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Cisatracurium

    Brands

    DEA Class;  Rx

    Common Brand Names; Nimbex

    • Neuromuscular Blockers, Nondepolarizing
     

    Parenteral, intermediate-acting, nondepolarizing, neuromuscular blocking agent (NMBA)
    Used for an adjunct to general anesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation
    Minimal histamine release

    Indicated for muscluar relaxation during non-emergent endotracheal intubation.

    For neuromuscular blockade during mechanical ventilation in intensive care patients.

    For neuromuscular blockade during surgery.

    Hypersensitivity to cisatracurium (or benzyl alcohol if 10 mL vial is used)

    Use of 10 mL vial in pediatric patients <1 month of age and low birth-weight infants (contains benzyl alcohol)

    • Bronchospasm
    • Bradycardia
    • Flushing
    • Pruritus
    • Myositis ossificans
    • Hypotension
    • Rash
    • Anaphylaxis
    • Histamine release
    • Prolonged neuromuscular block
    • Muscle weakness, myopathy

    Laudanosine, an active metabolite, reported to cause seizures in animals; patients with renal or hepatic impairment receiving extended therapy may be at higher risk of seizures; monitor level of neuromuscular blockade during long-term administration to limit exposure to toxic metabolites

    Severe anaphylactic reactions to neuromuscular blocking agents have been reported; some cases have been life threatening and fatal; take necessary precautions, such as the immediate availability of appropriate emergency treatment

    Confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings; ensure that the intended dose is clearly labeled and communicated when another healthcare provider is administered

    Neuromuscular blockade in the conscious patient can lead to distress; use drug in presence of appropriate sedation or general anesthesia and monitor patients to ensure level of anesthesia is adequate

    There are no adequate and well-controlled studies in pregnant women

    The 10 mL multiple-dose vials contain the preservative benzyl alcohol; if therapy is needed during lactation, consider using a benzyl alcohol-free formulation (ie, 5 mL and 20 mL single-dose vials)

    Specific maximum dosage information is not available. Dosage must be individualized based on clinical response.

    Cisatracurium besylate

    injectable solution

    • 2mg/mL (multidose vial)

    • Contains benzyl alcohol

    injectable solution, preservative free

    • 2mg/mL (single-dose vial)

    • 10mg/mL (single-dose vial)