succinylcholine
Trade name: anectine
Approved
Aug 20, 1952
Succinylcholine also known as suxamethonium is a quaternary skeletal muscle relaxant usually used in the form of its halogen salt. It is is indicated under brand name anectine as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine activates the muscle-type nicotinic acetylcholine receptor followed by desensitization. Succinylcholine does not inhibit the presynaptic alpha3beta2 autoreceptor at clinically relevant concentrations, that provides a possible mechanistic explanation for the typical lack of tetanic fade in succinylcholine-induced neuromuscular blockade. Finally, was explored, that cardiovascular side effects (e.g., tachyarrhythmias) of succinylcholine were not mediated via direct activation of the autonomic ganglionic alpha3beta4 subtype because succinylcholine didn’t not activate the neuronal nicotinic acetylcholine receptor (nAChR) subtypes. — NCATS
Clinical trial activity
45 trials · 43 clinical orgs · 32 marketing orgs
Earliest trial started Jan 1, 2006 (NCT00815048)
Timeline
1950s
1970s
- Sep 20, 1972
Organon — Marketing Organization
2010s
- May 4, 2018
Zydus Discovery DMCC — Marketing Organization
- Jun 4, 2018
Amring Pharmaceticals — Marketing Organization
- Nov 16, 2018
Amneal Pharmaceuticals — Marketing Organization
- Aug 2, 2019
Dr. Reddy's Laboratories — Marketing Organization
- Oct 9, 2019
Esteve Labs — Marketing Organization
2020s
- Jan 15, 2020
Somerset Pharmaceuticals — Marketing Organization
- Jan 15, 2020
Mylan — Marketing Organization
- May 4, 2020
Aspiro — Marketing Organization
- May 19, 2020
Nivagen Pharmaceuticals Inc. — Marketing Organization
- May 20, 2020
Accord Research — Marketing Organization
- May 22, 2020
Indoco Remedies — Marketing Organization
- Jun 8, 2020
Amphastar Pharmaceuticals — Marketing Organization
- Jun 12, 2020
Hikma — Marketing Organization
- Jun 16, 2020
Gland Pharma Ltd — Marketing Organization
- Jun 16, 2020
Fosun — Marketing Organization
- Oct 27, 2020
Nexus Pharmaceuticals — Marketing Organization
- Nov 20, 2020
Fresenius — Marketing Organization
- Nov 24, 2020
Micro Labs Ltd India — Marketing Organization
- Dec 21, 2020
Deva Holding A.S. — Marketing Organization
- Mar 29, 2021
Sagent Pharmaceuticals, Inc. — Marketing Organization
- Mar 29, 2021
Nichi-Iko Pharmaceutical Co., Ltd. — Marketing Organization
- Aug 20, 2021
Hikma — NDA Secondary Org
- Oct 19, 2021
Meitheal — Marketing Organization
- Oct 19, 2021
Eu Yan Sang — Marketing Organization
- Feb 7, 2022
BE Pharmaceuticals — Marketing Organization
- Feb 2, 2023
Mankind Pharma — Marketing Organization
- Oct 16, 2023
Eugia Pharma — Marketing Organization
- Jul 9, 2024
STERISCIENCE — Marketing Organization
- Jan 1, 2026
Earliest Phase 1 Sponsor(trial)
Indications
Approved for
Studied for
- Analgesics, Opioid · Phase 4
- Anemia, Sickle Cell · Phase 3
- Anesthesia · Phase 4
- Anesthesia, General · Phase 3
- Bradycardia · Phase 2
- Cesarean Section · Phase 4
- Coma · Phase 4
- Conjunctivitis · Phase 3
- Depression · Phase 4
- Hypersensitivity · Phase 3
- Hypotension · Phase 4
- Intubation · Phase 4
- Intubation, Intratracheal · Phase 4
- Lidocaine · Phase 4
- Major Depressive Disorder · Phase 4
- Muscle Relaxants, Central · Phase 4
- Myalgia · Phase 3
- Neuromuscular Blockade · Phase 4
- Opioid-Related Disorders · Early Phase 1
- Postoperative Complications · Phase 4
- Pregnancy · Phase 4
- Rapid Sequence Induction and Intubation · Phase 4
- Respiratory Distress Syndrome · Phase 4
