Last reviewed 2026-04-20 · How we verify

Succinylcholine Chloride (SUXAMETHONIUM)

Succinylcholine Chloride works by mimicking the action of acetylcholine at the neuromuscular junction, causing a rapid depolarization of muscle fibers.

At a glance

Mechanism of action

Succinylcholine is depolarizing neuromuscular blocker. As does acetylcholine, it combines with the cholinergic receptors of the motor end plate to produce depolarization. This depolarization may be observed as fasciculations. Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site. Onset of flaccid paralysis is rapid (less than one minute after intravenous administration), and with single administration lasts approximately to minutes.The paralysis following administration of succinylcholine is progressive, with differing sensitivities of different muscles. This initially involves consecutively the levator muscles of the face, muscles of the glottis and finally the intercostals and the diaphragm and all other skeletal muscles.

Approved indications

• General anesthesia
• Muscle relaxation, function
• Skeletal Muscle Relaxation for Endotracheal Intubation

Boxed warnings

• BOXED WARNING WARNING: VENTRICULAR DYSRHYTHMIAS, CARDIAC ARREST, AND DEATH FROM HYPERKALEMIC RHABDOMYOLYSIS IN PEDIATRIC PATIENTS Acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death has occurred after the administration of succinylcholine to apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy [see Warnings and Precautions ( 5.1 )]. When a healthy appearing pediatric patient develops cardiac arrest within minutes after administration of succinylcholine chloride, not felt to be due to inadequate ventilation, oxygenation or anesthetic overdose, immediate treatment for hyperkalemia should be instituted. In the presence of signs of malignant hyperthermia, appropriate treatment should be instituted concurrently [see Warnings and Precautions ( 5.1 )] . Reserve the use of succinylcholine chloride in pediatric patients for emergency intubation or instances where immediate securing of the airway is necessary, e.g., laryngospasm, difficult airway, full stomach, or for intramuscular use when a suitable vein is inaccessible [see Warnings and Precautions ( 5.1 )] . WARNING: VENTRICULAR DYSRHYTHMIAS, CARDIAC ARREST, AND DEATH FROM HYPERKALEMIC RHABDOMYOLYSIS IN PEDIATRIC PATIENTS See full prescribing information for complete boxed warning . Acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death has occurred after use in apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy. ( 5.1 ) When a healthy-appearing pediatric patient develops cardiac arrest soon after administration of succinylcholine chloride, not felt to be due to other causes, immediate treatment for hyperkalemia should be instituted. In the presence of signs of malignant hyperthermia, appropriate treatment should be instituted concurrently. ( 5.1 ) Reserve use of succinylcholine chloride in pediatric patients for emergency intubation or instances where immediate securing of the airway is necessary, or for intramuscular use when a suitable vein is inaccessible. ( 5.1 )

Common side effects

• Cardiac arrest
• Malignant hyperthermia
• Arrhythmias
• Bradycardia
• Tachycardia
• Hypertension
• Hypotension
• Hyperkalemia
• Prolonged respiratory depression or apnea
• Rhabdomyolysis
• Muscle fasciculation
• Jaw rigidity

Drug interactions

• tobramycin

Key clinical trials

• Which Rapid Sequence Induction Technique Should be Used in Urgent Surgery in Children? (NA)
• Subanesthetic Esketamine in Modified ECT for Severe Depression in Adolescents: Clinical and Mechanistic Study (EARLY_PHASE1)
• Two Video Laryngoscopes (Laringocel® and C-MAC®) for First-Attempt Intubation in Adults Undergoing Elective Surgery (NA)
• SEdation Versus General Anesthesia for Endovascular Therapy in Acute Ischemic Stroke (PHASE4)
• Anesthesia Management in Endovascular Therapy for Ischemic Stroke - 2 (NA)
• Optimisation Strategy for Emergency Tracheal Intubation (NA)
• Standardised Drug Provocation Testing in Perioperative Hypersensitivity (NA)
• Clonidine to Prevent Delirium After Electroconvulsive Therapy. (PHASE4)

Primary sources

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Competitive intelligence

For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:

• Succinylcholine Chloride CI brief — competitive landscape report
• Succinylcholine Chloride updates RSS · CI watch RSS
• Novartis portfolio CI