Vecuronium is ionized and water soluble prohibiting passage through the blood brain barrier. Thirty percent of an administered dose of vecuronium is metabolized in the liver, where it undergoes spontaneous deacetylation to three active metabolites. The elimination half-life is approximately 80 minutes. Thus, it may take patients with cirrhosis or cholestasis longer to clear the drug. The concomitant use of parenteral antibiotics such as aminoglycosides, tetracyclines, clindamycin, bacitracin, and polymixin B may intensify the neuromuscular blockade produced by vecuronium.
Recurrent paralysis can occur for patients receiving quinidine after vecuronium use.
The neuromuscular blocking effect and the duration of action of vecuronium also may be increased with the use of other NMBAs or calcium channel blockers. Conversely, the concomitant use of azathioprine or theophylline has been shown to decrease the neuromuscular blockade of vecuronium. In general, vecuronium is well tolerated by most patients. The block resolved spontaneously without sequelae. 8 Bronchospasm occurs rarely with vecuronium administration.