| MIVACURIUM CHLORIDE
Classifications: skeletal muscle relaxant, nondepolarizing; Therpeutic: skeletal muscle relaxant, nondepolarizing
Pregnancy Category: C
2 mg/mL injection
Short-acting, skeletal muscle relaxant that combines competitively to cholinergic receptors on the motor neuron end-plate.
Antagonizes action of acetylcholine, and blocks neuromuscular transmission. Neuromuscular blocking action is readily reversible
with an anticholinesterase agent.
Blocks nerve impulse transmission, which results in skeletal muscle relaxation and paralysis.
Adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery
or mechanical ventilation.
Allergic reactions to mivacurium or its ingredients; neonates; pregancy (category C).
Kidney function impairment, liver function impairment; older adult patients; pulmonary disease, COPD; lactation.
Route & Dosage
|Tracheal Intubation and Mechanical Ventilation
Adult: IV Loading Dose 0.150.25 mg/kg given over 515 sec (over 60 sec in patients with cardiovascular disease) IV Maintenance Dose 0.1 mg/kg generally q15min IV Continuous Infusion Initial infusion of 910 mcg/kg/min, then 67 mcg/kg/min
Child: IV Loading Dose 212 y, 0.2 mg/kg given over 515 sec (range: 0.090.2 mg/kg) then 14 mcg/kg/min
Decrease infusion rates by up to 50%.
May decrease infusing rate up to 50%.
PREPARE: Direct/Continuous: Add 3 mL of D5W, NS, D5/NS, RL, or D5/RL to each 1 mL mivacurium to yield 0.5 mg/mL.
ADMINISTER: Direct Loading Dose: Give over 515 sec (60 sec for those with CV disease). Continuous: Give at the rate determined by weight. Refer to manufacturer's infusion rate tables.
- Store diluted solution at 5°25° C (41°77° F) for up to 24 h.
Adverse Effects (≥1%)CV:
Transient decrease in arterial BP, hypotension, increases and decreases in heart rate. Skin: Transient flushing about the face, neck, and/or chest
(especially with rapid administration
InteractionsDrug: general anesthetics
may enhance the degree of neuromuscular blockade produced by mivacurium. aminoglycosides
, bacitracin, polymyxins
, lincomycin, clindamycin, colistin, magnesium salts, lithium, local anesthetics
may enhance the neuromuscular blockade.
26 min. Duration:
2530 min in adults, 816 min in children. Distribution:
Rapidly hydrolyzed by plasma
Assessment & Drug Effects
- Assess patients with neuromuscular disease carefully and adjust drug dosage using a peripheral nerve stimulator when they
experience prolonged neuromuscular blocks.
- Monitor hemodynamic status carefully in patients with significant cardiovascular disease or those with potentially greater
sensitivity to release of histamine-type mediators (e.g., asthma).
- Monitor for significant drop in BP because overdose may increase the risk of hemodynamic adverse effects.