• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your anaesthetist or other doctor.
• If you get any side effects, talk to your anaesthetist or other doctor. This includes any possible side effects not listed in this leaflet. See section 4.

1. What Esmeron is and what it is used for
2. What you need to know before Esmeron is given
3. How Esmeron is given
4. Possible side effects
5. How Esmeron is stored
6. Contents of the pack and other information

• if you are allergic (hypersensitive) to rocuronium, the bromide ion or any of the other ingredients of this medicine (listed in section 6).

Tell your anaesthetist if this applies to you.

Talk to your anaesthetist before you receive this medicine:

• if you are allergic to muscle relaxants
• if you have had kidney, heart, liver or gall bladder disease
• if you have had diseases affecting nerves and muscles
• if you have fluid retention (oedema).

• Tell your anaesthetist if any of these applies to you.

• if you have a history of malignant hyperthermia (sudden fever with rapid heartbeat, rapid breathing and stiffness, pain and/or weakness in your muscles)

Some conditions may influence the effects of Esmeron — for example:

• low calcium levels in the blood
• low potassium levels in the blood
• high magnesium levels in the blood
• low levels of protein in the blood
• too much carbon dioxide in the blood
• loss of too much water from the body, for example by being sick, diarrhoea or sweating
• over-breathing leading to too little carbon dioxide in the blood (alkalosis)
• general ill-health
• burns
• being very overweight (obesity)
• very low body temperature (hypothermia).

If you have any of these conditions, your anaesthetist will take it into account when deciding the correct dose of Esmeron for you.

Esmeron can be used in children (newborns and adolescence) and elderly but your anaesthetist should first assess your medical history.

Tell your anaesthetist if you are taking other medicines or have recently taken them. This includes medicines or herbal products that you have bought without a prescription. Esmeron may affect other medicines or be affected by them.

Medicines which increase the effect of Esmeron:

• certain antibiotics
• certain medicines for heart disease or high blood pressure (water tablets, calcium channel blockers, beta-blockers and quinidine)
• certain anti-inflammatory medicines (corticosteroids)
• medicines for manic depressive illness (bipolar disorder)
• magnesium salts
• certain medicines used to treat malaria.

Medicines which decrease the effect of Esmeron:

• certain medicines for epilepsy
• calcium chloride and potassium chloride
• certain protease inhibitors called gabexate and ulinastatin.

In addition, you may be given other medicines before or during surgery which can alter the effects of Esmeron. These include certain anaesthetics, other muscle relaxants, medicines such as phenytoin and medicines which reverse the effects of Esmeron. Esmeron may make certain anaesthetics work more quickly. Your anaesthetist will take this into account when deciding the correct dose of Esmeron for you.

Tell your anaesthetist if you are pregnant or might be pregnant, or if you are breast feeding.

Your anaesthetist may still give you Esmeron, but you need to discuss it first. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your anaesthetist or other doctor for advice before taking this medicine. Esmeron may be given to you if you are having a Caesarean section.

Breastfeeding should be suspended 6 hours after use of this medicine.

Do not drive or use machines until advised it is safe to do so. Because Esmeron is given as part of a general anaesthetic, you may feel tired, weak or dizzy for some time afterwards. Your anaesthetist will be able to advise you on how long the effects are likely to last.

This medicine contains less than 1 mmol sodium (23 mg) per vial, that is to say essentially ‘sodium-free’.

Your anaesthetist will work out the dose of Esmeron you need based on:

• the type of anaesthetic
• the expected length of the operation
• other drugs you are taking
• your state of health.

The normal dose is 0.6 mg per kg body weight and the effect will last 30–40 minutes.

Esmeron will be given to you by your anaesthetist. Esmeron is given intravenously (into a vein), either as single injections or as a continuous infusion (a drip).

As your anaesthetist will be monitoring your condition carefully it is unlikely that you will be given too much Esmeron. However, if this happens, your anaesthetist will keep you breathing artificially (on a ventilator) until you can breathe on your own. You will be kept asleep while this takes place.

Or if you notice any side effects not listed in this leaflet:

Tell your anaesthetist or other doctor.

If you get any side effects, talk to your anaesthetist or other doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

The active substance of Esmeron is rocuronium bromide 10 mg/ml.

The other ingredients are sodium acetate (E262), sodium chloride, acetic acid (E260) and water for injections. Each millilitre (ml) of Esmeron contains 1.64 mg of sodium. No preservative has been added.

Esmeron is a colourless to slightly yellow/brown solution for injection. It is available in vials containing 25 mg (10 vials per pack), 50 mg (10 vials per pack) or 100 mg (10 vials per pack) of rocuronium bromide.

Not all pack sizes may be marketed.

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