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Cisatracurium besylate (Intravenous)

Medically reviewed by Last updated on Sep 1, 2022.

Commonly used brand name(s)

In the U.S.

  • Nimbex

Available Dosage Forms:

  • Solution

Therapeutic Class: Musculoskeletal Agent

Pharmacologic Class: Cisatracurium

Uses for cisatracurium besylate

Cisatracurium injection is used before and during surgery to provide muscle relaxation and make intubation easier.

Cisatracurium besylate must be given only by or under the direct supervision of your doctor.

Before using cisatracurium besylate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For cisatracurium besylate, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to cisatracurium besylate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of cisatracurium injection in children 1 month to 12 years of age to provide intubation and in children 2 years of age and older to provide muscle relaxation during surgery. Safety and efficacy have been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of cisatracurium injection in the elderly. However, elderly patients are more sensitive to the effects of cisatracurium besylate than younger adults.


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving cisatracurium besylate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using cisatracurium besylate with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amikacin
  • Bacitracin
  • Capreomycin
  • Carbamazepine
  • Colistimethate Sodium
  • Desflurane
  • Dibekacin
  • Enflurane
  • Fosphenytoin
  • Framycetin
  • Gentamicin
  • Isepamicin
  • Isoflurane
  • Kanamycin
  • Neomycin
  • Netilmicin
  • Nitrous Oxide
  • Phenytoin
  • Polymyxin B
  • Procainamide
  • St John's Wort
  • Streptomycin
  • Tobramycin

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of cisatracurium besylate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Benzyl alcohol—Some strengths of cisatracurium besylate contain benzyl alcohol and should not be used in premature babies.
  • Burn injury or
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.
  • Carcinomatosis (cancer) or
  • Electrolyte imbalance or
  • Nerve or muscle disease (eg, myasthenia gravis, myasthenic syndrome) or
  • Seizures, history of—Use with caution. May cause side effects to become worse.

Proper use of cisatracurium besylate

A nurse or other trained health professional will give you cisatracurium besylate in a medical facility. It is given through a needle placed into one of your veins.

Precautions while using cisatracurium besylate

It is very important that your doctor check your or your child's progress at regular visits to make sure that cisatracurium besylate is working properly and to check for unwanted effects.

Cisatracurium besylate may increase your or your child's risk for muscle weakness, leading to paralysis, or seizures. Talk to your doctor if you have concerns.

Cisatracurium besylate may cause a serious allergic reaction, called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving cisatracurium besylate.

Cisatracurium besylate may cause a condition called malignant hyperthermia (dangerous increase in body temperature). Check with your doctor right away if you or your child have a fast heartbeat, high fever, or rigid muscles.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Cisatracurium besylate side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:


  • Blurred vision
  • chest pain or discomfort
  • confusion
  • cough
  • difficulty breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • lightheadedness, dizziness, or fainting
  • noisy breathing
  • slow or irregular heartbeat
  • sweating
  • tightness in the chest
  • unusual tiredness or weakness

Incidence not known

  • Difficulty swallowing
  • drowsiness
  • fast heartbeat
  • hives, itching, skin rash
  • muscular pain, tenderness, wasting, or weakness
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


  • Feeling of warmth
  • redness of the face, neck, arms, and occasionally, upper chest

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.