Pancuronium

Pancuronium is a prescription medication used to provide skeletal muscle relaxation during endotracheal intubation and as general anesthesia for surgery. 

• Pancuronium is available under the following different brand names: Pavulon

Adult and pediatric dosage

Injectable solution

• 1mg/mL
• 2mg/mL

General Anesthesia Adjunct/Caesarean Section

Adult dosage

• Load: 0.04-0.1 mg/kg IV  
• Maintenance: 0.015-0.1 mg/kg IV every 30-60min OR
• Continuous infusion: 0.1 mg/kg/hour IV
• The dose should be calculated based on ideal body weight
• Monitoring of muscle twitch response to a peripheral nerve stimulator is advised
• Pediatric dosage
• Neonates less than 28 days old:
  • Load: 0.02 mg/kg IV  
  • Maintenance: 0.05-0.1 mg/kg IV every 0.5-4hours or as needed
• Children more than 1 month old: 
  • Load: 0.04-0.1 mg/kg IV  
  • Maintenance: 0.015-0.1 mg/kg IV every 30-60min OR
  • Continual infusion: 0.1 mg/kg/hour IV

Endotracheal Intubation

Adult dosage

• Bolus dose 0.06-0.1 mg/kg  
• Usually effective within 2-3 minutes

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Pancuronium include:

• flushing,
• increased saliva,
• rash,
• bronchospasm,
• muscle weakness,
• low or high blood pressure, and
• rapid heartbeat.

Serious side effects of Pancuronium include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• increased blood pressure,
• increased cardiac work,
• fast heartbeat,
• double vision,
• drooping eyelids,
• trouble talking,
• difficulty walking,
• paralysis,
• drooling, and
• low blood pressure.

Rare side effects of Pancuronium include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Pancuronium has severe interactions with no other drugs.
• Pancuronium has serious interactions with at least 29 other drugs.
• Pancuronium has moderate interactions with at least 111 other drugs.
• Pancuronium has minor interactions with at least 37 other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Lack of ventilatory support, neuromuscular disease
• Hypersensitive to drug &/or bromides

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Pancuronium?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Pancuronium?”

Cautions

• Additive/synergistic effects if administered with or following an opioid, sedative, or anesthetic agent
• Use caution in patients with poor renal perfusion or severe renal disease, preexisting tachycardia
• Adequate ventilatory support mandatory may experience resistance with more than 25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)
• Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life-threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken.

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Not known if excreted in breast milk; effect on nursing infant not known