Soon Ho Cheong; Seunghee Ki; Jiyong Lee; Jeong Han Lee; Myoung-Hun Kim; Dongki Hur; Kwangrae Cho; Se Hun Lim; Kun Moo Lee; Young-Jae Kim; Wonjin Lee
Journal:  Korean J Anesthesiol       Date:  2015-11-25

Review 10.  Sugammadex as a reversal agent for neuromuscular block: an evidence-based review.

Authors:  Stefan Josef Schaller; Heidrun Fink
Journal:  Core Evid       Date:  2013-09-25
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