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GSK PRODUCTS

NIMBEX® Injection

Cisatracurium besylate


DESCRIPTION:

Cisatracurium besylate is a white to pale yellow powder.

Nimbex Injection is supplied in two strengths, either 2 mg or 5 mg of cisatracurium besylate per mL. Nimbex Injection also contains Water for Injections and benzenesulfonic acid.Nimbex Injection does not contain any preservative and is intended for single patient use only.

Pharmacodynamics

Cisatracurium besylate, a stereoisomer of atracurium, is an intermediate duration,non-depolarising benzylisoquinolinium skeletal muscle relaxant. Cisatracurium besylate binds to cholinergic receptors on the motor end-plate to antagonise the action of acetylcholine, resulting in a competitive block of neuromuscular transmission. This action is readily reversed

by anticholinesterase agents such as neostigmine. The ED95 (dose required to produce 95% depression of the twitch response of the adductor pollicis muscle to stimulation of the ulnar nerve) of cisatracurium besylate is estimated to be 0.05 mg/kg bodyweight during opioid anaesthesia (thiopentone, fentanyl, midazolam). The recommended intubation dose for isatracurium in adults is 3 x ED95, which has a longer clinically effective duration than the recommended intubation dose of atracurium (2 x ED95) (see DOSAGE AND ADMINISTRATION).