Atracurium besilate

Atracurium besilate
Clinical data
Trade namesTracrium, Acurium
Other namesAtracurium besylate
AHFS/Drugs.comMonograph
Pregnancy
category
  • C
Routes of
administration		IV
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability100% (IV)
Protein binding82%
MetabolismHofmann elimination (retro-Michael addition) and ester hydrolysis by nonspecific esterases
Elimination half-life17–21 minutes
Identifiers
  • 2,2'-{1,5-Pentanediylbis[oxy(3-oxo-3,1-propanediyl)]}bis[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-1,2,3,4-tetrahydroisoquinolinium] dibenzenesulfonate
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.058.840 Edit this at Wikidata
Chemical and physical data
FormulaC65H82N2O18S2
Molar mass1243.49 g·mol−1
3D model (JSmol)
Melting point85 to 90 °C (185 to 194 °F)
  • C[N+]1(CCc2cc(c(cc2C1Cc3ccc(c(c3)OC)OC)OC)OC)CCC(=O)OCCCCCOC(=O)CC[N+]4(CCc5cc(c(cc5C4Cc6ccc(c(c6)OC)OC)OC)OC)C.c1ccc(cc1)S(=O)(=O)[O-].c1ccc(cc1)S(=O)(=O)[O-]
  • InChI=1S/C53H72N2O12.2C6H6O3S/c1-54(22-18-38-32-48(62-7)50(64-9)34-40(38)42(54)28-36-14-16-44(58-3)46(30-36)60-5)24-20-52(56)66-26-12-11-13-27-67-53(57)21-25-55(2)23-19-39-33-49(63-8)51(65-10)35-41(39)43(55)29-37-15-17-45(59-4)47(31-37)61-6;2*7-10(8,9)6-4-2-1-3-5-6/h14-17,30-35,42-43H,11-13,18-29H2,1-10H3;2*1-5H,(H,7,8,9)/q+2;;/p-2 checkY
  • Key:XXZSQOVSEBAPGS-UHFFFAOYSA-L checkY
 ☒NcheckY (what is this?)  (verify)

Atracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation.[1] It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly.[1] It is given by injection into a vein.[1] Effects are greatest at about 4 minutes and last for up to an hour.[1]

Common side effects include flushing of the skin and low blood pressure.[1][2] Serious side effects may include allergic reactions; however, it has not been associated with malignant hyperthermia.[1][2] Prolonged paralysis may occur in people with conditions like myasthenia gravis.[1] It is unclear if use in pregnancy is safe for the baby.[1] Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type.[1] It works by blocking the action of acetylcholine on skeletal muscles.[1]

Atracurium was approved for medical use in the United States in 1983.[1] It is on the World Health Organization's List of Essential Medicines.[3] Atracurium is available as a generic medication.[1]

  1. ^ a b c d e f g h i j k l "Atracurium Besylate". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
  2. ^ a b "Atracurium Besilate 10 mg/ml Injection - (eMC)". www.medicines.org.uk. March 2015. Archived from the original on 20 December 2016. Retrieved 16 December 2016.
  3. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.