Mechanical ventilation

Active Ingredient: Cisatracurium

Indication for Cisatracurium

Population group: only infants (40 days - 1 year old) , children (1 year - 12 years old) , adolescents (12 years - 18 years old) , adults (18 years old or older)

Cisatracurium can be used as an adjunct to general anaesthesia, or sedation in the Intensive Care Unit (ICU) to relax skeletal muscles, and to facilitate tracheal intubation and mechanical ventilation.

For this indication, competent medicine agencies globally authorize below treatments:

0.03 to 0.6 mg/kg/hr


Dosage regimens

Intravenous, between 0.03 milligrams cisatracurium per kilogram of body weight and 0.6 milligrams cisatracurium per kilogram of body weight, hourly.

Detailed description

Dosage in Intensive Care Unit (ICU) patients

Cisatracurium may be administered by bolus dose and/or infusion to adult patients in the ICU.

An initial infusion rate of cisatracurium of 3 ฮผg/kg (body weight)/min (0.18 mg/kg/hr) is recommended for adult ICU patients. There may be wide interpatient variation in dosage requirements and these may increase or decrease with time. In clinical studies the average infusion rate was 3 ฮผg/kg/min [range 0.5 to 10.2 ฮผg/kg (body weight)/min (0.03 to 0.6mg/kg/hr )].

Table 6 provides guidelines for delivery of undiluted cisatracurium Forte (5mg/ml) injection.

The median time to full spontaneous recovery following long-term (up to 6 days) infusion of cisatracurium in ICU patients was approximately 50 minutes.

Table 6. Infusion Delivery Rate of cisatracurium Forte injection 5 mg/ml:

Patient (body weight) (kg)Dose (ยตg/kg/min)Infusion Rate

The recovery profile after infusions of cisatracurium to ICU patients is independent of duration of infusion.

Active ingredient


Cisatracurium is an intermediate-duration, non-depolarising benzylisoquinolinium skeletal muscle relaxant. Cisatracurium 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 anti-cholinesterase agents such as neostigmine or edrophonium.

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