Nimbex (Generic) cisatracurium besylate
NIMBEX is indicated:
as an adjunct to general anesthesia to facilitate tracheal intubation in adults and in pediatric patients 1 month to 12 years of age
to provide skeletal muscle relaxation in adults during surgical procedures or during mechanical ventilation in the ICU
to provide skeletal muscle relaxation during surgical procedures via infusion in pediatric patients 2 years and older
Limitations of Use:
NIMBEX is not recommended for rapid sequence endotracheal intubation due to the time required for its onset of action.
2.1 Important Dosage and Administration Instructions
Important administration instructions include:
NIMBEX is for intravenous use only.
Administer NIMBEX in carefully adjusted dosage by or under the supervision of experienced clinicians who are familiar with the drug’s actions and the possible complications.
Use NIMBEX only if the following are immediately available: personnel and facilities for resuscitation and life support (tracheal intubation, artificial ventilation, oxygen therapy); and an antagonist of NIMBEX.
The dosage information which follows is intended to serve as an initial guide for individual patients; base subsequent NIMBEX dosage on the patients’ responses to the initial doses.
Use a peripheral nerve stimulator to:
Determine the adequacy of neuromuscular blockade (e.g., need for additional NIMBEX doses, reduction of the infusion rate).
Minimize risk of overdosage or underdosage.
Assess the extent of recovery from neuromuscular blockade (e.g., spontaneous recovery or recovery after administration of a reversal agent, e.g., neostigmine).
Appropriately titrate doses to potentially limit exposure to toxic metabolites.
Facilitate more rapid reversal of the NIMBEX-induced paralysis.