What it does
Pacuronium is a muscle relaxant used during surgeries and procedures to help with anesthesia.
Commonly used for: muscle relaxation during surgery, facilitating intubation, assisting ventilation in critical care
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 20:07:59 · updated 2026-08-03 04:08:21
About this medicine
Pacuronium is a muscle relaxant used during surgeries and procedures to help with anesthesia.
What it treats
- muscle relaxation during surgery
- facilitating intubation
- assisting ventilation in critical care
How it works
Pacuronium works by blocking nerve signals to the muscles, causing them to relax.
Who it's for
Pacuronium is for patients undergoing surgery or certain medical procedures that require muscle relaxation.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: pacuronium
Pancuronium is a non-depolarizing neuromuscular blocking agent used primarily to induce muscle relaxation during surgical procedures or mechanical ventilation. It acts by blocking the transmission of nerve impulses at the neuromuscular junction, facilitating intubation and providing muscle relaxation.
Indications
- Induction of general anesthesia
- Facilitation of tracheal intubation
- Muscle relaxation during surgical procedures
- Adjunct to mechanical ventilation
Dosage
Children: Refer to the BNF for Children for specific dosing information.
Adults: Refer to the BNF for specific dosing information.
Mechanism of action
Pancuronium works by competitively antagonizing the action of acetylcholine at the motor end plate, preventing muscle contraction. It binds to nicotinic receptors on the postsynaptic membrane of the neuromuscular junction, inhibiting the effect of acetylcholine released from presynaptic nerve terminals.
Pharmacodynamics
The onset of action for pancuronium is typically within 2-4 minutes, with a duration of neuromuscular blockade lasting approximately 60-90 minutes depending on the dose. Its effects can be reversed with acetylcholinesterase inhibitors such as neostigmine, which increase the concentration of acetylcholine at the neuromuscular junction.
Pharmacokinetics
Pancuronium is primarily eliminated through renal excretion, with about 50-70% of the drug being excreted unchanged in the urine. The drug has a half-life of approximately 1-2 hours in healthy individuals, but this can be prolonged in patients with renal impairment. Pancuronium is poorly soluble in water and is administered intravenously.
Contra-indications
- Hypersensitivity to pancuronium or any component of the formulation
- Myasthenia gravis
- Severe electrolyte disturbances
- Some neuromuscular disorders
Adverse effects
- Prolonged neuromuscular block
- Respiratory depression
- Cardiovascular effects such as tachycardia and hypertension
- Allergic reactions including anaphylaxis
- Muscle weakness
Interactions
- Aminoglycosides may potentiate neuromuscular blockade
- Calcium channel blockers may enhance the effects of neuromuscular blockers
- Certain inhalational anesthetics can affect the neuromuscular transmission
- Anticonvulsants may reduce the effectiveness of neuromuscular blockers
Precautions
- Use with caution in patients with respiratory disease or neuromuscular disorders
- Monitor cardiovascular function closely during use
- Caution in patients with renal impairment
- Careful patient monitoring is essential during administration
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. There are limited data on the use of pancuronium in pregnant women.
Breast-feeding
There are no adequate studies on the excretion of pancuronium in human milk. Caution should be exercised when administering to nursing mothers.
Storage
Store in a cool, dry place, protected from light. Keep out of reach of children.
Formulations
- Injection solution
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.