atracurium besilate at a glance
Medicine class
Non-depolarising neuromuscular blocking agent
Usual setting
Given intravenously by specialist staff during anaesthesia or intensive care
What it does not do
It does not cause unconsciousness or relieve pain, so adequate anaesthesia or sedation is essential
Effect monitoring
Neuromuscular function is monitored to assess blockade and recovery
What is atracurium besilate used for?
Licensed uses for the selected product include:
Relaxing skeletal muscles alongside general anaesthesia during surgery.
Facilitating breathing-tube placement and mechanical ventilation.
Facilitating mechanical ventilation in intensive care.
Use in adults and children older than one month. Use in neonates is not recommended because evidence is insufficient.
How does atracurium besilate work?
Atracurium competes with acetylcholine at receptors where motor nerves communicate with skeletal muscle. This temporarily prevents muscle contraction. It does not affect consciousness or pain perception.
atracurium besilate preparations and strengths
Injection
Route: Parenteral
Strengths: 10 mg/mL
How to take atracurium besilate
Atracurium is not taken by mouth. A trained anaesthetic or intensive-care practitioner gives it into a vein by injection or infusion, with immediate access to airway support, ventilation and reversal medicines.
During surgery, it is given only after unconsciousness has been induced.
It must not be injected into muscle.
Follow the hospital's fasting and usual-medicine instructions before general anaesthesia.
atracurium besilate side effects
Common or expected effects
- Flushing, rash, itching or other localised skin reactions
- Temporary low or high blood pressure
- Slow or fast heart rate
- Wheezing
- Injection-site reaction
Get urgent medical advice
- Severe allergic or anaphylactic reaction, potentially with shock or cardiac arrest
- Bronchospasm, severe breathing difficulty or airway spasm
- Low blood oxygen
- Prolonged neuromuscular blockade with delayed return of adequate breathing
atracurium besilate in pregnancy
Atracurium crosses the placenta in small amounts. The selected product advises avoiding it during the first three months and using it later only when clearly necessary. It may be selected for muscle relaxation during caesarean section, with the newborn observed for possible respiratory depression.
atracurium besilate while breastfeeding
Transfer into milk is expected to be limited, and transferred atracurium should degrade rapidly. However, the selected product advises interrupting breastfeeding for 24 hours after administration, particularly because of possible respiratory effects in a premature infant. Agree a feeding plan with the anaesthetic team.
atracurium besilate interactions
Several medicines can alter the depth or duration of neuromuscular blockade. Give the anaesthetic team a complete medicines history.
Inhaled anaesthetics, including isoflurane, desflurane and sevoflurane
May increase atracurium's neuromuscular-blocking effect.
Aminoglycosides, polymyxins, lincosamides, tetracyclines and some other antibiotics
May strengthen or prolong muscle blockade, including when given after surgery.
Injected magnesium sulphate
May increase blockade and make reversal less reliable.
Common questions about atracurium besilate
Answers are fully visible for fast scanning and source review.
Is atracurium besilate a general anaesthetic?
No. It relaxes skeletal muscles but does not cause unconsciousness or relieve pain, so adequate anaesthesia or sedation is required.
How is atracurium besilate given?
It is administered into a vein by injection or infusion. It must not be injected into muscle.
Can it be used in intensive care?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.