Cisatracurium
Cisatracurium is a neuromuscular blocking agent used to relax muscles during surgical procedures and mechanical ventilation. It works by blocking the action of acetylcholine at the motor end-plate, preventing neuromuscular transmission. This medication is administered in healthcare settings by trained professionals and is reversible with acetylcholinesterase inhibitors.
A neuromuscular blocking agent that temporarily paralyzes muscles during surgery or intensive care.
Key facts at a glance
- ATC
- M03AC11
- RxNorm
- 319864
- Generic
- Cisatracurium
- Class
- atc-m03
- Brands
- Nimbex
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
first trimesteruse lowest effective dose
use only when clearly needed for maternal anesthesia during surgery; avoid elective procedures during first trimester if possible
standard maternal vital signs and fetal monitoring during procedures
Use with caution and monitor for adverse effects.
pregnancy
third trimesterstandard dosing with careful timing
use for cesarean delivery when benefits outweigh risks; avoid close to delivery if prolonged paralysis of newborn is a concern
neonatal assessment for respiratory effort and muscle tone after delivery
Use with caution and monitor for adverse effects.
pediatric_age
infants 1 month to 2 yearsreduced initial dose and careful titration
use lower initial dose (0.1 mg/kg) compared to adults; longer recovery time may be required
continuous neuromuscular function monitoring
Use with caution and monitor for adverse effects.
geriatric
elderly over 65start with lower end of dosing range
administer slowly with careful titration; consider reduced initial dose due to increased sensitivity and prolonged recovery
continuous neuromuscular monitoring essential; monitor for prolonged paralysis
renal_impairment
severe renal impairmentstandard dosing initially but monitor closely
use standard initial dose; recovery may be prolonged; monitor for metabolite accumulation
neuromuscular monitoring mandatory; consider monitoring laudanosine levels in prolonged use
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentstandard dosing with careful titration
use standard initial dose; recovery may be slightly prolonged; monitor closely
neuromuscular function monitoring essential
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment needed
compatible with breastfeeding; very minimal transfer to breast milk expected
standard postpartum monitoring
Statistics and clinical data
FDA approval year
General prescribing information
Drug class
Drug class information
Common uses
Common therapeutic uses
Onset of action
Pharmacokinetic properties
Used to facilitate endotracheal intubation and mechanical ventilation, provide muscle relaxation during surgical procedures (including prolonged surgeries), and assist with patient ventilation in intensive care settings.
Cisatracurium binds competitively to nicotinic acetylcholine receptors on the motor end-plate, blocking the action of acetylcholine. This results in paralysis of skeletal muscles by preventing neuromuscular transmission.
Must be administered by trained healthcare professionals in settings with appropriate monitoring and ventilation equipment. Effects can be reversed with acetylcholinesterase inhibitors like neostigmine. Patients require adequate sedation and analgesia as cisatracurium has no effect on consciousness or pain perception. Storage requires refrigeration (2-8°C).
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy