Doxacurium binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in a block of neuromuscular transmission (non-depolarizing). This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine. Doxacurium is a long-acting, nondepolarizing skeletal muscle relaxant. The neuromuscular block produced by doxacurium may be antagonized by anticholinesterase agents. As with other nondepolarizing neuromuscular blocking agents, the more profound the neuromuscular block at reversal, the longer the time and the greater the dose of anticholinesterase required for recovery of neuromuscular function. Doxacurium is approximately 2.5 to 3 times more potent than pancuronium and 10 to 12 times more potent than metocurine.
REFERENCE-KD TRIPATHI, JAYPEE BROTHERS MEDICAL PUBLISHERS PVT.LTD 7TH EDITION, REPRINT 2001,PG NO.:347,352,353.