Drug reference

Cisatracurium

Neuromuscular Blocker

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AmikacinSevereDatabaseDDInter
Botulinum Toxin Type ASevereDatabaseDDInter
Botulinum Toxin Type BSevereDatabaseDDInter
ColistimethateSevereDatabaseDDInter

Mechanism

Cisatracurium, a non-depolarising neuromuscular blocking drug, competes with acetylcholine for receptor sites at the neuromuscular junction. Its action can be reversed with anticholinesterases.

Indications

To enable light anaesthesia with adequate relaxation of muscles of the abdomen and diaphragmTo relax vocal cords and allow tracheal tube passageTracheal intubation and mechanical ventilation in intensive care patientsLong-term neuromuscular blockadeAdjuvant in surgical anesthesia to obtain relaxation of skeletal muscleGood choice for patients with impaired renal function

Dosing

Adult: 0.15–0.2 mg/kg (initiation); 0.03 mg/kg (intermittent injection); 1–3 µg/kg/min (continuous infusion)
Pediatric: Commonly administered for short procedures where only a single intubating dose is required
Renal adjustment: No adjustment required; suitable for use in patients with renal impairment as duration of action is not dependent on kidney elimination.
Hepatic adjustment: No adjustment required; suitable for use in patients with hepatic impairment as duration of action is not dependent on liver elimination.

Pharmacokinetics

Onset

2–8 min

Duration

Slightly longer than atracurium besilate (intermediate-acting, typically 30-40 minutes); suitable for long-term neuromuscular blockade.

Protein binding

nearly 4 times more potent than atracurium

Metabolism

Undergoes non-enzymatic metabolism which is independent of liver and kidney function.

Excretion

Not dependent on hepatic or renal elimination pathways.

Side effects

Common

less histamine releasefewer side effects

Serious

No histamine release

Drug interactions

Amikacin

Severe

Database

Clinical effect not specified

Source: DDInter

Botulinum Toxin Type A

Severe

Database

Clinical effect not specified

Source: DDInter

Botulinum Toxin Type B

Severe

Database

Clinical effect not specified

Source: DDInter

Colistimethate

Severe

Database

Clinical effect not specified

Source: DDInter

Colistin Sulphate

Severe

Database

Prolonged duration of neuromuscular blockade, leading to delayed recovery from anesthesia and prolonged mechanical ventilation.

Avoid concomitant use if possible. If co-administration is unavoidable, monitor neuromuscular function closely and be prepared for prolonged mechanical ventilation. Consider reducing the dose of cisatracurium.

Gentamicin

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Kanamycin

Severe

Database

Clinical effect not specified

Source: DDInter

Neomycin

Severe