Drug interactions- summary-

Concurrent use with anticholinstrases, cyclophospomide, antiarrhythmics,
aminoglycosides, lincosamides, ( clindamycin , lincomycin ) anticonvulsants,
phenelzine, magnesium, metoclopramide, inhalation anesthetics,

Exposure to organophosphates insecticides may enhance neuromuscular block of
suxamethonium

Increased risk of arrhythmias with cardiac glycosides

Muscle relaxant in general anesthesia

Bradycardia, tachycardia, hypotension, hypertension,
raised intraocular pressure,

Hyperkalemia, excessive salivation

Respiratory depression dysarhthmias , rhabomyoisis ,

Malignant hyperthermia

Genetic disorders of plasma pseudocholinesterates ,
Personal/family history of hyperthermia,

Hypersensitivity from previous neuromuscular drug,
severe burns, massive trauma,

Extensive denervation of skeletal muscle
Patients at risk of hyperkalemia, 

Renal impairment,
Angle closure glaucoma

Special Precautions-
Bone fracture,
Raised intraocular pressure,

Neuromuscular disease
Infants, children, adolescents

Pregnancy and lactation

Indication

Muscle relaxant in general anesthesia

Dosage-
Adult- as chloride - 3-4mg/kg
Max total dose - 150mg

Child-  as chloride - < 1 yr - upto 4-5mg/kg
> 1yr - up to 4mg/kg
Max dose 150mg

Interavenous-
Adult- as chloride - single dose of 0.3- 1.1 mg/kg injected
supplementary doses of 50-100%  of the total dose may be given
 at 5-10 minutes intervals

Max dose (repeated IV inj or continuous infusion )  500mg/hr

Child- as chloride - < 1 yr - 1mg/kg
1-12 yr - 2mg/kg

Use contraindicated. Observe caution