Suxamethonium chloride

Suxamethonium chloride, [Scoline, Sucostrin] also known as suxamethonium or succinylcholine, or simply sux by medical abbreviation, is a medication used to cause short-term paralysis as part of general anesthesia. This is done to help with tracheal intubation or electroconvulsive therapy. It is administered by injection, either into a vein or into a muscle. When used in a vein, onset of action is generally within one minute and effects last for up to 10 minutes.

Suxamethonium chloride
Clinical data
Pronunciation/ˌsʌksɪnɪlˈkoʊliːn/
Trade namesQuelicin, Anectine, others
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: A
Routes of
administration		Intravenous, intramuscular
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: WARNINGRx-only
Pharmacokinetic data
BioavailabilityNA
MetabolismBy pseudocholinesterase, to succinylmonocholine and choline
Onset of action30–60 sec (IV), 2–3 min (IM)
Duration of action< 10 min (IV), 10–30 min (IM)
ExcretionKidney (10%)
Identifiers
  • 2,2'-[(1,4-dioxobutane-1,4-diyl)bis(oxy)]bis
    (N,N,N-trimethylethanaminium)
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC14H30Cl2N2O4
Molar mass361.30 g·mol−1
3D model (JSmol)
  • [Cl-].[Cl-].O=C(OCC[N+](C)(C)C)CCC(=O)OCC[N+](C)(C)C
  • InChI=1S/C14H30N2O4.2ClH/c1-15(2,3)9-11-19-13(17)7-8-14(18)20-12-10-16(4,5)6;;/h7-12H2,1-6H3;2*1H/q+2;;/p-2 Y
  • Key:YOEWQQVKRJEPAE-UHFFFAOYSA-L Y
 NY (what is this?)  (verify)

Common side effects include low blood pressure, increased saliva production, muscle pain, and rash. Serious side effects include malignant hyperthermia, hyperkalemia and allergic reactions. It is not recommended in people who are at risk of high blood potassium or a history of myopathy. Use during pregnancy appears to be safe for the baby.

Suxamethonium is in the neuromuscular blocker family of medications and is of the depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.

Suxamethonium was described as early as 1906 and came into medical use in 1951. It is on the World Health Organization's List of Essential Medicines. Suxamethonium is available as a generic medication.

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