Sugammadex: the first selective binding reversal agent for neuromuscular block

Sugammadex is a novel cyclodextrin, the first in a new class of selective binding reversal agents that terminates neuromuscular block (NMB) with the steroidal nondepolarizing agents, rocuronium and vecuronium. Sugammadex can reverse a moderate or deep NMB. The dose required depends on the level of NMB that needs to be reversed. Smaller doses are sufficient for a moderate versus deep NMB. In October 2007, a new drug application for sugammadex was submitted to the U.S. Food and Drug Administration (FDA). The FDA issued a not-approvable letter in July 2008. The manufacturer continues clinical trials.