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Rapacuronium, an aminosteroid non-depolarizing neuromuscular blocking agent with a rapid onset and a comparatively short duration of action [ , ], was withdrawn from the US market in March 2001 and subsequently worldwide. The manufacturers informed the FDA in an open letter about postmarketing reports of severe bronchospasm and some deaths of unknown origin associated with rapacuronium. The severity of the incidents recently reported to the manufacturers was impressive enough to cause fears about patient safety. This event highlights the need for continued surveillance, not only during clinical trials but also during the routine use of approved drugs.
A major adverse reaction to rapacuronium is an increase in heart rate [ ]. Plasma histamine concentrations may increase after rapacuronium injection, but this was not correlated with changes in blood pressure or heart rate [ ].
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