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NIMBEX
®
INJECTION
_CISATRACURIUM BESYLATE_
CONSUMER MEDICINE INFORMATION
WHAT IS IN THIS LEAFLET
This
leaflet
answers
some
common
questions about NIMBEX. It does not
contain all of the available information.
Reading this leaflet does not take the place
of talking to your doctor or pharmacist.
Taking any medicine involves some risk. It
is possible that all risks associated with this
medicine might not have been detected,
despite proper testing. Only your doctor or
pharmacist is able to weigh up all of the
relevant facts, and you should consult them
if you have any queries.
IF YOU HAVE ANY CONCERNS ABOUT THE USE
OF
NIMBEX
ASK
YOUR
DOCTOR
OR
PHARMACIST.
KEEP THIS INFORMATION.
You may want to read it again.
This leaflet provides information about
NIMBEX. The statements that are made in
this leaflet cannot be applied to any other
medicine, even those that are similar or
appear to contain the same ingredients.
WHAT NIMBEX IS USED FOR
NIMBEX is used to relax the body’s
muscles. NIMBEX will normally be given to
you when you are in surgery, or during
other medical procedures. NIMBEX is only
used in conjunction with an anaesthetic, so
you will be asleep during the procedure.
IF YOU HAVE ANY QUESTIONS ABOUT WHY
NIMBEX IS USED ASK YOUR DOCTOR.
_HOW DOES NIMBEX WORK?_
Cisatracurium
besylate
(the
active
ingredient in NIMBEX) belongs to a group
of
medicines
called
“neuromuscular
blockers”.
NIMBEX works by blocking the effects of
one of the body’s chemical messengers
called acetylcholine. Acetylcholin
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PRODUCT INFORMATION
NIMBEX
®
INJECTION
NAME OF THE MEDICINE:
Cisatracurium besylate
The chemical name of cisatracurium besylate is (1R,1’R,2R,2’R,)-2,2’-(3,11-dioxo-4,10-
dioxatridecamethylene)
bis
(1,2,3,4-tetrahydro-6,7-dimethoxy-2-methyl-1-
veratrylisoquinolinium) dibenzenesulfonate. The molecular formula of cisatracurium besylate
is C
65
H
82
N
2
O
18
S
2
and it has a molecular weight of 1243.5. The structural formula is given
below:
CAS NUMBER: 96946-42-8
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.
PHARMACOLOGY:
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 ED
95
(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 cisatracurium in
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