rocuronium Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definitionDrug idCAS RN
neuromuscular blocking agents with rigid structure 2396 119302-91-9

Description:

MoleculeDescription

Molfile Inchi Smiles

Synonyms:

  • ORG-9426
  • ORG 9426
  • rocuronium
  • rocuronium bromide
  • zemuron
  • esmeron
Rocuronium bromide is a nondepolarizing neuromuscular blocking agent with a rapid to intermediate onset depending on dose and intermediate duration. It acts by competing for cholinergic receptors at the motor end-plate. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine and edrophonium.
  • Molecular weight: 529.79
  • Formula: C32H53N2O4
  • CLOGP: 2.43
  • LIPINSKI: 1
  • HAC: 6
  • HDO: 1
  • TPSA: 59
  • ALOGS: -7.30
  • ROTB: 6

  • Status: OFP

  • Legend:
    OFP - off patent
    OFM - off market
    ONP - on patent

Drug dosage:

None

ADMET properties:

PropertyValueReference
BDDCS (Biopharmaceutical Drug Disposition Classification System) 3 Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine) 17 % Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose) 0.38 ┬ÁM/kg/day Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
Vd (Volume of distribution) 0.21 L/kg Lombardo F, Berellini G, Obach RS
CL (Clearance) 3.70 mL/min/kg Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma) 0.54 % Lombardo F, Berellini G, Obach RS
t_half (Half-life) 1.60 hours Lombardo F, Berellini G, Obach RS

Approvals:

DateAgencyCompanyOrphan
March 17, 1994 FDA ORGANON USA INC

FDA Adverse Event Reporting System (Female)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Anaphylactic reaction 1266.06 28.78 443 8175 52669 46624775
Anaphylactic shock 841.70 28.78 258 8360 20016 46657428
Neuromuscular block prolonged 447.93 28.78 79 8539 467 46676977
Bronchospasm 406.79 28.78 140 8478 15567 46661877
Cardiac arrest 366.49 28.78 220 8398 90179 46587265
Hypotension 334.01 28.78 302 8316 232287 46445157
Circulatory collapse 216.97 28.78 97 8521 21527 46655917
Delayed recovery from anaesthesia 203.70 28.78 44 8574 817 46676627
Tachycardia 201.36 28.78 158 8460 99464 46577980
Stress cardiomyopathy 173.06 28.78 62 8556 7722 46669722
Serotonin syndrome 164.29 28.78 83 8535 24137 46653307
Therapeutic product effect prolonged 130.56 28.78 26 8592 317 46677127
Bradycardia 124.86 28.78 101 8517 66197 46611247
Recurrence of neuromuscular blockade 119.21 28.78 20 8598 83 46677361
Wrist surgery 103.85 28.78 25 8593 763 46676681
Hypoventilation 103.78 28.78 36 8582 4074 46673370
Finger deformity 103.10 28.78 38 8580 5124 46672320
Drug interaction 99.03 28.78 152 8466 202942 46474502
Unwanted awareness during anaesthesia 98.13 28.78 20 8598 276 46677168
Airway peak pressure increased 98.13 28.78 20 8598 276 46677168
Neuromuscular blockade 96.33 28.78 20 8598 304 46677140
Urticaria 92.09 28.78 111 8507 117781 46559663
Tenosynovitis 85.95 28.78 37 8581 7478 46669966
