Bromuro de vecuronio
Vecuronium Bromide
También conocido como: Norcuron · Curlem · Rivecrum · Vecural · Org-NC-45 · Vecuronium bromide · Vecuronii bromidum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Muscle relaxation during anesthesia | 0.1 mg/kg | IV | initially (after meperidine and/or acepromazine pre-op 30 minutes before); may give subsequent incremental doses of 0.04 mg/kg | — | 🌎 NA |
| Muscle relaxation during anesthesia | 10-20 micrograms/kg | IV | — | — | 🌎 NA |
| Muscle relaxation (CRI maintenance with propofol-fentanyl) | 0.2 mg/kg/hr | IV | CRI | — | 🌎 NA |
| Muscle relaxation (CRI maintenance with fentanyl-isoflurane or fentanyl-sevoflurane) | 0.1 mg/kg/hr | IV | CRI | — | 🌎 NA |
| Neuromuscular blockade (loading dose) | 0.1 mg/kg | IV | initially | Produces blockade for 25-30 min | 🌍 EU |
| Neuromuscular blockade (maintenance) | 0.03 mg/kg increments OR 0.1-0.2 mg/kg/h | IV | PRN or CRI | As needed during surgery | 🌍 EU |
| Reversal of neuromuscular blockade | 8 mg/kg | IV | once | Immediate | 🌍 EU |
- Muscle relaxation during anesthesia: Duration of action after initial dose averages 25 minutes.
- Neuromuscular blockade (loading dose): Lower loading dose of 0.05 mg/kg IV produces shorter duration (16-19 min).
- Neuromuscular blockade (maintenance): Repeated doses are relatively non-cumulative in healthy animals.
- Reversal of neuromuscular blockade: Dose for Sugammadex to reverse vecuronium-induced blockade.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Muscle relaxation during anesthesia | 20-40 micrograms/kg (0.02-0.04 mg/kg) | IV | — | — | 🌎 NA |
| Neuromuscular blockade (loading dose) | 0.1 mg/kg | IV | initially | Produces blockade for 25-30 min | 🌍 EU |
| Neuromuscular blockade (maintenance) | 0.03 mg/kg increments OR 0.1-0.2 mg/kg/h | IV | PRN or CRI | As needed during surgery | 🌍 EU |
- Neuromuscular blockade (loading dose): Lower loading dose of 0.05 mg/kg IV produces shorter duration (16-19 min).
- Neuromuscular blockade (maintenance): Repeated doses are relatively non-cumulative in healthy animals.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El bromuro de vecuronio es un agente bloqueante neuromuscular no despolarizante aminosteroideo sintético de acción intermedia.
Las características clínicas clave incluyen:
- Adyuvante quirúrgico: Se utiliza principalmente como adyuvante de la anestesia general para producir una relajación profunda del músculo esquelético.
- Facilita procedimientos: Ideal para facilitar la intubación endotraqueal, la ventilación mecánica y procedimientos quirúrgicos delicados (p. ej., cirugías oftálmicas u ortopédicas).
- Estabilidad cardiovascular: A diferencia de otros bloqueantes neuromusculares, causa efectos cardiovasculares mínimos y, por lo general, no desencadena la liberación de histamina.
- Uso en aves: Se ha utilizado tópicamente para inducir midriasis (dilatación pupilar) en aves, ya que los iris aviares contienen músculo estriado.
PERLA CLÍNICA CRÍTICA: El vecuronio NO posee propiedades analgésicas, sedantes ni amnésicas. Paraliza todos los músculos esqueléticos, incluido el diafragma. Los pacientes deben estar completamente anestesiados, inconscientes y recibiendo ventilación mecánica a presión positiva antes y durante toda su administración.
Mecanismo de acción
Vecuronium acts as a competitive antagonist at the nicotinic cholinergic receptors (nAChRs) located at the motor endplate of the neuromuscular junction.
- Mechanism: Vecuronium binds to the alpha subunits of the nAChR → prevents acetylcholine (ACh) from binding → inhibits depolarization of the muscle fiber → results in flaccid paralysis.
- Potency: It is highly potent, estimated to be equipotent to up to 3 times as potent as pancuronium on a weight basis, but with a shorter duration of action (approximately ⅓ to ½ as long).
