Details of the Drug

General Information of Drug (ID: DMY9BMK)

Drug Name
Rocuronium
Synonyms
Esmeron (TN); Zemuron (TN); (2beta,3alpha,5alpha,16beta,17beta)-17-acetoxy-16-(1-allylpyrrolidinium-1-yl)-3-hydroxy-2-(morpholin-4-yl)androstane; [(2S,3S,5S,8R,9S,10S,13S,14S,16S,17R)-3-hydroxy-10,13-dimethyl-2-morpholin-4-yl-16-(1-prop-2-enylpyrrolidin-1-ium-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl] acetate
Indication
Disease Entry ICD 11 Status REF
Muscle spasm MB47.3 Approved [1]
Therapeutic Class
Neuromuscular Nondepolarizing Agents
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 1 Molecular Weight (mw) 529.8
Logarithm of the Partition Coefficient (xlogp) 5
Rotatable Bond Count (rotbonds) 6
Hydrogen Bond Donor Count (hbonddonor) 1
Hydrogen Bond Acceptor Count (hbondacc) 5
ADMET Property
Absorption
The drug is poorly absorbed from the digestive tract []
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [2]
Clearance
The drug present in the plasma can be removed from the body at the rate of 3.7 mL/min/kg [3]
Elimination
17% of drug is excreted from urine in the unchanged form [2]
Half-life
The concentration or amount of drug in body reduced by one-half in 1 - 2 minutes [3]
Metabolism
The drug is metabolized via the liver []
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.3798 micromolar/kg/day [4]
Unbound Fraction
The unbound fraction of drug in plasma is 0.54% [3]
Vd
The volume of distribution (Vd) of drug is 0.3 L/kg []
Chemical Identifiers
Formula
C32H53N2O4+
IUPAC Name
[(2S,3S,5S,8R,9S,10S,13S,14S,16S,17R)-3-hydroxy-10,13-dimethyl-2-morpholin-4-yl-16-(1-prop-2-enylpyrrolidin-1-ium-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl] acetate
Canonical SMILES
CC(=O)O[C@H]1[C@H](C[C@@H]2[C@@]1(CC[C@H]3[C@H]2CC[C@@H]4[C@@]3(C[C@@H]([C@H](C4)O)N5CCOCC5)C)C)[N+]6(CCCC6)CC=C
InChI
InChI=1S/C32H53N2O4/c1-5-14-34(15-6-7-16-34)28-20-26-24-9-8-23-19-29(36)27(33-12-17-37-18-13-33)21-32(23,4)25(24)10-11-31(26,3)30(28)38-22(2)35/h5,23-30,36H,1,6-21H2,2-4H3/q+1/t23-,24+,25-,26-,27-,28-,29-,30-,31-,32-/m0/s1
InChIKey
YXRDKMPIGHSVRX-OOJCLDBCSA-N
Cross-matching ID
PubChem CID
441290
ChEBI ID
CHEBI:8884
CAS Number
143558-00-3
DrugBank ID
DB00728
TTD ID
D0L5CZ
VARIDT ID
DR00442
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Neuronal acetylcholine receptor alpha-2 (CHRNA2) TTF4E0J ACHA2_HUMAN Antagonist [5]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Organic anion transporting polypeptide 2B1 (SLCO2B1) DTPFTEQ SO2B1_HUMAN Substrate [6]
Organic anion transporting polypeptide 1A2 (SLCO1A2) DTE2B1D SO1A2_HUMAN Substrate [7]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Rocuronium
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Vecuronium DMP0UK2 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Vecuronium. Tonus and reflex abnormality [MB47] [8]
Coadministration of a Drug Treating the Disease Different from Rocuronium (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Clindamycin DM15HL8 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Clindamycin. Acne vulgaris [ED80] [9]
Framycetin DMF8DNE Major Additive neuromuscular blocking effects by the combination of Rocuronium and Framycetin. Alcoholic liver disease [DB94] [10]
Paromomycin DM1AGXN Major Additive neuromuscular blocking effects by the combination of Rocuronium and Paromomycin. Amoebiasis [1A36] [10]
Trimethaphan DMHF4IQ Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Trimethaphan. Aneurysm/dissection [BD50] [11]
Terbutaline DMD4381 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Terbutaline. Asthma [CA23] [11]
Spectinomycin DM0MQ35 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Spectinomycin. Bacterial infection [1A00-1C4Z] [11]
Kanamycin DM2DMPO Major Additive neuromuscular blocking effects by the combination of Rocuronium and Kanamycin. Bacterial infection [1A00-1C4Z] [10]
Streptomycin DME1LQN Major Additive neuromuscular blocking effects by the combination of Rocuronium and Streptomycin. Bacterial infection [1A00-1C4Z] [10]
Gentamicin DMKINJO Major Additive neuromuscular blocking effects by the combination of Rocuronium and Gentamicin. Bacterial infection [1A00-1C4Z] [10]
Netilmicin DMRD1QK Major Additive neuromuscular blocking effects by the combination of Rocuronium and Netilmicin. Bacterial infection [1A00-1C4Z] [10]
Minocycline DMVN5OH Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Minocycline. Bacterial infection [1A00-1C4Z] [11]
Tetracycline DMZA017 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Tetracycline. Bacterial infection [1A00-1C4Z] [11]
Irinotecan DMP6SC2 Minor Antagonize the effect of Rocuronium when combined with Irinotecan. Colorectal cancer [2B91] [12]
Alfentanil DMVO0UB Moderate Increased risk of bradycardia by the combination of Rocuronium and Alfentanil. Corneal disease [9A76-9A78] [13]
Fosphenytoin DMOX3LB Moderate Increased metabolism of Rocuronium caused by Fosphenytoin mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [14]
Ethotoin DMXWOCP Moderate Increased metabolism of Rocuronium caused by Ethotoin mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [14]
Nadolol DMW6GVL Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Nadolol. Essential hypertension [BA00] [15]
Metipranolol DMJMVKI Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Metipranolol. Glaucoma [9C61] [16]
Levobetaxolol DMSREPX Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Levobetaxolol. Glaucoma [9C61] [16]
Levobunolol DMTNFCQ Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Levobunolol. Glaucoma [9C61] [16]
Lincomycin DMVTHER Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Lincomycin. Gram-positive bacterial infection [1B74-1F40] [9]
Carvedilol DMHTEAO Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Carvedilol. Heart failure [BD10-BD1Z] [15]
Acebutolol DM0TI4U Moderate Additive cardiorespiratory depression effects by the combination of Rocuronium and Acebutolol. Hypertension [BA00-BA04] [15]
Penbutolol DM4ES8F Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Penbutolol. Hypertension [BA00-BA04] [15]
Nebivolol DM7F1PA Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Nebivolol. Hypertension [BA00-BA04] [15]
Pindolol DMD2NV7 Moderate Additive cardiorespiratory depression effects by the combination of Rocuronium and Pindolol. Hypertension [BA00-BA04] [15]
Metoclopramide DMFA5MY Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Metoclopramide. Nausea/vomiting [MD90] [11]
Ranitidine DM0GUSX Minor Antagonize the effect of Rocuronium when combined with Ranitidine. Peptic ulcer [DA61] [17]
Hydrocortisone DMGEMB7 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Hydrocortisone. Postoperative inflammation [1A00-CA43] [18]
Colistimethate DMZ9BMU Major Additive neuromuscular blocking effects by the combination of Rocuronium and Colistimethate. Respiratory infection [CA07-CA4Z] [18]
Dexamethasone DMMWZET Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Dexamethasone. Rheumatoid arthritis [FA20] [18]
Fentanyl DM8WAHT Moderate Increased risk of bradycardia by the combination of Rocuronium and Fentanyl. Sensation disturbance [MB40] [13]
Methylprednisolone DM4BDON Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Methylprednisolone. Solid tumour/cancer [2A00-2F9Z] [18]
Prednisolone DMQ8FR2 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Prednisolone. Solid tumour/cancer [2A00-2F9Z] [18]
Plazomicin DMKMBES Major Additive neuromuscular blocking effects by the combination of Rocuronium and Plazomicin. Urinary tract infection [GC08] [10]
Procainamide DMNMXR8 Moderate Additive neuromuscular blocking effects by the combination of Rocuronium and Procainamide. Ventricular tachyarrhythmia [BC71] [11]
⏷ Show the Full List of 36 DDI Information of This Drug