Ventricular tachycardia 83.54 28.78 47 8571 16920 46660524
Pulseless electrical activity 81.03 28.78 35 8583 7132 46670312
Paralysis 80.67 28.78 37 8581 8684 46668760
Breast cancer recurrent 78.87 28.78 29 8589 3882 46673562
Fatigue 74.11 28.78 12 8606 608685 46068759
Type I hypersensitivity 72.82 28.78 24 8594 2322 46675122
Oxygen saturation decreased 70.79 28.78 75 8543 69089 46608355
Blood pressure decreased 69.45 28.78 68 8550 57091 46620353
Limb operation 68.23 28.78 25 8593 3313 46674131
Anaphylactoid reaction 63.50 28.78 24 8594 3467 46673977
Ventricular fibrillation 62.50 28.78 34 8584 11462 46665982
Apnoea 61.25 28.78 29 8589 7310 46670134
Diarrhoea 59.81 28.78 15 8603 559587 46117857
Endotracheal intubation complication 58.48 28.78 14 8604 417 46677027
Haemodynamic instability 56.83 28.78 28 8590 7697 46669747
Headache 54.74 28.78 11 8607 478341 46199103
Postoperative delirium 51.78 28.78 9 8609 48 46677396
Nausea 51.34 28.78 32 8586 687422 45990022
Airway complication of anaesthesia 50.82 28.78 11 8607 206 46677238
Hyperthermia malignant 50.80 28.78 14 8604 735 46676709
Anaesthetic complication 50.09 28.78 17 8601 1800 46675644
Exposure during pregnancy 48.42 28.78 78 8540 108134 46569310
Anaphylactoid shock 47.09 28.78 11 8607 294 46677150
Arthralgia 47.02 28.78 6 8612 364597 46312847
Hypoxia 45.70 28.78 52 8566 51786 46625658
Subcutaneous emphysema 44.94 28.78 13 8605 814 46676630
Hyperreflexia 44.57 28.78 21 8597 5233 46672211
Premature delivery 44.41 28.78 35 8583 22034 46655410
Dystonia 44.35 28.78 27 8591 11230 46666214
Procedural hypotension 44.26 28.78 14 8604 1188 46676256
Muscle rigidity 42.12 28.78 25 8593 9936 46667508
Respiratory acidosis 41.44 28.78 21 8597 6127 46671317
Fall 41.03 28.78 6 8612 329091 46348353
Laryngospasm 39.05 28.78 16 8602 2857 46674587
Tracheal injury 38.16 28.78 7 8611 53 46677391
Skin test positive 37.30 28.78 11 8607 737 46676707
Vasoplegia syndrome 37.25 28.78 12 8606 1080 46676364
Clonus 36.75 28.78 17 8601 4063 46673381
Maternal exposure during pregnancy 36.75 28.78 67 8551 102482 46574962
Maternal exposure during delivery 36.36 28.78 11 8607 805 46676639
Erythema 35.33 28.78 80 8538 142740 46534704
Anticholinergic syndrome 34.97 28.78 13 8605 1793 46675651
Myasthenic syndrome 34.13 28.78 8 8610 217 46677227
Atrioventricular dissociation 34.13 28.78 8 8610 217 46677227
Muscle twitching 33.30 28.78 25 8593 14647 46662797
Carcinoid crisis 33.29 28.78 8 8610 242 46677202
Endotracheal intubation 32.68 28.78 13 8605 2152 46675292
Vomiting 32.44 28.78 22 8596 452772 46224672
Angioedema 32.20 28.78 38 8580 39304 46638140
Pulmonary oedema 31.73 28.78 43 8575 51062 46626382
Post procedural stroke 31.30 28.78 6 8612 59 46677385
Therapeutic product effect increased 29.82 28.78 10 8608 1020 46676424
Spirometry abnormal 29.75 28.78 7 8611 193 46677251
Coronary artery embolism 29.69 28.78 7 8611 195 46677249
Tryptase increased 29.32 28.78 7 8611 206 46677238