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to vecuronium or bromides
- Conscious or inadequately anesthetized animals
- Lack of facilities for positive pressure ventilation/mechanical ventilation
- Severe hepatic dysfunction (relative contraindication; atracurium preferred)
Efectos adversos
- Profound, prolonged musculoskeletal paralysis (pharmacologic effect)
- Skeletal muscle weakness
- Respiratory arrest (if mechanical ventilation is not provided)
- Prolonged apnea (expected pharmacological effect)
- No cardiovascular effects or histamine release reported at clinical doses
Precauciones
- Ventilation Required: Must only be used when facilities for intubation and mechanical ventilation are immediately available.
- Organ Dysfunction: Use with caution in patients with severe renal dysfunction. Lower doses may be necessary in patients with hepatic or biliary disease due to delayed clearance and prolonged recovery times.
- Myasthenia Gravis: Neuromuscular blocking agents should be used with extreme caution, if at all, in patients with myasthenia gravis (though one successful case in a dog has been reported).
- Pregnancy: FDA Category C. Animal studies show adverse fetal effects, but adequate human/veterinary studies are lacking. Use only if benefits outweigh risks.
- No Analgesia: Does not provide pain relief or sedation. Ensure adequate depth of anesthesia.
Interacciones farmacológicas
May have a synergistic effect if used concurrently with vecuronium.
May speed the onset of action and enhance the neuromuscular blocking actions of vecuronium; do not give vecuronium until succinylcholine effects have subsided.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Monitorización
- Level of neuromuscular relaxation (using a peripheral nerve stimulator/train-of-four monitor)
- Heart rate, blood pressure, and ECG
- SpO2 and End-tidal CO2 (capnography)
- Core body temperature
- Neuromuscular function (Peripheral nerve stimulator / Train-of-Four)
- Continuous respiratory monitoring (Capnography/ETCO2, SpO2)
- Heart rate and blood pressure
- Acid-base and electrolyte status (especially potassium)
Farmacocinética
Vida media
Absorción
Onset of neuromuscular blockade after IV injection is dose-dependent. In dogs at 0.1 mg/kg IV, full block occurs within 2 minutes. Intratracheal administration (studied in rats) has a slower onset than IV but faster than IM, with a longer duration of action than IV.
Distribución
Distributes to the neuromuscular junction (motor endplate).
Metabolismo
Partially metabolized in the liver.
Eliminación
Vecuronium and its metabolites are excreted into the bile and urine. Clearance may be delayed in patients with significant renal or hepatic disease.
Sobredosis
No cases of vecuronium overdosage have been reported in human or veterinary medicine.
Treatment of Overdose:
- Treat conservatively with mechanical ventilation, oxygen therapy, and IV fluids until the block wears off naturally.
- Pharmacologic Reversal: Blockade can be reversed using an anticholinesterase agent (e.g., edrophonium, physostigmine, or neostigmine) combined with an anticholinergic (atropine or glycopyrrolate) to prevent severe bradycardia and excessive salivation.
- Suggested Reversal Protocol: Neostigmine 0.06 mg/kg IV administered after Atropine 0.02 mg/kg IV.
Productos disponibles
Formulaciones
- Powder for injection
- Injectable: 10 mg powder for reconstitution
Etiquetado para humanos
- Vecuronium Bromide Powder for Injection: 10 mg & 20 mg; in 10 mL & 20 mL vials, with and without diluent (Norcuron, generic)
- Norcuron 10 mg powder for solution for injection
Estado regulador
Available as a human POM (Prescription Only Medicine) used under the cascade.
POM. Used under the prescribing cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store commercially available powder at room temperature and protect from light. After reconstitution with sterile water, it is stable for 24 hours at 2-8°C or room temperature (<30°C) in the original container. Contains no preservative; discard unused portions. Do not mix with alkaline solutions (e.g., thiobarbiturates). Physically compatible with D5W, normal saline, D5 in normal saline, and lactated Ringer's.
Información para el cliente
Este medicamento es estrictamente para uso por profesionales veterinarios en un entorno hospitalario.
- Propósito: Es un relajante muscular utilizado durante cirugías complejas o cuando un paciente necesita ser conectado a un ventilador mecánico para ayudarle a respirar.
- Seguridad: Su mascota estará completamente dormida (bajo anestesia general) y no será consciente de su entorno antes de que se administre este fármaco. Debido a que relaja los músculos respiratorios, el equipo veterinario utilizará una máquina para respirar por su mascota mientras esté bajo los efectos del medicamento.
- Monitoreo: Su mascota será monitoreada continuamente por profesionales capacitados hasta que el efecto del medicamento desaparezca y pueda respirar cómodamente por sí misma.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.