Cisatracurium
Muscle Relaxant · Non-depolarising muscle relaxant
Indications
Cisatracurium is injected for use during surgical and other procedures and in intensive care. It is used as an adjunct to general anaesthesia, or sedation in the intensive care unit (ICU), to relax skeletal muscles and to facilitate tracheal intubation and mechanical ventilation.
Dosage
Adults: Intubation and surgery: 150 mcg/kg by IV injection, maintenance 30 mcg/kg every 20 min by IV injection or by IV infusion initially 180 mcg/kg/hr, then after stabilisation 60-120 mcg/kg/hr. Intensive care: 150 mcg/kg by IV injection, maintenance 30 mcg/kg initially then by IV infusion initially 180 mcg/kg/hr, then adjusted according to response. Children: To avoid excessive dosage in obese children, dose should be calculated on the basis of ideal weight. Neuromuscular blockade (intermediate duration) during surgery: IV injection: 1 mth-2 yr, initially 150 mcg/kg, then 30 mcg /kg repeated approx every 20 minutes as necessary; 2-12 yr, initially 150 mcg/kg (80-100 mcg/kg if not for intubation), then 20 mcg /kg repeated approx every 10 minutes as necessary; 12-18 yr, initially 150 mcg /kg, then 30 mcg /kg repeated approx. every 20 minutes as necessary. IV infusion: 2-18 yr,…
Administration
Administer IV only. Give undiluted as a bolus injection. Continuous administration requires the use of an infusion pump. Compatibility: Stable in D5W, NS, D5NS. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, aztreonam, bumetanide, calcium gluconate, ceftriaxone, cimetidine, ciprofloxacin, dexamethasone, digoxin, diltiazem, diphenhydramine, dobutamine, dopamine, enalapril, epinephrine, esmolol, famotidine, fentanyl, fluconazole, gentamicin, hydrocortisone, hydromorphone, imipenem, ketorolac, linezolid, lorazepam, magnesium sulphate, metoclopramide, metronidazole, midazolam, morphine, nitroglycerin, norepinephrine, ondansetron, phenylephrine, piperacillin/tazobactam, ranitidine, tobramycin, vancomycin. Drug to Drug IV Incompatibility: Amphotericin B cholesteryl sulphate complex, cefoperazone, cephazolin, furosemide, heparin, methylprednisolone, nitroprusside,…
Adverse Effects
Cutaneous flushing, rash, bradycardia, hypotension and bronchospasm.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Precautions: Paralyses the respiratory muscles as well as skeletal muscles, but has no known effect on consciousness or pain threshold. Caution in allergic hypersensitivity to other neuromuscular blocking agents. Caution in Myasthaenia gravis and other neuromuscular diseases.
Interactions
Enflurane, isoflurane, halothane, ketamine, aminoglycosides, polymyxin, spectinomycin, tetracyclines, lincomycin, clindamycin, propranolol, calcium-channel blockers, lignocaine, procainamide, quinidine, furosemide, thiazides, mannitol, acetazolamide, phenytoin, carbamazepine.
Advice to Patient
Before administration, patient is usually unconscious. Continuous monitoring is required during and after administration. After muscle tone becomes normal, do not change position and rise up without help. Contact prescriber if there is difficulty in breathing, muscle tremors, fast heartbeat, skin rash, hives.
Pharmacokinetics
Metabolism: Via Hofmann elimination. Half-life elimination: 20-28 mins. Excretion: Urine. Faeces.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.