Baby Safety / Compounds / Succinylcholine

Is Succinylcholine safe for babies and kids?

Elevated risk for kids

Infants have immature drug-metabolizing enzymes (CYP450 ontogeny), reduced renal clearance, and different volume of distribution. Accidental exposure or breast milk transfer of Succinylcholine poses heightened risk.

What is succinylcholine?

The IUPAC name is trimethyl-[2-[4-oxo-4-[2-(trimethylazaniumyl)ethoxy]butanoyl]oxyethyl]azanium dichloride.

Also known as: trimethyl-[2-[4-oxo-4-[2-(trimethylazaniumyl)ethoxy]butanoyl]oxyethyl]azanium dichloride, Succinylcholine chloride, Succinyldicholine chloride, Anectine.

IUPAC name
trimethyl-[2-[4-oxo-4-[2-(trimethylazaniumyl)ethoxy]butanoyl]oxyethyl]azanium dichloride
CAS number
71-27-2
Molecular formula
C14H30Cl2N2O4
Molecular weight
361.3 g/mol
SMILES
C[N+](C)(C)CCOC(=O)CCC(=O)OCC[N+](C)(C)C.[Cl-].[Cl-]
PubChem CID
22475

Risk for babies

Elevated risk

Infants have immature drug-metabolizing enzymes (CYP450 ontogeny), reduced renal clearance, and different volume of distribution. Accidental exposure or breast milk transfer of Succinylcholine poses heightened risk.

Neonates and infants up to 12 months have incomplete blood-brain barrier development, immature Phase I/II metabolic enzymes (particularly CYP3A4, UGT1A1), and higher gastrointestinal permeability. Equivalent doses produce higher internal concentrations and longer residence times.

What to do: Minimize infant exposure through source control. For breastfeeding mothers: reduce maternal exposure. For formula-fed infants: use certified low-migration bottles and verified water sources. Consult pediatrician regarding any concerns.

Risk for pregnant and nursing people

Elevated risk

Succinylcholine poses pregnancy risk through potential teratogenicity, altered pharmacokinetics (increased blood volume, changed CYP activity), and placental transfer. FDA pregnancy category should be evaluated.

Suspected reproductive toxicant (GHS H361) or suspected endocrine disruptor. Precautionary approach warranted. Animal studies or limited human data suggest developmental toxicity potential.

What to do: Minimize exposure during pregnancy and lactation. Consult healthcare provider regarding specific risks. Consider alternative products with lower hazard profiles.

Regulatory consensus

1 regulatory bodyhas classified Succinylcholine.

AgencyYearClassificationNotes
US FDA (approved drug; non-scheduled)2023no carcinogenicity classification; FDA-approved depolarizing neuromuscular blocking agent for endotracheal intubation and short surgical procedures; FDA black box warning for pediatric hyperkalemic cardiac arrest; not classified for carcinogenicity by NTP, IARC, or EFSA

Regulators apply different standards of evidence — animal-data weighting, exposure-pattern assumptions, epidemiological power thresholds — which is why two scientific bodies can review the same data and reach different conclusions. The disagreement is the data.

Where kids encounter succinylcholine

  • Industrial Facilities — Manufacturing plants, Chemical storage areas, Waste treatment sites
  • Occupational Environments — Factories, Warehouses, Transportation vehicles

Safer alternatives

Lower-risk approaches that achieve a similar outcome to Succinylcholine:

  • Alternative drug class; Non-pharmacological therapy; Lowest effective dose
    Trade-offs: Direct chemical substitution requires verification that the replacement does not introduce new hazards (regrettable substitution). Conduct full hazard assessment of proposed alternative before adoption.
    Relative cost: 1.2-2×

Frequently asked questions

Is succinylcholine safe for kids?

Infants have immature drug-metabolizing enzymes (CYP450 ontogeny), reduced renal clearance, and different volume of distribution. Accidental exposure or breast milk transfer of Succinylcholine poses heightened risk.

What products contain succinylcholine?

Succinylcholine appears in: Manufacturing plants (Industrial facilities); Chemical storage areas (Industrial facilities); Factories (Occupational environments); Warehouses (Occupational environments).

What should I do if my child is exposed to succinylcholine?

Minimize infant exposure through source control. For breastfeeding mothers: reduce maternal exposure. For formula-fed infants: use certified low-migration bottles and verified water sources. Consult pediatrician regarding any concerns.

See Succinylcholine in the baby app

Look up products containing succinylcholine, compare to alternatives, and explore the full data record.

Open in baby View raw API data

Sources (1)
  1. FDA Succinylcholine Prescribing Information Black Box Pediatric Hyperkalemic Cardiac Arrest 2023: Duchenne DMD Undiagnosed Myopathy; RSI Emergency Airway Retained Use; Malignant Hyperthermia RYR1 Dantrolene Antidote; Pseudocholinesterase Deficiency Prolonged Paralysis (2023) — regulatory

Reference data, not professional advice. Aggregates publicly available regulatory and scientific data; not a substitute for veterinary, medical, legal, or regulatory advice. Why we built ALETHEIA →