SUGAMMADEX AND A HIDDEN SIDE EFFECT

Sugammadex, or Bridion, has recently increased greatly in popularity. The drug is used for rapid-reversal of neuromuscular blockade induced by rocuronium. Many anesthesiologists and CRNAs favor this drug because of how quickly it acts, compared to other rocuronium reversal agents. However, many practitioners don't realize that sugammadex lowers efficacy of hormonal contraceptives. I recommend that patients receiving sugammadex be supplied with an informational letter and education before discharge. Below is a sample letter you can use to inform patients of sugammadex use. CLICK HERE to download an editable version of the letter.

Birth Control Drug Interaction with Sugammadex (Bridionâ) and/or Aprepitant (Emendâ): Information for Female Surgery Patients During your procedure or surgery you received medication that lower the effectiveness of birth control medications. You need to be aware of this if you are on any type of hormonal contraceptive (birth control medication): Sugammadex (Bridionâ) is a medicine that helps to speed up recovery from anesthesia (muscle relaxant) drugs patients received during surgery. Sugammadex may decrease the effectiveness of your hormonal contraceptive (birth control) for up to 7 days.

  • Use back up birth control method for up to 7 days after your procedure or surgery.

  • Continue taking your hormonal contraceptive during this period.

Aprepitant (Emendâ) is a medicine that prevents nausea. Aprepitant may decrease the effectiveness of your hormonal contraceptive (birth control) for 28 days.

  • Use backup birth control method for up to 28 days after your procedure or surgery

  • Continue taking your hormonal contraceptive during this period.

What are some examples of hormonal contraceptives?

  • Oral contraceptives (birth control pills)

  • Injectable contraceptives (birth control shot)

  • Implantable contraceptives (small plastic rod of device inserted under the skin or inside the uterus)

  • Patches (small adhesive patch worn on the skin)

  • Vaginal rings (flexible plastic ring inserted into the vagina)

What are some examples of back up birth control methods?

  • Male condom

  • Female condom

  • Female diaphragm

  • Female cervical cap and sponge

  • Abstinence (not having sex)

Where can I learn more about backup birth control methods? If you have any questions of concerns, contact your doctor or pharmacist. Access the FDA birth control guide at: https://www.fda.gov/media/99605/download References: 1.    Bridionâ Package Insert https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022225lbl.pdf 2.    Emendâ Package Insert https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/022023s014lbl.pdf

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