DrugindexOnline^{2nd edition}

Generic Name: Cisatracurium (sis-ah-trah-KYOO-ree-um)
Brand Name: Nimbex

Cisatracurium is used for:

Providing muscle relaxation during surgery, medically assisted breathing, or insertion of a breathing tube.

Cisatracurium is a nondepolarizing skeletal muscle relaxant. It works by blocking the effects of acetylcholine, a chemical involved in muscle contraction. This relaxes muscles in the body before surgery or insertion of a breathing tube.

Do NOT use Cisatracurium if:

• you are allergic to any ingredient in Cisatracurium

Contact your doctor or health care provider right away if any of these apply to you.

Before using Cisatracurium :

Some medical conditions may interact with Cisatracurium . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, plan to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have muscle weakness or partial paralysis on one side of the body or partial paralysis affecting the lower limbs (eg, Lambert-Eaton syndrome, myasthenia gravis)
• if you have an electrolyte disturbance or acid-base imbalance or tissue wasting, or are debilitated

Some MEDICINES MAY INTERACT with Cisatracurium . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Carbamazepine, inhaled general anesthetics (eg, halothane), phenytoin, or theophyllines because the effectiveness of Cisatracurium may be decreased
• Clindamycin/lincomycin, ketamine, magnesium salts (eg, magnesium sulfate), polypeptide antibiotics (eg, actinomycin), quinidine, quinine, trimethaphan, or verapamil because the actions and side effects of Cisatracurium may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cisatracurium may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Cisatracurium :

Use Cisatracurium as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Cisatracurium is usually administered as an injection at your doctor's office, hospital, or clinic. Ask your doctor or pharmacist any questions that you may have about Cisatracurium .
• If Cisatracurium contains particles or is discolored, or if the vial/container is cracked or damaged in any way, do not use it.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.
• If you miss a dose of Cisatracurium , contact your doctor right away.

Ask your health care provider any questions you may have about how to use Cisatracurium .

Important safety information:

• Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Cisatracurium or other medicines you were given during surgery. Using Cisatracurium alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Do not use Cisatracurium if you are allergic to benzyl alcohol.
• Cisatracurium is not recommended for use in CHILDREN younger than 1 month of age. Safety and effectiveness in this age group have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Cisatracurium during pregnancy. It is unknown if Cisatracurium is excreted in breast milk. If you are or will be breast-feeding while you are using Cisatracurium , check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Cisatracurium :

All medicines may cause side effects, but many people have no, or minor, side effects. No COMMON side effects have been reported with the proper use of Cisatracurium . If you notice any unusual effects, contact your doctor or pharmacist. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; flushing; itching; muscle weakness; rash; slow or irregular heartbeat; tightening of the airway.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include prolonged muscle paralysis.

Proper storage of Cisatracurium :

Store Cisatracurium in the refrigerator (36 to 46 degrees F; 2 to 8 degrees C) in the original carton. Protect from light. Do not freeze. When removing from refrigeration to room temperature (68 to 77 degrees F; 20 to 25 degrees C), use Cisatracurium within 21 days, even if re-refrigerated. Keep Cisatracurium , as well as needles and syringes, out of the reach of children and away from pets.

General information:

• If you have any questions about Cisatracurium , please talk with your doctor, pharmacist, or other health care provider.
• Cisatracurium is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Cisatracurium . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.