- Rhinitis · Phase 3
- Rhinitis, Allergic · Phase 3
- Shock · Phase 4
- Stroke · Phase 3
- Succinylcholine · Phase 4
- Traumatology · Phase 4
Mechanism of action
Approval history
- approvedPriority reviewAug 20, 1952
Chemistry & pharmacology
SMILES
C[N+](C)(C)CCOC(=O)CCC(=O)OCC[N+](C)(C)C- Mol. weight
- 290.4 g/mol
- Lipinski Ro5
- Pass
- Rule of 3
- No
- Chirality
- Achiral Molecule
- Inorganic
- No
- Polymer
- No
- Delivery
- Parenteral
- Availability
- Prescription Only
Oral
No
Parenteral
Yes
Topical
No
Sources
- ChEMBLCHEMBL703 ↗
- WikipediaSuxamethonium chloride ↗
- NCATSJ2R869A8YF ↗
- ChEMBLCHEMBL983 ↗
Also known as
- 2,2'-[(1,4-dioxobutane-1,4-diyl)bis(oxy)]bis(n,n,n-trimethylethanaminium)
- 2,2'-[(1,4-dioxobutane-1,4-diyl)bis(oxy)]bis(n,n,n-trimethylethanaminium)
- anectine
- anectine
- anectine
- dicholine succinate
- dicholine succinate
- dicholine succinate
- quelicin
- quelicin
- quelicin preservative free
- quelicin preservative free
- sc411
- sch 39641
- sch 697243
- scoline
- scoline
- succinic acid dicholine diester
- succinic acid, diester with choline
- succinic acid, diester with choline
- succinocholine
- succinocholine
- succinocholine
- succinoylcholine
- succinoylcholine
- succinoylcholine
- succinylbischoline
- succinylbischoline
- succinylbischoline
- succinylcholine
- succinylcholine
- succinylcholine
- succinylcholine
- succinylcholine
- succinylcholine
- succinylcholine
- succinylcholine chloride
- succinylcholine chloride
- succinylcholine chloride
- succinylcholine chloride
- succinyldicholine
- succinyldicholine
- sucostrin
- sucostrin
- suxamethone
- suxamethone
- suxamethonium
- suxamethonium
- suxamethonium
- suxamethonium
- suxamethonium
- suxamethonium
- suxamethonium chloride
- suxamethonium chloride
- suxamethonium chloride
- suxamethonium chloride
- suxamethonium chloride
- suxamethonium chloride
Clinical trials
| NCT ID | Phase | Start date | Sponsor(s) |
|---|---|---|---|
| NCT07211399 | Early Phase 1 (Phase 1) | Jan 1, 2026 | University of Pittsburgh |
| NCT06772727 | Phase 4 | Jan 15, 2025 | Cairo University |
| NCT06029049 | Phase 4 | Sep 13, 2023 | University of Texas at Houston |
| NCT04868409 | Phase 4 | Aug 12, 2021 | University of Copenhagen |
| NCT04581395 | Phase 3 | Oct 2, 2020 | Indiana University |
| NCT04709315 | Phase 3 | Oct 1, 2020 | South Valley University |
| NCT03960801 | Phase 3 | Sep 30, 2019 | University of Nantes |
| NCT03532178 | Phase 2 | Jul 31, 2018 | Merck, University of California, San Francisco |
| NCT03469323 | N/A | Mar 31, 2018 | National Taiwan University |
| NCT03367988 | N/A | Jan 31, 2018 | University of South Florida |
| NCT02604368 | Phase 3 | Jul 1, 2017 | Micelle BioPharma |
| NCT02822144 | Phase 3 | Sep 29, 2016 | University of Rennes |
| NCT02635542 | Phase 4 | Mar 1, 2016 | University of Chicago |
| NCT02676011 | Phase 2 | Feb 1, 2016 | Assiut University |
| NCT01996358 | N/A | Aug 1, 2015 | Johannes Gutenburg University |
| NCT02410590 | Phase 4 | Jul 1, 2015 | Merck |
| NCT02425449 | Phase 4 | Apr 1, 2015 | University of Toledo |
| NCT05556408 | Phase 4 | Mar 1, 2015 | Peking University |
| NCT02237443 | Phase 4 | Aug 1, 2014 | University of Washington |
| NCT02000674 | Phase 4 | Dec 1, 2013 | Centre Hospitalier Universitaire de la Réunion |
Organizations
Research & Development (43)
| Organization | Org type | Trials | As lead sponsor | Phases | Earliest year |
|---|---|---|---|---|---|
| ALK-Abello, S.A. | For profit | 6 | 6 | 2 | 2007 |
