Parenteral Manual

Succinylcholine chloride

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Neuromuscular blocking agent
Original Date: 
August 2005
Revised Date: 
September 2009
  • Adjunct to anaesthesia to induce skeletal muscle relaxation
  • Endotracheal intubation, endoscopy and short manipulative procedures                           
Reconstitution and Stability: 
  • Available as a 20 mg/mL injection
  • Refrigerate vials - unopened vials stable 6 months at room temperature      
  • Diluted solutions stable 24 hours in the fridge in D5W, NS and ringer's lactate

- Solutions Compatible: dextrose solutions up to D10W, saline solutions, dextrose-saline combinations, ringer's solution, ringer's lactate

- Additive/buretrol Compatible: no information

- Y-site Compatible: heparin, propofol, KCl (up to 40 mEq/L)

- Incompatible: alkaline solutions (e.g. thiopental, pentobarbital), sodium bicarbonate



(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IM YES, deep
IV Push

Usual dilution: 20 mg/mL
Infusion time: 10-30 seconds

IV Intermittant Infusion NO
IV Continuous Infusion

YES; (in adults)
Usual dilution: 1-2 mg/mL

NOT recommended in infants and children


(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • 2.5-4 mg/kg IM (Maximum: 150 mg/dose)
  • 1-2 mg/kg IV initially (Maximum: 150 mg/dose); then
  • Maintenance:  0.3-0.6 mg/kg IV every 5-10 minutes PRN


  • 0.6 mg/kg IV/IM (range:  0.3-1.1 mg/kg), up to 150 mg total dose
  • Maintenance: 0.04-0.07 mg/kg IV/IM Q 5-10 minutes PRN
  • Continuous IV infusion: 0.5-10 mg/minute
Potential hazards of parenteral administration: 
  • Paralysis of respiratory muscles causing apnea and hypoxia
  • Transient muscle fasciculations with too rapid administration
  • Transient cardiac arrhythmias, especially bradycardia in children
  • Malignant hyperthermia
  • Increased intraocular pressure                                                                    
  • Hyperkalemia
  • Monitor temperature, serum potassium, serum calcium, heart rate
  • Facilities for intubation, artificial respiration and oxygen must be available  
  • Caution in patients with electrolyte imbalance, decreased plasma pseudocholinesterase activity, severe liver disease or severe anemia or recovering from severe trauma
  • Contraindicated in malignant hyperthermia, narrow-angle glaucoma, severe sepsis, severe burns 
  • Anticholinesterases (eg. edrophonium, neostigmine)  do not reverse the effects but may prolong the effects
  • Onset of action:
    - IV: 1 minute
    - IM: 2-3 minutes
  • Duration:
    - IV: 4-6 minutes                                   
    - IM: 10-30 minutes 

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.