Atracurium

Atracurium is a prescription medication used to treat Skeletal Muscle Relaxation during Surgery, Endotracheal Intubation and Mechanical Ventilation.

• Atracurium is available under the following different brand names: Tacrium.

Adult and pediatric dosage

Injectable solution

• 10mg/mL

Endotracheal Intubation, Mechanical Ventilation

Adult dosage

• Calculate dose based on ideal body weight
• 0.4-0.5 mg/kg IVP over 60 seconds, then 0.08-0.1 mg/kg 20-45 minutes after initial dose to maintain neuromuscular block, repeat maintenance dose every 15-25 minutes as needed or
• Continuous infusion: 0.005-0.01 mg/kg/min IV (ranges from 0.002-0.015 mg/kg/min) or
• 0.2-0.4 mg/kg IVP if following succinylcholine for intubation

Pediatric dosage

• Children younger than 1 month: Safety and efficacy not established
• Children 1 month – 2 years: 0.3-0.4 mg/kg IVP under halothane anesthesia
• Maintenance dose: Children may need more frequent maintenance doses than adult
• Children 2 years or older: 0.4-0.5 mg/kg IVP over 60 seconds, then 0.08-0.1 mg/kg 20-45 minutes after initial dose to maintain neuromuscular block, repeat maintenance dose every 15-25 minutes as needed

Skeletal Muscle Relaxation During Surgery

• 0.4-0.5 mg/kg IVP over 60 seconds, then 0.05-0.10 mg/kg/min; block usually maintained at rate of 0.011-0.013 mg/kg/min

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Atracurium include:

• skin flushing or redness 

Serious side effects of Atracurium include:

• injection site reactions, 
• hives, 
• itching, 
• wheezing, 
• shortness of breath, 
• allergic reactions, 
• inadequate musculoskeletal block, 
• severe dizziness,
• low blood pressure, and 
• fast or slow heart rate

Rare side effects of Atracurium include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

• Atracurium has unknown severe interactions with no other drugs.
• Atracurium has serious interactions with at least 29 other drugs.
• Atracurium has moderate interactions with at least 108 other drugs.
• Atracurium has minor interactions with at least 41 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to drug or components; lack of ventilatory support, neuromuscular disease.

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Atracurium?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Atracurium?”

Cautions

• Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
• Closely monitor patients with bronchogenic carcinoma, dehydration, electrolyte imbalance, hypotension, hypothermia, myasthenia gravis, pulmonary disease
• Adequate ventilatory support mandatory, may experience resistance with greater than 25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)

Pregnancy and Lactation

• Use with caution in pregnancy if benefits outweigh risks. 

Excretion in milk is unknown; use with caution.