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Suxamethonium is used in anesthesia to induce muscle relaxation during operations, to facilitate endotracheal intubation (help insert a tube into the windpipe) and reduce strong muscle contraction.

How it works

Suxamethonium belongs to a group of medicines called muscle relaxants. It exerts a depolarizing effect at the neuromuscular junction thereby relaxing some of the muscles in the body.

Common side effects

Post operative muscle pain, Protein in urine, Blood in urine, Altered heart rate, Urine discolouration, Dark colored urine, Increased blood pressure, Decreased blood pressure, Increased potassium level in blood, Increased saliva production, Blurred vision, Headache, Increased intraocular pressure, Muscle damage, Muscle stiffness, Muscle weakness, Muscle twitching, Muscle pain, Rash, Skin flushing, Tenderness, Abdominal cramp, Bloating, Nausea


Expert advice

  • Tell your doctor before using suxamethonium if you have or had tetanus, tuberculosis, other severe or long standing infection or illness, cancer, anemia, malnutrition, liver or kidney problems, auto-immune diseases (multiple sclerosis), an underactive thyroid gland (myxoedema), muscle disease (such as myasthenia gravis), a blood transfusion or a heart-lung by pass, been in contact with insecticides, allergic reaction to any muscle relaxant given as part of an operation.
  • Suxamethonium paralyses the respiratory muscles as well as other skeletal muscles but has no effect on consciousness.
  • You may experience some muscle pain after suxamethonium administration if you have undergone short surgical procedure under general anaesthesia.
  • Do not drive or use machinery too soon after having an operation.
  • Tell your doctor if you are or planning to become pregnant or are breastfeeding.

Frequently asked questions


Q. Is suxamethonium a non-competitive antagonist/ agonist?
Suxamethonium is a nicotinic acetylcholine receptor non-competitive agonist.
Q. What is suxamethonium chloride used for/ how does suxamethonium work/ how does suxamethonium chloride work?
Suxamethonium is used in anesthesia to induce muscle relaxation during operations, to facilitate endotracheal intubation (help insert a tube into the windpipe), reduce strong muscle contraction.
Q. What is suxamethonium apnoea?
Suxamethonium apnoea occurs when a patient does not have the enzymes to metabolise the drug. Due to this, a patient may remain paralysed for an increased length of time and cannot breathe adequately at the end of an anaesthetic.
Q. Why does suxamethonium cause bradycardia (abnormally slow heart beat)?
The initial metabolite of suxamethonium produces a transient negative chronotropic effect through its stimulation of sinus node muscarinic receptors. Repeated dosing or infusions of suxamethonium may lead to bradycardia that is appropriately treated with atropine. 
Q. Why does suxamethonium cause hyperkalemia (high potassium levels in the blood)?
Administration of suxamethonium may lead to depolarization and a large efflux of intracellular potassium into the plasma thereby resulting in hyperkalemia. 
Q. Why does suxamethonium cause fasciculation (twitching of muscles under the skin)?
Suxamethonium cause fasciculation by an action on some distal part of motor nerve fibres.
Q. Is suxamethonium still used?
Suxamethonium is still used during general anesthesia.
Q. Is suxamethonium reversible?
Suxamethonium is a short-acting muscle relaxant which exerts a depolarizing effect at the neuromuscular junction. This effect is not reversible pharmacologically.
Q. Is suxamethonium is contraindicated in burned patients?
Yes, suxamethonium should not be used in burned patients.
Q. What is suxamethonium sensitivity?
Suxamethonium sensitivity is when the drug remains active for a longer period of time than is usual due to which muscles stay relaxed.
Q. Does suxamethonium cross the placenta?
In normal therapeutic doses, suxamethonium does not cross the placental barrier in sufficient amounts.

Content on this page was last updated on 30 September, 2016, by Dr. Varun Gupta (MD Pharmacology)