What Ricavo is

Ricavo contains the active substance sugammadex. Ricavo is considered to be a Selective Relaxant Binding Agent since it only works with specific muscle relaxants, rocuronium bromide or vecuronium bromide.

What Ricavo is used for

When you have some types of operations, your muscles must be completely relaxed. This makes it easier for the surgeon to do the operation. For this, the general anaesthetic you are given includes medicines to make your muscles relax. These are called muscle relaxants, and examples include rocuronium bromide and vecuronium bromide. Because these medicines also make your breathing muscles relax, you need help to breathe (artificial ventilation) during and after your operation until you can breathe on your own again.

Ricavo is used to speed up the recovery of your muscles after an operation to allow you to breathe on your own again earlier. It does this by combining with the rocuronium bromide or vecuronium bromide in your body. It can be used in adults whenever rocuronium bromide or vecuronium bromide is used and in children and adolescents (aged 2 to 17 years) when rocuronium bromide is used for a moderate level of relaxation.

    You should not be given Ricavo

• If you are allergic to sugammadex or any of the other ingredients of this medicine (listed in section 6).

          Tell your anaesthetist if this applies to you.

    Warnings and precautions

    Talk to your anaesthetist before Ricavo is given

•  If you have kidney disease or had in the past. This is important as sugammadex is removed from your body by the kidneys.
•  If you have liver disease or have had it in the past.
•  If you have fluid retention (oedema).
•  If you have diseases which are known to give an increased risk of bleeding (disturbances of blood clotting) or anticoagulation medication. 

    Children and adolescents

    This medicine is not recommended for infants less than 2 years of age.

    Other medicines and Ricavo

    Tell your anaesthetist if you are taking, have recently taken or might take any other medicines.

    Ricavo may affect other medicines or be affected by them.

    Some medicines reduce the effect of Ricavo

    It is especially important that you tell your anaesthetist if you have recently taken:

•    Toremifene (used to treat breast cancer).
•    Fusidic acid (an antibiotic).

     Ricavo can affect hormonal contraceptives

• Ricavo can make hormonal contraceptives - including the ‘Pill’, vaginal ring, implants or a hormonal IntraUterine System (IUS) - less effective because it reduces how much you get of the progestogen hormone. The amount of progestogen lost by using Ricavo is about the same as missing one oral contraceptive Pill.

  −    If you are taking the Pill on the same day as Ricavo is given to you, follow the instructions for a missed dose in the Pill’s package leaflet.

  −  If you are using other hormonal contraceptives (for example a vaginal ring, implant or IUS) you should use an additional non-hormonal contraceptive method (such as a condom) for the next 7 days and follow the advice in the package leaflet.

      Effects on blood tests

      In general, Ricavo does not have an effect on laboratory tests. However, it may affect the results of a blood test for a hormone called progesterone.Talk to            your doctor if your progesterone levels need to be tested on the same day you receive Ricavo.

      Pregnancy and breast-feeding

   Tell your anaesthetist if you are pregnant or might be pregnant or if you are breast-feeding.

  You may still be given Ricavo, but you need to discuss it first.

 It is not known whether sugammadex can pass into breast milk. Your anaesthetist will help you decide whether to stop breast-feeding, or whether to abstainfrom sugammadex therapy, considering the benefit of breast-feeding to the baby and the benefit of sugammadex to the mother.

      Driving and using machines

      Sugammadex has no known influence on your ability to drive and use machines.

      Ricavo contains sodium

      Ricavo contains sodium. Each 2 ml of Ricavo 200 mg/2 ml Solution for Injection contains 18.38 mg sodium (main component of cooking/table salt). This is              equivalent to 0.919% of the recommended maximum daily dietary intake of sodium for an adult.

    Ricavo will be given to you by your anaesthetist, or under the care of your anaesthetist.

    The dose

    Your anaesthetist will work out the dose of Ricavo you need based on:

•     Your weight
•     How much the muscle relaxant medicine is still affecting you.

    The usual dose is 2-4 mg per kg body weight for adults and for children and adolescents between 2-17 years old.

A dose of 16 mg/kg can be used in adults if urgent recovery from muscle relaxation is needed.

    How Ricavo is given

    Ricavo will be given to you by your anaesthetist. It is given as a single injection through an intravenous line.

    If more Ricavo is given to you than recommended

    As your anaesthetist will be monitoring your condition carefully, it is unlikely that you will be given too much Ricavo. But even if this happens, it is unlikely to        cause any problems.

    If you have any further questions on the use of this medicine, ask your anaesthetist or other doctor.

    Like all medicines, this medicine can cause side effects, although not everybody gets them.

    If these side effects occur while you are under anaesthesia, they will be seen and treated by your anaesthetist.

     Common side effects (may affect up to 1 in 10 people)

•    Cough
•    Airway difficulties that may include coughing or moving as if you are waking or taking a breath
•    Light anaesthesia - you may start to come out of deep sleep, so need more anaesthesia. This might cause you to move or cough at the end of the operation
•    Complications during your procedure such as changes in heart rate, coughing or moving
•    Decreased blood pressure due to the surgical procedure.

     Uncommon side effects (may affect up to 1 in 100 people)

•   Shortness of breath due to muscle cramps of the airways (bronchospasm) occurred in patients with a history of lung problems
•   Allergic (drug hypersensitivity) reactions - such as a rash, red skin, swelling of your tongue and/or throat, shortness of breath, changes in blood pressure or heart rate, sometimes resulting in a serious decrease of blood pressure. Severe allergic or allergic-like reactions can be life threatening Allergic reactions were reported more commonly in healthy, conscious volunteers.
•   Return of muscle relaxation after the operation.

     Frequency not known

     Severe slowing of the heart and slowing of the heart up to cardiac arrest may occur when sugammadex is administered.​​   

Keep this medicine out of the sight and reach of children.

Store below 30°C. Avoid freeze.

Protect from light.

Store in the original package.

After first opening and dilution, store at 2 to 25°C and use within 48 hours.

Do not use this medicine after the expiry date which is stated on the package after “EXP”. The expiry date refers to the last day of that month.

Do not use this medicine if you notice any visible signs of deterioration.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.