Sugamadex and Pregnancy

[Bluebolt]

So I just attended a CRNA conference where they were hyping sugammadex as the best way to reverse Roc and Vec. Have any of you had good experience with it? I've been told it's significantly more expensive than other alternatives.

Another unusual complication mentioned is the possibility of oral contraceptives being inactive up to 7 days after use, meaning your patient could unknowingly get pregnant.

[offlabel]

It works. Nice for fixing a sloppy anesthetic or a surprise ending. Not that much more expensive where I am as neostigmine has mysteriously become more expensive.

As far as patients on OC's, don't use it or counsel the patient to avoid sex for the next seven days if she wants to avoid a pregnancy. No big deal.

[wtbcrna, MSN, DNP, CRNA]

So I just attended a CRNA conference where they were hyping sugammadex as the best way to reverse Roc and Vec. Have any of you had good experience with it? I've been told it's significantly more expensive than other alternatives.

Another unusual complication mentioned is the possibility of oral contraceptives being inactive up to 7 days after use, meaning your patient could unknowingly get pregnant.

The cost is comparable to neostigmine and glycopyrolate since the price of both has gone up. It's recommended to use an alternate birth control method for 7 days, supposably it is the equivalent of missing one birth control pill.

[philcaloha]

I agree with both wtbcrna and off label. The price of the neo/glyco combo has gone up recently, thus making both reversals comparable in terms of pricing. I think it was around 80-90 dollars per neo/glyco vials and the same for suggamadex.

As far as using suggamadex, my facility uses it like water. We are a big teaching institution and buys suggamadex in large quantities... From what I have seen, it literally takes seconds for the drug the work and the patient doesn't have the "floppy" look afterwards. It's interesting since one of the surgical attending was like.... What did you guys give, she's super flat and now awake like crazy.....??? lol.

[philcaloha]

As for the pregnancy, it is a steroidal binding agent....all you have to do is tell the child bearing age female to use another form of contraceptive

[dukehellokitty]

Yes Sugammadex is nice to have at your disposal in case you have an emergent reversal. It has a much stronger binding affinity to rocuronium vs. vecuronium. We have a booklet at prep to tell patient that she will need other type of contraceptive measures for 7 days.