๐Ÿฉบ MUSCLE RELAXANT ๐Ÿท๏ธ Non-depolarising neuromuscular blocking drugs
๐Ÿ‘จโ€โš•๏ธ Clinically Reviewed by: PakistaniBano Medical Editorial Board (Pharm.D Panel)
๐Ÿ“… Reviewed: November 2026 โ€ข ๐Ÿ” Authority: DRAP / WHO ATC
๐Ÿ“ฆ Formulations, Pack Sizes & Retail Prices Currency: Rs.
Dosage Form Reg. No Pack Size Trade Price (TP) Maximum Retail Price (MRP)
Inj 10 mg 034887 5 Ampx5 ml Rs.489.88 Rs.576.33 Inj 10 mg(034887)

๐Ÿ“‹ Indications & Clinical Dosage

*Neuromuscular blockade (short to intermediate duration) for surgery and wide range of procedures, to facilitate controlled ventilation and endotracheal intubation:* BY IV INJ: Adult: Initially 300-600 mcg/kg, then (by IV injection) 100-200 mcg/kg as required, This dosage provides relaxation for 15-35 min. Full block can be prolonged with supplementary doses of 0.1-0.2 mg/kg as required. Endotracheal intubation can usually be accomplished within 90 sec from the IV inj of 0.5-0.6 mg/kg. As an INF: After an initial bolus dose of 0.3-0.6 mg/kg neuromuscular block can be maintained by administration as a continuous INF at rates of 0.3-0.6, mg/kg/hr. Children Neonate: initially by IV injection 300-500 mcg/kg followed either by IV injection, 100-200 mcg/kg repeated as necessary or by IV INF, 300-400 mcg/kg/hr adjusted according to response 1 month-18 yr: Initially by IV injection 300-600 mcg/kg then 100-200 mcg /kg repeated as necessary or initially by IV injection 300-600 mcg/kg followed by IV INF, 300-600 mcg/kg/hr adjusted according to response. *Neuromuscular blockade during intensive care:* BY IV INJ: Adult: Initially 300-600 mc/kg, initial dose is optional, then (by intravenous INF) 270-1770 mc/kg/hour; (by intravenous INF) usual dose 650-780 mcg/kg/hour. Children Neonate: initially by IV injection 300-500 mcg/kg followed either by IV injection, 100-200 mcg /kg repeated as necessary or by IV INF, 300-400 mcg/kg/hr adjusted according to response; higher doses may be necessary; 1 month-18 yr: Initially by IV injection 300-600 mcg/kg (optional) then by IV INF, 270-1770 mcg/kg/hr (usual dose 650-780 mcg/kg/ hr).

๐Ÿ’Š Mode of Administration

Should be administered only with adequate general anaesthesia and under the close supervision of an experienced anaesthetist and with adequate facilities for endotracheal intubation and artificial ventilation. May be administered undiluted as a bolus injection, administration via infusion requires the use of an infu-sion pump. Use infusion solutions within 24 hours of preparation.

โ›” Contraindications

Atracurium besylate hypersensitivity.

โš ๏ธ Precautions & Warnings

Burns (increased doses may be required), cardiovascular disease (reduce rate of administration), electrolyte and fluid disturbances, hypothermia, myasthenia gravis, neuromuscular disorders. To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal body-weight.

๐Ÿ”„ Drug Interactions

Anticholinesterases, thiazide diuretics.

โš ๏ธ Adverse Reactions / Side Effects

Anaphylactoid reactions (rare), acute myopathy (after prolonged use in intensive care), bronchospasm, hypotension, seizures, skin flushing, tachycardia, cardiovascular effects

๐Ÿคฐ Pregnancy & Lactation Safety

Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised

๐Ÿงช Compatibility & Storage Stability

Compatibility: Stable in D5W, NS, D5NS; incompatible with LR. At Y-site administration, incompatible with diazepam, propofol, thiopental

Stability & Storage: Refrigerate; unstable in alkaline solution.

๐Ÿ“š Official Regulatory & Clinical References

  • Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
  • World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
  • Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.

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