Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about Esmeron.
It does not contain all the available information.
It does not take the place of talking to your doctor.
All medicines have risks and benefits. Your doctor has weighed the risks of you having
Esmeron against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor.
Keep this leaflet.
You may need to read it again.
What Esmeron is used for
Esmeron is one of a group of medicines called muscle relaxants.
Muscle relaxants are used during an operation as part of the general anaesthetic.
When you have an operation, your muscles must be completely relaxed. This makes it
easier for the surgeon to perform the operation.
Normally the nerves send messages to the muscles by impulses. Esmeron acts by blocking
these impulses so the muscles are relaxed. Because the muscles needed for breathing
also become relaxed you will need help with your breathing (artificial respiration)
during and after your operation until you can breathe on your own. During the operation
the effect of the muscle relaxant is constantly checked and if necessary some more
drug is given. At the end of the operation the effects of Esmeron are allowed to
wear off and you can start breathing on your own. Sometimes another drug is given
to help speed this up. Esmeron can also be used in Intensive Care to keep your muscles
Ask your doctor if you want any more information about this medicine.
Esmeron is not addictive.
Before you are given Esmeron
When you must not be given it
You must not be given Esmeron if you have an allergy to:
any medicine containing rocuronium bromide
any of the ingredients listed at the end of this leaflet
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing
or difficulty breathing; swelling of the face, lips, tongue or other parts of the
body; rash, itching or hives on the skin.
Before you are given it
If you are going to have an operation it is important that you discuss the following
points with your doctor, since it can influence the way Esmeron is given to you.
Tell your doctor if you have or have had any medical conditions, especially the following:
an allergy to muscle relaxants
liver or gallbladder disease
a heart disease
diseases affecting nerves or muscles
oedema (local or generalised swelling due to fluid)
Certain medical conditions may affect how Esmeron works.
low potassium levels in the blood
high magnesium levels in the blood
low calcium levels in the blood
low levels of protein in the blood
too much acid in the blood
too much carbon dioxide in the blood
If you are suffering from any of these conditions your doctor will take this into
account when deciding the correct dose of Esmeron for you.
Esmeron can be used in term newborn infants (0-28 days), infants (28 days-23 months),
children (2-11 years), adolescents (12-18 years) and elderly patients but your doctor
should first assess your medical history.
Elderly (65 years and older) may be at an increased risk of residual paralysis.
Tell your doctor if you have allergies to any other medicines, foods, preservatives
Tell your doctor if you are pregnant or plan to become pregnant or are breast-feeding.
Your doctor will discuss the risks and benefits of using Esmeron if you are pregnant
If you have not told your doctor about any of the above, tell them before you are
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you get
without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may be affected by Esmeron, or affect how well it works. These include:
anaesthetics, medicines to make you sleep during surgery
long term concurrent use of corticosteroids (anti-inflammatory medicines) and Esmeron
in the Intensive Care Unit
lithium, a medicine used to treat bipolar disorder
medicines used to treat heart disease or high blood pressure (quinidine, calcium channel
blockers, beta-blockers and diuretics (fluid tablets))
quinine, a medicine used to treat malaria
lidocaine (lignocaine) and bupivacaine (local anaesthetics)
other muscle relaxants
carbamazepine and phenytoin, medicines used to treat epilepsy
You may need to use different amounts of your medicines or take different medicines.
Your doctor will advise you.
If you are taking magnesium sulfate to treat toxaemia of pregnancy (preeclampsia),
tell your doctor as the dose of Esmeron may need to be reduced.
Your doctor will have a complete list of medicines that may cause problems when used
How Esmeron is given
Esmeron will be given by a doctor. It will not be given to you until you are asleep
from the anaesthetic.
It will be injected into a vein before and/or during an operation. It will be given
as a single injection or continuous infusion.
The usual dose is 0.6 mg rocuronium bromide per kg body weight and the effect lasts
30-40 minutes. During the operation your doctor will check whether Esmeron is still
working. You may be given additional doses if they are needed.
As Esmeron doses are carefully worked out and are given by a doctor experienced in
its use, it is extremely unlikely that you will be given too much Esmeron. However,
if this does happen, your doctor will make sure that you continue breathing artificially
until you can breathe on your own again. Your doctor may speed-up your recovery by
giving you a drug that reverses the effects of Esmeron.
After having Esmeron
Things to be careful of
Your doctor will tell you when it is safe to drive and operate potentially dangerous
machinery after you have been given Esmeron.
Tell your doctor if you notice anything that is making you feel unwell.
All medicines can have side effects. Sometimes they are serious, most of the time
they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by the following list of side effects. You may not experience any
Ask your doctor to answer any questions you may have.
Tell your doctor if you notice the following and they worry you:
pain at injection site
irritation at injection site
red skin rash or itchy rash
Tell your doctor immediately if you notice any of the following:
fast heart beat
dizziness, light-headedness (low blood pressure)
muscle weakness or paralysis
aching muscles or weakness, not caused by exercise
rapid, shallow breathing, cold, clammy skin, a rapid, weak pulse, dizziness, weakness
swelling of the face, lips, mouth, tongue or throat which may cause difficulty in
swallowing or breathing
sudden signs of allergy such as rash, itching, hives on the skin, swelling of the
face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble
Sudden fever with rapid heartbeat, rapid breathing and stiffness, pain and/or weakness
in your muscles
These are serious side effects. You may need urgent medical attention or hospitalisation.
Esmeron is stored in the hospital.
It should be kept in the refrigerator at 2-8°C and not be frozen. Esmeron can be
stored outside the refrigerator at a temperature up to 30°C for a maximum of 12 weeks.
After first removal from the refrigerator, the 12 week shelf life applies. The storage
period may not exceed the labelled shelf-life.
What it looks like
A vial containing a clear, colourless to faintly yellow solution.
Esmeron is available in two quantities: 50 and 100 mg.
Esmeron contains 10 mg/mL of rocuronium bromide as the active ingredient. It also
glacial acetic acid
water for injections
No preservative has been added.
Merck Sharp & Dohme (Australia) Pty Limited
Level 1, Building A
26 Talavera Road
Macquarie Park, NSW 2113
Merck Sharp & Dohme (New Zealand) Ltd
P O Box 99851
Australian Registration Numbers:
AUST R 57063 (50mg)
AUST R 57064 (100mg)
This leaflet was revised in March 2020.