mivacurium chloride at a glance
Medicine class
Non-depolarising neuromuscular blocker
Usual role
Muscle relaxation during general anaesthesia
Administration
Given intravenously by or under an experienced anaesthetist
Important point
It causes paralysis but does not make a person unconscious
What is mivacurium chloride used for?
Licensed uses as an adjunct to general anaesthesia include:
Temporarily relaxing skeletal muscles during procedures
Facilitating placement of a breathing tube
Supporting mechanical ventilation in adults, children and infants aged 2 months and over
How does mivacurium chloride work?
Mivacurium competes with acetylcholine at receptors where motor nerves communicate with muscles. This temporarily blocks nerve-to-muscle signals and produces paralysis. Plasma cholinesterase then rapidly breaks it down.
mivacurium chloride preparations and strengths
Injection
Route: Parenteral
Strengths: 2 mg/mL
How to take mivacurium chloride
Mivacurium is not self-administered. It is given into a vein during general anaesthesia where facilities for airway management, artificial ventilation and neuromuscular monitoring are available.
The solution contains no antimicrobial preservative and is intended for one patient.
Dilution must be prepared aseptically immediately before use, with any remainder discarded.
It must not be mixed with highly alkaline solutions such as barbiturate solutions.
mivacurium chloride side effects
Common or expected effects
- Flushing is very common.
Get urgent medical advice
- Severe allergic or anaphylactoid reaction
- Bronchospasm or severe breathing difficulty
- Low blood pressure or cardiovascular instability
- Unexpectedly prolonged muscle paralysis and inability to breathe independently
mivacurium chloride in pregnancy
Mivacurium should be used during pregnancy only when the expected maternal benefit outweighs potential fetal risk. Pregnancy and the period soon after birth can reduce plasma cholinesterase activity and prolong its effect; magnesium sulfate can increase the neuromuscular block further.
mivacurium chloride while breastfeeding
It is not known whether mivacurium passes into human milk. Because it is used in a specialist anaesthetic setting, breastfeeding advice should consider the full anaesthetic, the mother's recovery and the infant's health rather than mivacurium alone.
mivacurium chloride interactions
Several medicines can intensify or prolong neuromuscular blockade. The anaesthetic team should review all medicines before use.
Inhaled anaesthetics
Agents including sevoflurane, isoflurane, enflurane and halothane can increase the neuromuscular block.
Aminoglycosides and certain other antibiotics
These can increase or prolong muscle paralysis.
Magnesium salts
Magnesium can enhance neuromuscular blockade, including when used around Caesarean birth.
Antiarrhythmics, beta-blockers and calcium-channel blockers
Common questions about mivacurium chloride
Answers are fully visible for fast scanning and source review.
What is mivacurium chloride used for during surgery?
It temporarily relaxes skeletal muscles during general anaesthesia, helping with tracheal intubation and mechanical ventilation.
Does mivacurium chloride make you unconscious?
No. It causes muscle paralysis but does not affect consciousness, so it must be used with adequate general anaesthesia or sedation.
How is mivacurium chloride given?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.