FDA Adverse Event Reporting System (Male)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Anaphylactic shock 645.79 23.05 209 7512 13784 29930973
Anaphylactic reaction 615.44 23.05 241 7480 27741 29917016
Hyperthermia malignant 336.53 23.05 81 7640 1753 29943004
Neuromuscular block prolonged 295.09 23.05 55 7666 314 29944443
Hypotension 198.28 23.05 250 7471 200315 29744442
Bronchospasm 174.97 23.05 74 7647 10264 29934493
Cardiac arrest 172.97 23.05 162 7559 92688 29852069
Recurrence of neuromuscular blockade 148.10 23.05 26 7695 99 29944658
Delayed recovery from anaesthesia 118.09 23.05 29 7692 682 29944075
Bradycardia 117.35 23.05 112 7609 65414 29879343
Pulseless electrical activity 100.37 23.05 43 7678 6144 29938613
Negative pressure pulmonary oedema 97.21 23.05 20 7701 202 29944555
Tachycardia 90.52 23.05 103 7618 73636 29871121
Kounis syndrome 89.33 23.05 28 7693 1645 29943112
Respiratory depression 88.74 23.05 48 7673 11455 29933302
Blood pressure decreased 85.21 23.05 81 7640 46994 29897763
Anaesthetic complication 83.52 23.05 24 7697 1045 29943712
Haemodynamic instability 74.80 23.05 38 7683 7977 29936780
Procedural hypotension 71.18 23.05 21 7700 1004 29943753
Airway complication of anaesthesia 69.91 23.05 14 7707 122 29944635
Oxygen saturation decreased 69.72 23.05 70 7651 43370 29901387
Arteriospasm coronary 69.65 23.05 26 7695 2592 29942165
Electrocardiogram ST segment elevation 69.17 23.05 30 7691 4412 29940345
Neuromuscular blockade 67.99 23.05 14 7707 142 29944615
Hypoventilation 62.53 23.05 25 7696 2998 29941759
Endotracheal intubation complication 62.11 23.05 15 7706 328 29944429
Fatigue 61.31 23.05 6 7715 320667 29624090
Serotonin syndrome 53.28 23.05 41 7680 17850 29926907
Circulatory collapse 53.06 23.05 43 7678 20171 29924586
Ventricular tachycardia 50.80 23.05 45 7676 23817 29920940
Ventricular fibrillation 50.20 23.05 37 7684 15101 29929656
Respiratory arrest 48.48 23.05 48 7673 29210 29915547
Hypoxia 44.25 23.05 58 7663 47796 29896961
Intensive care unit acquired weakness 44.08 23.05 14 7707 858 29943899
Unwanted awareness during anaesthesia 43.63 23.05 8 7713 41 29944716
Respiratory acidosis 42.37 23.05 21 7700 4181 29940576
Airway peak pressure increased 41.67 23.05 7 7714 19 29944738
Hypoxic-ischaemic encephalopathy 40.20 23.05 21 7700 4666 29940091
Rhabdomyolysis 39.72 23.05 64 7657 63516 29881241
Multiple organ dysfunction syndrome 38.43 23.05 63 7658 63424 29881333
Thyrotoxic crisis 36.68 23.05 10 7711 358 29944399
Cardio-respiratory arrest 36.22 23.05 58 7663 57248 29887509
Death 34.79 23.05 25 7696 357258 29587499
Hypotonic-hyporesponsive episode 34.79 23.05 6 7715 20 29944737
Brain oedema 33.85 23.05 27 7694 12371 29932386
Anaesthetic complication neurological 32.91 23.05 9 7712 326 29944431
Propofol infusion syndrome 32.10 23.05 11 7710 855 29943902
Acidosis 31.52 23.05 24 7697 10277 29934480
Tachypnoea 31.42 23.05 28 7693 14924 29929833
Pulmonary oedema 29.85 23.05 46 7675 43929 29900828
Therapeutic product effect decreased 29.63 23.05 37 7684 29039 29915718
Blood catecholamines increased 29.15 23.05 5 7716 16 29944741
Respiratory failure 28.61 23.05 73 7648 100569 29844188
Fear 28.33 23.05 23 7698 10802 29933955
Dizziness 27.66 23.05 8 7713 194901 29749856
Urticaria 27.54 23.05 50 7671 54556 29890201
Apnoea 27.05 23.05 18 7703 6240 29938517
Endotracheal intubation 26.96 23.05 13 7708 2437 29942320
Fall 26.67 23.05 7 7714 181865 29762892
Pulmonary alveolar haemorrhage 26.23 23.05 18 7703 6563 29938194
Oromandibular dystonia 25.73 23.05 8 7713 457 29944300
Anaphylactoid reaction 25.27 23.05 12 7709 2174 29942583
Therapeutic product effect prolonged 24.95 23.05 7 7714 279 29944478
Anticholinergic syndrome 24.94 23.05 9 7712 815 29943942
Diarrhoea 24.69 23.05 30 7691 334073 29610684
Electrocardiogram ST segment depression 24.39 23.05 12 7709 2350 29942407
Hyperkalaemia 24.32 23.05 53 7668 65957 29878800
Atrioventricular block complete 24.30 23.05 19 7702 8458 29936299
Laryngospasm 23.99 23.05 10 7711 1333 29943424
Prinzmetal angina 23.88 23.05 9 7712 920 29943837
Drug ineffective 23.60 23.05 159 7562 340228 29604529
Headache 23.21 23.05 9 7712 182297 29762460

