CISATRACURIUM BESYLATE

Dosing Considerations • Cisatracurium Besylate Injection, USP Multi–Dose contains benzyl alcohol. See CONTRAINDICATIONS and WARNINGS AND PRECAUTIONS. • Cisatracurium Besylate Injection, USP Multi–Dose should be administered only by the intravenous route.

These drugs should be administered by or under the supervision of experienced clinicians familiar with the use of neuromuscular blocking agents. Dosage must be individualized in each case. • To avoid patient distress, Cisatracurium Besylate Injection, USP Multi–Dose should NOT be administered prior to the induction of unconsciousness.

g. barbiturate solutions). Recommended Dose and Dosage Adjustment The dosage information provided below is intended as a guide only. Doses of Cisatracurium Besylate Injection, USP Multi–Dose should be individualized and a peripheral nerve stimulator should be used to measure neuromuscular function during administration of Cisatracurium Besylate Injection, USP Multi–Dose in order to monitor drug effect, to determine the need for additional doses, and to confirm recovery from neuromuscular block.

The use of a peripheral nerve stimulator will permit the most advantageous use of Cisatracurium Besylate Injection, USP Multi– Dose, minimize the possibility of overdosage or underdosage, and assist in the evaluation of recovery. Adults Initial Doses One of two intubating doses of cisatracurium may be chosen, based on the desired time to intubation and the anticipated length of surgery.

0 minutes. 20 mg/kg cisatracurium during propofol anesthesia are 55 minutes (range: 44 to 74 min) and 61 minutes (range: 41 to 81 min), respectively. Lower doses may result in a longer time for the development of satisfactory intubation conditions.

, fentanyl and midazolam) and the depth of anesthesia are factors that can influence intubation conditions. 40 mg/kg) have been administered to a limited number of healthy adult patients (n=15) and patients with serious cardiovascular disease (n=31).

These larger doses are associated with a longer clinically effective duration of action. See ACTION AND CLINICAL PHARMACOLOGY. 30 mg/kg (6 x ED95) cisatracurium were found to have no significant hemodynamic effects in patients with cardiovascular disease (New York Heart Association Class I-III).

30 mg/kg in this patient population. 10 mg/kg an extension of the interval between administration of Cisatracurium Besylate Injection, USP Multi–Dose and the intubation attempt may be required to achieve satisfactory intubation conditions.

Elderly and Renal Failure Patients Because a slower time to onset of complete neuromuscular block was observed in elderly patients and in patients with renal failure, extending the interval between administration of Cisatracurium Besylate Injection, USP Multi–Dose and the intubation attempt for these patients may be required to achieve adequate intubation conditions.

03 mg/kg cisatracurium is recommended for maintenance of neuromuscular block during prolonged surgical procedures. 03 mg/kg each sustain neuromuscular block for approximately 20 minutes. 20 mg/kg (4 x ED95) cisatracurium besylate injection, the need for maintenance doses should be determined by clinical criteria.

For a shorter or longer duration of action, smaller or larger maintenance doses may be administered. 25 MAC (Minimum Alveolar Concentration) may prolong the clinically effective duration of action of initial and maintenance doses. The magnitude of these effects may depend on the duration of administration of the volatile agents.

25 MAC isoflurane or enflurane had minimal effects on the duration of action of initial doses of cisatracurium besylate injection; therefore, no adjustment to the initial dose should be necessary when Cisatracurium Besylate Injection, USP Multi–Dose is administered shortly after initiation of volatile agents.

In long surgical procedures during enflurane or isoflurane anesthesia, less frequent maintenance dosing or lower maintenance doses of Cisatracurium Besylate Injection, USP Multi–Dose may be necessary. No adjustments to the initial dose of Cisatracurium Besylate Injection, USP Multi–Dose are required when used in patients receiving propofol anesthesia.

10 mg/kg of cisatracurium administered over 5 to 10 seconds during either halothane or opioid anesthesia. 7 min) and clinically effective block for an average of 28 minutes (range: 21 to 38 min). Cisatracurium besylate injection has not been studied in children under 2 years of age.

Cisatracurium Besylate Injection, USP Multi–Dose contains benzyl alcohol. Special […]