Sugammadex sodium is a novel medication used for reversal of neuromuscular blockade induced by rocuronium and vecuronium in anesthetized patients. Overall, sugammadex has minimal interactions with other medications. However, there are some drugs that warrant caution when co-administered with sugammadex.

Hormonal Contraceptives

No interactions have been observed between sugammadex and oral hormonal contraceptive medications containing ethinylestradiol and levonorgestrel. Sugammadex does not appear to affect the efficacy of birth control pills.

Anticoagulants

Clinical studies have found no pharmacodynamic interactions between sugammadex and the anticoagulants unfractionated heparin or low molecular weight heparin. No increased bleeding risks were seen.

However, as a precaution, coagulation parameters should be monitored closely if sugammadex is used in patients being treated with anticoagulant or antiplatelet drugs due to potential for slightly prolonged clotting times.

Toremifene

In one study, co-administration of sugammadex manufacturer and the selective estrogen receptor modulator toremifene in healthy volunteers resulted in a 29% decrease in toremifene exposure. The clinical impact of this is unknown.

Probenecid

No pharmacokinetic or dynamic interactions have been observed between sugammadex and probenecid in studies. Probenecid is sometimes used to prolong the effects of neuromuscular blocking agents, but it does not impact the efficacy of sugammadex reversal.

Corticosteroids

No clinical studies have been conducted on concomitant use of sugammadex and systemic corticosteroids. Since both drugs have minimal side effect profiles, no major interactions would be expected. But potential effects are unknown and monitoring is advised.

NSAIDs

Non-steroidal anti-inflammatory drugs like ibuprofen have been administered uneventfully with sugammadex. However, formal interaction studies have not been done, so additive pharmacodynamic effects cannot be ruled out.

Opioids

No clinical opioid-sugammadex interaction studies have been performed. Opioids have been given during anesthesia in clinical trials without apparent interactions. However, opioid effects could potentially be masked by residual paralysis reversal with sugammadex in some cases.

Antibiotics

No data are available on concomitant use of sugammadex and common perioperative antibiotics like cephalosporins, penicillins, fluoroquinolones, etc. No pharmacokinetic interactions are anticipated, but clinical monitoring for efficacy of both drugs is prudent.

Overview

In summary, there are minimal known drug interactions associated with sugammadex sodium. The main precautions involve monitoring coagulation status with anticoagulants and being observant for potential masking of opioid effects. As a leading sugammadex manufacturer we stay up-to-date on emerging interaction data to assist clinicians in safe use of this medication.