Sugammadex Sugammadex (Bridion®) has a novel approach to the rapid reversal of steroid based NMBA's.17, 18 The drug has been developed in The Netherlands by Organon, which is now part of Schering-Plough, which is part of Merck. The drug is a modified gamma-cyclodextrin that is water soluble but has a lipophilic cavity that traps the NMBA. The formation of this sugammadex/NMBA complex results in a reduction in the amount of free circulating NMBA, leaving the receptor available for binding to Ach.19 Sugammadex acts selectively against the steroidal NMBAs rocuronium and vecuronium but has little or no activity against nonsteroidal NMBAs (eg, succinylcholine, atracurium, cisatracurium). There is no evidence that sugammadex is metabolized; the drug is primarily eliminated via the renal route as unchanged drug. The drug is in Europe approved for routine clinical use to reverse neuromuscular blockade induced by steroidal non-depolarizing muscle relaxants.