What Sumadix^® is

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

What Sumadix^® 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.

Sumadix^® 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 Sumadix^®

• 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 Sumadix^® is given

• if you have kidney disease or had in the past. This is important as Sumadix^® 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 Sumadix^®

→ Tell your anaesthetist if you are taking, have recently taken or might take any other medicines. Sumadix^® may affect other medicines or be affected by them.

 Some medicines reduce the effect of Sumadix^®

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

• toremifene (used to treat breast cancer).

• fusidic acid (an antibiotic).

Sumadix^® can affect hormonal contraceptives

• Sugammadex 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 Sumadix^® is about the same as missing one oral contraceptive Pill.

→ If you are taking the Pill on the same day as Sumadix^® 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, Sumadix^® 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 Sumadix^®.

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 Sumadix^®, 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 abstain from sugammadex therapy, considering the benefit of breast-feeding to the baby and the benefit of Sumadix^® to the mother.

Driving and using machines

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

Important information about some ingredients in Sumadix^®

Sumadix^® contains sodium

This medicine contains up to 9.19 mg sodium (main component of cooking / table salt) in each mL. This is equivalent to around 0.5 % of the recommended maximum daily dietary intake of sodium for an adult.

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

The dose of Sumadix^® for children is 2 mg/kg (children and adolescents between 2-17 years old.

How Sumadix^® is given

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

 If more Sumadix^® 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 sugammadex. 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 subjects

• 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

Reporting of side effects

If you get any side effects, talk to your anaesthetist or other doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via The National Pharmacovigilance and Drug Safety Centre (NPC) /SFDA. 

By reporting side effects you can help provide more information on the safety of this medicine.

Storage will be handled by healthcare professionals. 

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

Do not use this medicine after the expiry date which is stated on the carton and on the label after ‘EXP’. 

Do not store above 30°C. Do not freeze. Keep the vial in the outer carton in order to protect from light. 

After first opening and dilution, store at 2 to 8°C and use within 24 hours.