| Merck | For profit | 4 | 3 | 3 | 2006 |
| Johannes Gutenburg University | Academic/Hospital | 3 | 3 | 1 | 2011 |
| Harvard University | Academic/Hospital | 2 | 2 | 2 | 2010 |
| University of Copenhagen | Academic/Hospital | 2 | 2 | 1 | 2009 |
| University of Versailles | Academic/Hospital | 2 | 2 | 2 | 2009 |
| Assiut University | Academic/Hospital | 1 | 1 | 1 | 2016 |
| Cairo University | Academic/Hospital | 1 | 1 | 1 | 2025 |
| Centre Hospitalier Universitaire de la Réunion | Academic/Hospital | 1 | 1 | 1 | 2013 |
| Charles University | Academic/Hospital | 1 | 1 | 1 | 2013 |
| Health Research Board, Ireland | Academic/Hospital | 1 | 0 | 1 | 2008 |
| Indiana University | Academic/Hospital | 1 | 1 | 1 | 2020 |
| Katholieke Universiteit Leuven | Academic/Hospital | 1 | 1 | 1 | 2011 |
| King Saud University | Academic/Hospital | 1 | 1 | 1 | 2006 |
| Makassed General Hospital | Academic/Hospital | 1 | 0 | 1 | 2011 |
| Masaryk University | Academic/Hospital | 1 | 0 | 1 | 2012 |
| McMaster University | Academic/Hospital | 1 | 0 | 1 | 2006 |
| Micelle BioPharma | For profit | 1 | 1 | 1 | 2017 |
| National Taiwan University | Academic/Hospital | 1 | 1 | 1 | 2018 |
| Northwestern University | Academic/Hospital | 1 | 1 | 1 | 2012 |
Marketing (40)
| Organization | Org type | Relationship | Date |
|---|---|---|---|
| Accord Research | For profit | MKTG | May 20, 2020 |
| Amneal Pharmaceuticals | For profit | MKTG | Nov 16, 2018 |
| Amneal Pharmaceuticals | For profit | SYN | Nov 16, 2018 |
| Amphastar Pharmaceuticals | For profit | MKTG | Jun 8, 2020 |
| Amring Pharmaceticals | For profit | MKTG | Jun 4, 2018 |
| Apothecon | For profit | MKTG | Apr 24, 1953 |
| Apothecon | For profit | NDA2 | Apr 24, 1953 |
| Aspiro | For profit | MKTG | May 4, 2020 |
| BE Pharmaceuticals | For profit | MKTG | Feb 7, 2022 |
| Deva Holding A.S. | For profit | MKTG | Dec 21, 2020 |
| Dr. Reddy's Laboratories | For profit | MKTG | Aug 2, 2019 |
| Esteve Labs | For profit | MKTG | Oct 9, 2019 |
| Eu Yan Sang | For profit | MKTG | Oct 19, 2021 |
| Eugia Pharma | For profit | MKTG | Oct 16, 2023 |
| Fosun | For profit | MKTG | Jun 16, 2020 |
| Fresenius | For profit | MKTG | Nov 20, 2020 |
| Gland Pharma Ltd | For profit | MKTG | Jun 16, 2020 |
| Hikma | For profit | MKTG | Jun 12, 2020 |
| Hikma | For profit | SYN | Aug 20, 2021 |
| Hikma | For profit | NDA2 | Aug 20, 2021 |
| Hospira | For profit | NDA2 | May 1, 1953 |
| Indoco Remedies | For profit | MKTG | May 22, 2020 |
| Indoco Remedies | For profit | SYN | May 22, 2020 |
| International Medication | For profit | MKTG | — |
| Mankind Pharma | For profit | MKTG | Feb 2, 2023 |
| Meitheal | For profit | MKTG | Oct 19, 2021 |
| Micro Labs Ltd India | For profit | MKTG | Nov 24, 2020 |
| Mylan | For profit | MKTG | Jan 15, 2020 |
| Nexus Pharmaceuticals | For profit | MKTG | Oct 27, 2020 |
| Nexus Pharmaceuticals | For profit | SYN | Oct 27, 2020 |
| Nichi-Iko Pharmaceutical Co., Ltd. | For profit | MKTG | Mar 29, 2021 |
| Nivagen Pharmaceuticals Inc. | For profit | MKTG | May 19, 2020 |
| Organon | For profit | MKTG | Sep 20, 1972 |
| STERISCIENCE | For profit | MKTG | Jul 9, 2024 |
| Sagent Pharmaceuticals, Inc. | For profit | MKTG | Mar 29, 2021 |
| Sandoz | For profit | NDA | Aug 20, 1952 |
| Sandoz | For profit | SYN | Oct 9, 2019 |
| Sandoz | For profit | MKTG | Aug 20, 1952 |
| Somerset Pharmaceuticals | For profit | MKTG | Jan 15, 2020 |
| Zydus Discovery DMCC | For profit | MKTG | May 4, 2018 |