References

1 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
2 BDDCS applied to over 900 drugs
3 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
5 Pharmacological characteristics of the inhibition of nondepolarizing neuromuscular blocking agents at human adult muscle nicotinic acetylcholine receptor. Anesthesiology. 2009 Jun;110(6):1244-52.
6 Drug Interactions in Infectious Diseases.
7 Polyspecific organic anion transporting polypeptides mediate hepatic uptake of amphipathic type II organic cations. J Pharmacol Exp Ther. 1999 Oct;291(1):147-52.
8 Pandit SK, Ferres CJ, Gibson FM, Mirakhur RK "Time course of action of combinations of vecuronium and pancuronium." Anaesthesia 41 (1986): 151-4. [PMID: 2869710]
9 Alahdal O, Bevan DR "Clindamycin-induced neuromuscular blockade." Can J Anaesth 42 (1995): 614-7. [PMID: 7553999]
10 Burkett L, Bikhazi GB, Thomas KC Jr, Rosenthal DA, Wirta MG, Foldes FF "Mutual potentiation of the neuromuscular effects of antibiotics and relaxants." Anesth Analg 58 (1979): 107-15. [PMID: 571233]
11 Multum Information Services, Inc. Expert Review Panel.
12 Product Information. Camptosar (irinotecan). Pharmacia and Upjohn, Kalamazoo, MI.
13 Product Information. Alfenta (alfentanil). Janssen Pharmaceutica, Titusville, NJ.
14 Liberman BA, Norman P, Hardy BG "Pancuronium-phenytoin interaction: a case of decreased duration of neuromuscular blockade." Int J Clin Pharmacol Ther Toxicol 26 (1988): 371-4. [PMID: 3220609]
15 Chapple DJ, Clark JS, Hughes R "Interaction between atracurium and drugs used in anaesthesia." Br J Anaesth 55 Suppl 1 (1983): s17-22. [PMID: 6688011]
16 Harrah MD, Way WL, Katzung BG "The interaction of d-tubocurarine with antiarrhythmic drugs." Anesthesiology 33 (1970): 406-10. [PMID: 5512329]
17 Katende RS, Dimich I "Resistance to nondepolarizing muscle relaxants in a patient treated with ranitidine." Mt Sinai J Med 54 (1987): 330-1. [PMID: 2955219]
18 Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".