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Alcuronium is a synthetic indole alkaloid of the curare family and a non-depolarizing skeletal muscle relaxant, historically used as an anesthesia adjuvant to facilitate endotracheal intubation and provide muscle relaxation during surgical procedures. It acts as a competitive antagonist at nicotinic acetylcholine receptors at the neuromuscular junction, inhibiting synaptic transmission and resulting in muscle paralysis. Alcuronium is about 1.5–2 times as potent as tubocurarine, with an onset of action around 2 minutes and duration of 20–30 minutes. Its effects are reversible by neostigmine, and it produces little histamine release but can cause vagolytic effects due to blockade of cardiac muscarinic receptors.
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