What is in this leaflet
This leaflet answers some common questions about Esmeron.
It does not contain all the available information.
It does not take the place of talking to your doctor.
All medicines have risks and benefits. Your doctor has weighed the risks of you having Esmeron against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor.
Keep this leaflet. You may need to read it again.
What Esmeron is used for
Esmeron is one of a group of medicines called muscle relaxants.
Muscle relaxants are used during an operation as part of the general anaesthetic. When you have an operation, your muscles must be completely relaxed. This makes it easier for the surgeon to perform the operation.
Normally the nerves send messages to the muscles by impulses. Esmeron acts by blocking these impulses so the muscles are relaxed. Because the muscles needed for breathing also become relaxed you will need help with your breathing (artificial respiration) during and after your operation until you can breathe on your own. During the operation the effect of the muscle relaxant is constantly checked and if necessary some more drug is given. At the end of the operation the effects of Esmeron are allowed to wear off and you can start breathing on your own. Sometimes another drug is given to help speed this up. Esmeron can also be used in Intensive Care to keep your muscles relaxed.
Ask your doctor if you want any more information about this medicine.
Esmeron is not addictive.
Before you are given Esmeron
When you must not be given it
You must not be given Esmeron if you have an allergy to:
- any medicine containing rocuronium bromide
- any of the ingredients listed at the end of this leaflet
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Before you are given it
If you are going to have an operation it is important that you discuss the following points with your doctor, since it can influence the way Esmeron is given to you.
Tell your doctor if you have or have had any medical conditions, especially the following:
- an allergy to muscle relaxants
- kidney disease
- liver or gallbladder disease
- a heart disease
- diseases affecting nerves or muscles
- oedema (local or generalised swelling due to fluid)
Certain medical conditions may affect how Esmeron works.
- low potassium levels in the blood
- high magnesium levels in the blood
- low calcium levels in the blood
- low levels of protein in the blood
- too much acid in the blood
- too much carbon dioxide in the blood
- general ill-health
If you are suffering from any of these conditions your doctor will take this into account when deciding the correct dose of Esmeron for you.
Esmeron can be used in term newborn infants (0-28 days), infants (28 days-23 months), children (2-11 years), adolescents (12-18 years) and elderly patients but your doctor should first assess your medical history.
Elderly (65 years and older) may be at an increased risk of residual paralysis.
Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you are pregnant or plan to become pregnant or are breast-feeding. Your doctor will discuss the risks and benefits of using Esmeron if you are pregnant or breast-feeding.
If you have not told your doctor about any of the above, tell them before you are given Esmeron.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may be affected by Esmeron, or affect how well it works. These include:
- anaesthetics, medicines to make you sleep during surgery
- long term concurrent use of corticosteroids (anti-inflammatory medicines) and Esmeron in the Intensive Care Unit
- lithium, a medicine used to treat bipolar disorder
- medicines used to treat heart disease or high blood pressure (quinidine, calcium channel blockers, beta-blockers and diuretics (fluid tablets))
- quinine, a medicine used to treat malaria
- magnesium salts
- lidocaine (lignocaine) and bupivacaine (local anaesthetics)
- other muscle relaxants
- carbamazepine and phenytoin, medicines used to treat epilepsy
You may need to use different amounts of your medicines or take different medicines. Your doctor will advise you.
If you are taking magnesium sulfate to treat toxaemia of pregnancy (preeclampsia), tell your doctor as the dose of Esmeron may need to be reduced.
Your doctor will have a complete list of medicines that may cause problems when used with Esmeron.
How Esmeron is given
Esmeron will be given by a doctor. It will not be given to you until you are asleep from the anaesthetic.
It will be injected into a vein before and/or during an operation. It will be given as a single injection or continuous infusion.
The usual dose is 0.6 mg rocuronium bromide per kg body weight and the effect lasts 30-40 minutes. During the operation your doctor will check whether Esmeron is still working. You may be given additional doses if they are needed.
As Esmeron doses are carefully worked out and are given by a doctor experienced in its use, it is extremely unlikely that you will be given too much Esmeron. However, if this does happen, your doctor will make sure that you continue breathing artificially until you can breathe on your own again. Your doctor may speed-up your recovery by giving you a drug that reverses the effects of Esmeron.
After having Esmeron
Things to be careful of
Your doctor will tell you when it is safe to drive and operate potentially dangerous machinery after you have been given Esmeron.
Tell your doctor if you notice anything that is making you feel unwell.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by the following list of side effects. You may not experience any of them.
Ask your doctor to answer any questions you may have.
Tell your doctor if you notice the following and they worry you:
- pain at injection site
- irritation at injection site
- red skin rash or itchy rash
Tell your doctor immediately if you notice any of the following:
- fast heart beat
- dizziness, light-headedness (low blood pressure)
- muscle weakness or paralysis
- aching muscles or weakness, not caused by exercise
- wheezing, coughing
- difficulty breathing
- rapid, shallow breathing, cold, clammy skin, a rapid, weak pulse, dizziness, weakness and fainting
- swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing
- sudden signs of allergy such as rash, itching, hives on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing
- Sudden fever with rapid heartbeat, rapid breathing and stiffness, pain and/or weakness in your muscles
- Severe allergic coronary blood vessel spasm (Kounis syndrome) resulting in chest pain (angina) or heart attack (myocardial infarction).
These are serious side effects. You may need urgent medical attention or hospitalisation.
Esmeron is stored in the hospital.
It should be kept in the refrigerator at 2-8°C and not be frozen. Esmeron can be stored outside the refrigerator at a temperature up to 30°C for a maximum of 12 weeks. After first removal from the refrigerator, the 12 week shelf life applies. The storage period may not exceed the labelled shelf-life.
What it looks like
A vial containing a clear, colourless to faintly yellow solution.
Esmeron is available in two quantities: 50 and 100 mg.
Esmeron contains 10 mg/mL of rocuronium bromide as the active ingredient. It also contains:
- sodium acetate
- sodium chloride
- glacial acetic acid
- water for injections
No preservative has been added.
Merck Sharp & Dohme (Australia) Pty Limited
Level 1, Building A
26 Talavera Road
Macquarie Park, NSW 2113
Merck Sharp & Dohme (New Zealand) Ltd
P O Box 99851
Australian Registration Numbers:
AUST R 57063 (50mg)
AUST R 57064 (100mg)
This leaflet was revised in January 2021.
Published by MIMS March 2021