Survec® is indicated as an adjunct to general anesthesia to facilitate tracheal intubation and provide skeletal muscle relaxation during surgery.

Dosage

In adult patients, the following dosage recommendations may serve as a general guideline for tracheal intubation and muscle relaxation for short to long-lasting surgical procedures.

Tracheal Intubation

The standard intubating dose during routine anesthesia is 0.08 to 0.1 mg of Vecuronium bromide per kg of body weight, after which adequate intubation conditions are established within 90 to 120 seconds in nearly all patients.

Recommended Doses

0.03 to 0.05 mg of Vecuronium bromide per kg of body weight.

If suxamethonium is used for intubation, the administration of Survec® should be delayed until the patient has clinically recovered from the neuromuscular block induced by suxamethonium.

Maintenance Dosing

Alternatively, to obtain a solution with a lower concentration, Survec® 10 mg may be reconstituted with a volume of up to 10 mL of the following infusion fluids:

5% glucose injection fluid

0.9% sodium chloride injection fluid

Lactated Ringer's solution

Lactated Ringer's solution for injection and 5% glucose

Glucose 5% and 0.9% sodium chloride injection

Side effects are rare (<1/1000). The most commonly occurring side effects include changes in vital signs and prolonged neuromuscular block.

Pregnancy

There are insufficient data on the use of Survec® during animal or human pregnancy to assess potential harm to the fetus. Survec® should be given to a pregnant woman only when the attending physician decides that the benefits outweigh the risks.

Lactation

There is no human data on the use of Survec® during lactation. Survec® should be given to lactating women only when the attending physician decides that the benefits outweigh the risks.

In the event of an overdose and prolonged neuromuscular block, the patient should continue to receive ventilatory support and sedation. Upon the start of spontaneous recovery, an acetylcholinesterase inhibitor should be administered in adequate doses. If the administration of an acetylcholinesterase-inhibiting agent fails to reverse the neuromuscular effects of Survec®, ventilation must be continued until spontaneous breathing is restored.

The recommended maintenance dose is 0.02 to 0.03 mg of Vecuronium bromide per kg of body weight. Repeated administration of an acetylcholinesterase inhibitor can be dangerous.

The same intubation and maintenance doses as for younger adults (0.08-0.1 mg/kg and 0.02-0.03 mg/kg, respectively) can be used. However, the duration of action is prolonged in elderly patients compared to younger subjects due to changes in pharmacokinetic mechanisms. The onset time in elderly patients is similar to that of younger adults.

In cesarean sections and neonatal surgery, the dose should not exceed 0.1 mg/kg.

Survec® should be administered following reconstitution. It is administered intravenously either as a bolus injection or as a continuous infusion.

The addition of 5 mL of water for injection results in an isotonic solution of pH 4 containing 2 mg of Vecuronium bromide per mL (2 mg/mL).

Store at a temperature not exceeding 25°C in a dry place. Protect from light.

Medicine: Keep out of reach of children.