Nimbex-100 (100mg) 20 Tablets

Cisatracurium is a neuromuscular blocking agent, specifically a non-depolarizing muscle relaxant, used as part of general anesthesia during surgery or mechanical ventilation. Its mechanism of action involves competitive binding to nicotinic acetylcholine receptors (nAChRs) at the neuromuscular junction. By blocking these receptors, cisatracurium inhibits the binding of acetylcholine, a neurotransmitter that stimulates muscle contraction. This inhibition leads to a reversible blockade of neuromuscular transmission, resulting in muscle relaxation and paralysis. The drug's unique stereochemistry, with two cis-oriented benzyl tetrahydroisoquinolinium groups, contributes to its rapid onset and intermediate duration of action compared to other neuromuscular blocking agents.

Cisatracurium 100mg

Neuromuscular blocking agent

Injection

The following are the uses of Cisatracurium 100mg Tablet:

• Used for muscle relaxation during surgery and mechanical ventilation.
• Used to facilitate endotracheal intubation.
• Used in intensive care settings to maintain a relaxed state and enable controlled ventilation.
• Used for rapid sequence induction and intubation in emergency situations.
• Effective in patients with hepatic or renal impairment.
• Used to prevent muscle contractions that may interfere with surgical precision.

In the case of an overdose of Cisatracurium 100mg Tablets, symptoms may include severe muscle weakness, prolonged paralysis, and respiratory distress. The severity of the overdose effects depends on the amount ingested and the individual's health. Seek immediate medical assistance if an overdose is suspected, as prompt intervention is vital to prevent potential complications. Healthcare professionals should be informed about the overdose to provide appropriate treatment, which may include supportive care and monitoring until the drug's effects wear off.

In the case of a missed dose of Cisatracurium 100mg Tablet, it is important to administer the medication as soon as possible. If it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one. It is crucial to follow the prescribed dosing regimen, as this medication is typically administered in a controlled medical setting with close monitoring. If you have any concerns or questions about missed doses, consult your healthcare provider for specific guidance.

To administer Cisatracurium 100mg Tablet, prepare the injection by reconstituting the powder with the provided diluent, gently swirl to dissolve, and then inject the prescribed dose intravenously over a period of 60 seconds, following the instructions provided by your healthcare professional.

Here are the conditions and situations when Cisatracurium 100mg Tablet should not be used:

• Should not be administered to individuals with a known allergy or hypersensitivity to Cisatracurium or any of its components, including benzyl alcohol.
• Contraindicated in patients with a known history of myasthenia gravis.
• Not recommended for individuals with personal or family histories of malignant hyperthermia.
• Should be avoided in patients with severe liver disease or impaired liver function.
• Not suitable for patients with severe kidney disease or those on dialysis.
• Should not be used in individuals with uncontrolled or severe cardiovascular disease.
• Contraindicated during pregnancy or breastfeeding, unless the potential benefits outweigh the risks.
• Should not be used in children below 18 years of age due to limited safety data.
• Avoid using in patients with known or suspected esophageal, gastric, or duodenal ulcers.
• Not recommended for patients with neuromuscular diseases or conditions affecting muscle function.

The side effects of Cisatracurium 100mg Tablet may include:

• Muscle weakness or paralysis (prolonged effect)
• Bradycardia (slow heart rate)
• Hypotension (low blood pressure)
• Allergic reactions (skin rash, itching, swelling)
• Respiratory depression (difficulty in breathing)
• Increased salivation
• Nausea and vomiting
• Local injection site reactions

Following are the precautions and warnings for Cisatracurium 100mg Tablet:

• This medication should only be administered by trained medical professionals in a clinical setting, as it requires careful monitoring and dosage adjustments.
• Not recommended for patients with known hypersensitivity or allergies to cisatracurium or any of its components.
• Caution is advised in patients with myasthenia gravis, as it may exacerbate muscle weakness.
• Patients with renal impairment or hepatic dysfunction may require dosage adjustments, as the drug is primarily eliminated by the kidneys and liver.
• Close monitoring is necessary for patients with cardiovascular diseases, as cisatracurium can cause hypotension and bradycardia.
• Elderly patients may be more susceptible to the effects and side effects of the medication, requiring careful dose titration.
• Cisatracurium should be used with caution during pregnancy and breastfeeding, as its safety is not fully established.
• Ensure that adequate resuscitation equipment and medications are readily available before administering this medication to manage potential adverse reactions.

Following are the drug interactions for Cisatracurium 100mg Tablet:

• Cisatracurium may interact with other neuromuscular blocking agents, leading to prolonged paralysis and respiratory depression.
• Concomitant use with aminoglycoside antibiotics can enhance neuromuscular blockade and increase the risk of respiratory complications.
• Drugs that affect calcium homeostasis, such as calcium channel blockers, may potentiate the effects of Cisatracurium.
• Anesthetics like propofol or opioids can have additive respiratory and cardiovascular effects when used with Cisatracurium.
• Cisatracurium metabolism can be affected by medications that induce or inhibit cytochrome P450 enzymes, altering its duration of action.
• Neuromuscular monitoring is recommended when using Cisatracurium with other drugs that have neuromuscular effects, such as magnesium-containing drugs.
• Caution is advised when combining Cisatracurium with medications that prolong QT intervals, as it may further prolong cardiac repolarization.

Following are the food interactions for Cisatracurium 100mg Tablet:

• Avoid grapefruit and grapefruit juice as they can interfere with the metabolism of the drug, potentially affecting its effectiveness.
• Alcohol consumption should be minimized or avoided as it may enhance the neuromuscular blocking effects of Cisatracurium, leading to prolonged respiratory muscle paralysis.
• High-fat meals may slightly delay the onset of action, but it does not significantly affect the overall efficacy of the medication.
• Caffeine-rich foods and beverages might interact with Cisatracurium, potentially affecting its duration of action; thus, monitoring is advised.
• Avoid potassium-rich foods like bananas and oranges, as Cisatracurium can cause hyperkalemia, and these foods can further elevate potassium levels.
• Limit vitamin K-rich foods like spinach and broccoli, as Cisatracurium can affect blood clotting, and these foods can counteract this effect.
• Herbal supplements, particularly those affecting blood pressure or heart rate, should be used cautiously as they may influence the drug's action.
• Always consult a healthcare professional for specific dietary advice when using Cisatracurium to ensure safe and effective treatment.

Cisatracurium 100mg Tablets should be stored in a secure and dry location, preferably in their original packaging, to maintain their integrity and potency. It is crucial to keep the tablets away from direct sunlight, moisture, and extreme temperatures, as these factors can degrade the medication. Always store the tablets in a child-proof container to prevent accidental consumption by children. When disposing of unused or expired tablets, it is recommended to follow local guidelines and regulations. Do not flush the medication down the toilet or dispose of it in regular household trash. Instead, utilize designated medication disposal programs or contact your local pharmacy or healthcare facility for guidance on safe disposal practices, ensuring the protection of both individuals and the environment.

Following are the quick tips for Cisatracurium 100mg Tablet:

• Administer this medication via intravenous injection or infusion as directed by your healthcare professional.
• Ensure the medication is prepared and administered by trained medical staff.
• Monitor vital signs and respiratory function during and after administration.
• Adjust the dosage based on the patient's response and medical condition.
• Avoid rapid injection to prevent potential side effects.
• Do not use if the solution appears discolored or contains particles.
• Store the medication as directed and protect it from light.