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NIMBEX® Injection

Cisatracurium besylate


Cisatracurium besylate is a white to pale yellow powder.

Nimbex Injection is supplied in two strengths, either 2 mg or 5 mg of cisatracurium besylate per mL. Nimbex Injection also contains Water for Injections and benzenesulfonic acid.Nimbex Injection does not contain any preservative and is intended for single patient use only.


Cisatracurium besylate, a stereoisomer of atracurium, is an intermediate duration,non-depolarising benzylisoquinolinium skeletal muscle relaxant. Cisatracurium besylate binds to cholinergic receptors on the motor end-plate to antagonise the action of acetylcholine, resulting in a competitive block of neuromuscular transmission. This action is readily reversed

by anticholinesterase agents such as neostigmine. The ED95 (dose required to produce 95% depression of the twitch response of the adductor pollicis muscle to stimulation of the ulnar nerve) of cisatracurium besylate is estimated to be 0.05 mg/kg bodyweight during opioid anaesthesia (thiopentone, fentanyl, midazolam). The recommended intubation dose for isatracurium in adults is 3 x ED95, which has a longer clinically effective duration than the recommended intubation dose of atracurium (2 x ED95) (see DOSAGE AND ADMINISTRATION).