Precipitation of Sugammadex With Nicardipine And Labetalol

Background: There is a paucity of clinical data about whether sugammadex forms precipitates with other medications. This laboratory experimental study was performed to determine the drugs that produce precipitate with sugammadex. Methods: Samples of 1 mL of sugammadex were prepared in transparent cylinders, to which 1 mL of test drugs (rocuronium, neostigmine, glycopyrrolate, atropine, nitroglycerin, dobutamine, dopamine, epinephrine, vasopressin, norepinephrine, phenylephrine, ephedrine, esmolol, nicardipine, labetalol) was then added. The precipitation reaction was observed by eyes and light microscope. The pH of each drugs before and after mixing with sugammadex was measured. Results: White crystals were formed when sugammadex mixed with nicardipine or labetalol. Conclusions: Sugammadex formed precipitate when mixed with nicardipine or labetalol. Sufficient fluid flushing is required between injections of each drug to prevent these reactions.