Pharmacologic Action:

SourceCodeDescription
ATC M03AC09 MUSCULO-SKELETAL SYSTEM
MUSCLE RELAXANTS
MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS
Other quaternary ammonium compounds
FDA EPC N0000175720 Nondepolarizing Neuromuscular Blocker
FDA PE N0000175732 Neuromuscular Nondepolarizing Blockade
CHEBI has role CHEBI:51371 muscle relaxants
MeSH PA D009465 Neuromuscular Agents
MeSH PA D009466 Neuromuscular Blocking Agents
MeSH PA D003473 Neuromuscular Nondepolarizing Agents
MeSH PA D018373 Peripheral Nervous System Agents

Drug Use (View source of the data)

DiseaseRelationSNOMED_IDDOID
Muscle relaxation, function indication 11977004
General anesthesia indication 50697003
Skeletal Muscle Relaxation for Endotracheal Intubation indication
Respiratory acidosis contraindication 12326000
Alkalosis contraindication 21420006
Acidosis contraindication 51387008
Eaton-Lambert syndrome contraindication 56989000 DOID:0050214
Pulmonary hypertension contraindication 70995007 DOID:6432
Kidney disease contraindication 90708001 DOID:557
Myasthenia gravis contraindication 91637004 DOID:437
Respiratory alkalosis contraindication 111378004
Disease of liver contraindication 235856003 DOID:409
Disorder of electrolytes contraindication 237840007
Malignant hyperthermia contraindication 405501007

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation levelDissociation constantType (acidic/basic)
pKa1 7.61 Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

TargetClassPharosUniProtActionTypeActivity value
(-log[M])
Mechanism
action
Bioact sourceMoA source
Acetylcholine receptor Ion channel ANTAGONIST IC50 7.77 WOMBAT-PK CHEMBL
Acetylcholine receptor; alpha1/beta1/delta/gamma Ion channel IC50 7.09 CHEMBL

External reference:

IDSource
D00765 KEGG_DRUG
143558-00-3 SECONDARY_CAS_RN
4020866 VANDF
C0209337 UMLSCUI
CHEBI:8885 CHEBI
CHEMBL1200648 ChEMBL_ID
CHEMBL1201244 ChEMBL_ID
D000077123 MESH_DESCRIPTOR_UI
441351 PUBCHEM_CID
4003 IUPHAR_LIGAND_ID
6864 INN_ID
DB00728 DRUGBANK_ID
WRE554RFEZ UNII
151718 RXNORM
1460 MMSL
159147 MMSL
5433 MMSL
d03766 MMSL
004442 NDDF
013418 NDDF
108449002 SNOMEDCT_US
108450002 SNOMEDCT_US
372494005 SNOMEDCT_US

Pharmaceutical products:

ProductCategoryIngredientsNDCFormQuantityRouteMarketingLabel
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 0143-9250 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 0143-9251 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 0409-9558 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 0409-9558 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 0781-3220 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 25021-662 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 27 sections
rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 39822-4200 SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 43066-007 INJECTION 50 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 43066-013 INJECTION 100 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 47781-616 INJECTION 10 mg INTRAVENOUS ANDA 25 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 47781-617 INJECTION 10 mg INTRAVENOUS ANDA 25 sections
ROCURONIUM BROMIDE HUMAN PRESCRIPTION DRUG LABEL 1 51662-1354 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 18 sections
ROCURONIUM BROMIDE HUMAN PRESCRIPTION DRUG LABEL 1 51662-1355 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 18 sections
Rocuronium Bromide Human Prescription Drug Label 1 55150-225 INJECTION, SOLUTION 50 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide Human Prescription Drug Label 1 55150-226 INJECTION, SOLUTION 100 mg INTRAVENOUS ANDA 26 sections
Rocuronium HUMAN PRESCRIPTION DRUG LABEL 1 63323-426 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium HUMAN PRESCRIPTION DRUG LABEL 1 66794-228 INJECTION, SOLUTION 50 mg INTRAVENOUS ANDA 17 sections
Rocuronium HUMAN PRESCRIPTION DRUG LABEL 1 66794-229 INJECTION, SOLUTION 100 mg INTRAVENOUS ANDA 17 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 67457-228 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide Human Prescription Drug Label 1 68083-364 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide Human Prescription Drug Label 1 68083-365 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 70860-651 SOLUTION 10 mg INTRAVENOUS ANDA 27 sections
Rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 71479-004 INJECTION, SOLUTION 100 mg INTRAVENOUS ANDA 29 sections
Rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 71479-005 INJECTION, SOLUTION 50 mg INTRAVENOUS ANDA 29 sections
rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 71872-7036 SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
rocuronium bromide HUMAN PRESCRIPTION DRUG LABEL 1 71872-7202 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 27 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 71872-7207 INJECTION, SOLUTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 71872-7211 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 72572-650 INJECTION 10 mg INTRAVENOUS ANDA 26 sections
Rocuronium Bromide HUMAN PRESCRIPTION DRUG LABEL 1 72572-651 INJECTION 10 mg INTRAVENOUS ANDA 26 sections