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You are here: Home » eGM Resources » Health Information & Resources Portal|Home » RX Drug List (listed alphabetically) » Drug Reference (C's) » Cisatracurium Besylate


NIMBEX Ò Injection (cisatracurium besylate)

This drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards.

NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal muscle relaxant for intravenous administration. Compared to other neuromuscular blocking agents, it is intermediate in its onset and duration of action. Cisatracurium besylate is one of 10 isomers of atracurium besylate and constitutes approximately 15% of that mixture. Cisatracurium besylate is [1R-[1a,2a(1'R*,2'R*)]]- 2,2'-[1,5- pentanediylbis[oxy(3-oxo-3,1- propanediyl)]] bis[1-[(3,4-dimethoxyphenyl)methyl]- 1,2,3,4-tetrahydro-6,7-dimethoxy-2-methylisoquinolinium]dibenzenesulfonate.

The molecular formula of the cisatracurium parent bis-cation is C53H72N2O12 and the molecular weight is 929.2. The molecular formula of cisatracurium as the besylate salt is C65H82N2O18S2 and the molecular weight is 1243.50.

The log of the partition coefficient of cisatracurium besylate is -2.12 in a 1-octanol/distilled water system at 25° C.

NIMBEX Injection is a sterile, non-pyrogenic aqueous solution provided in 5-mL, 10-mL, and 20-mL vials. The pH is adjusted to 3.25 to 3.65 with benzenesulfonic acid. The 5-mL and 10-mL vials each contain cisatracurium besylate, equivalent to 2 mg/mL cisatracurium. The 20-mL vial, intended for ICU use only, contains cisatracurium besylate, equivalent to 10 mg/mL cisatracurium. The 10-mL vial, intended for multiple-dose use, contains 0.9% benzyl alcohol as a preservative. The 5-mL and 20-mL vials are single-use vials and do not contain benzyl alcohol.

Cisatracurium besylate slowly loses potency with time at a rate of approximately 5% per year under refrigeration (5° C). NIMBEX should be refrigerated at 2° to 8° C (36° to 46° F) in the carton to preserve potency. The rate of loss in potency increases to approximately 5% per month at 25° C (77° F). Upon removal from refrigeration to room temperature storage conditions (25° C/ 77° F), use NIMBEX within 21 days, even if rerefrigerated.

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