Vecuronium bromide

Vecuronium bromide
Clinical data
Trade names	Norcuron, others
AHFS/Drugs.com	Monograph
License data	US DailyMed: Vecuronium bromide;
Routes of; administration	Intravenous
ATC code	M03AC03 (WHO) ;
Legal status
Legal status	US: ℞-only;
Pharmacokinetic data
Bioavailability	100% (IV)
Metabolism	liver 30%
Onset of action	< 1 min
Elimination half-life	51–80 minutes (longer with kidney failure)
Duration of action	15–30 min
Excretion	Fecal (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	50700-72-6 ;
PubChem CID	39764;
DrugBank	DB01339 ;
ChemSpider	36357 ;
UNII	7E4PHP5N1D;
KEGG	D00767;
ChEMBL	ChEMBL1201219 ;
CompTox Dashboard (EPA)	DTXSID1023736 ;
ECHA InfoCard	100.051.549
Chemical and physical data
Formula	C34H57BrN2O4
Molar mass	637.744 g·mol−1
3D model (JSmol)	Interactive image;
	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 ; Key:VEPSYABRBFXYIB-PWXDFCLTSA-M ;
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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. 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. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.

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

Vecuronium is in the aminosteroid neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by competitively blocking the action of acetylcholine on skeletal muscles. 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.

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