Sugammadex Anaphylaxis: Mechanisms, Diagnosis, and Incidence.

Savic, L.; Silversides, J.A.; Leslie, K.

Sugammadex Anaphylaxis: Mechanisms, Diagnosis, and Incidence.

All Authors

Savic, L.

Silversides, J.A.

Leslie, K.

LTHT Author

Savic, Louise

LTHT Department

Theatres & Anaesthetics
Anaesthesia

Publication Date

2025

Item Type

Review

Abstract

Global use of sugammadex, a novel encapsulating agent for reversal of aminosteroid-induced neuromuscular blockade, has hitherto been limited by lack of regulatory approval, limited supply, institutional policies, and self-imposed restrictions.1 Since the expiry of patent protections in many countries, generic preparations have entered the market, facilitating local supplies at lower cost. Even in the United States, where patent protection has been extended until at least January 2026, sugammadex sales are growing.2 The aims of this clinical focus review are to (1) discuss the risks and benefits of sugammadex and neostigmine for reversal of neuromuscular blockade and (2) review the literature about sugammadex, neostigmine, and neuromuscular-blocking drug (NMBD) allergy, because reversal agents are usually administered to patients who have received a NMBD, and NMBDs (in particular rocuronium) are a leading cause of anesthetic-related anaphylaxis worldwide.