U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C53H72N2O12.2C6H5O3S
Molecular Weight 1243.479
Optical Activity UNSPECIFIED
Defined Stereocenters 4 / 4
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of CISATRACURIUM BESYLATE

SMILES

[O-]S(=O)(=O)C1=CC=CC=C1.[O-]S(=O)(=O)C2=CC=CC=C2.COC3=C(OC)C=C(C[C@@H]4C5=CC(OC)=C(OC)C=C5CC[N@+]4(C)CCC(=O)OCCCCCOC(=O)CC[N@@+]6(C)CCC7=CC(OC)=C(OC)C=C7[C@H]6CC8=CC(OC)=C(OC)C=C8)C=C3

InChI

InChIKey=XXZSQOVSEBAPGS-DONVQRBFSA-L
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/t42-,43-,54-,55-;;/m1../s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including www.ncbi.nlm.nih.gov/pubmed/9349062

Cisatracurium is a cis-cis isomer of atracurium and five time as potent as atracurium. The drug is approved by FDA and marketed under the name Nimbex. It is indicated as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation due to its antagonistic properties toward nicotinic acetylcholine receptors.

Originator

Sources: ISBN-13: 978-1461484400
Curator's Comment: Now part of GlaxoSmithKline.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
54.0 nM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
NIMBEX

Approved Use

Cisatracurium besylate injection is an intermediate-onset/intermediate-duration neuromuscular blocking agent indicated for inpatients and outpatients as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation in the ICU.

Launch Date

1995
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
22 min
0.1 mg/kg 1 times / day steady-state, intravenous
dose: 0.1 mg/kg
route of administration: Intravenous
experiment type: STEADY-STATE
co-administered:
CISATRACURIUM unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
PubMed

PubMed

TitleDatePubMed
Prolonged weakness after cisatracurium infusion: a case report.
1998 Jul
Effects of pretreatment with cisatracurium, rocuronium, and d-tubocurarine on succinylcholine-induced fasciculations and myalgia: a comparison with placebo.
1999 Dec
Severe anaphylactic reaction to cisatracurium.
1999 Feb
[Precurarization of succinylcholine with cisatracurium: the influence of the precurarization interval].
2002 Sep
Acute motor axonal polyneuropathy after a cisatracurium infusion and concomitant corticosteroid therapy.
2004 Feb
Complete recovery from prolonged cardiac arrest following self-administration of cisatracurium.
2005 Jan
Prevention of succinylcholine-induced fasciculation and myalgia: a meta-analysis of randomized trials.
2005 Oct
Distinct pharmacologic properties of neuromuscular blocking agents on human neuronal nicotinic acetylcholine receptors: a possible explanation for the train-of-four fade.
2006 Sep
Cisatracurium in "weakening doses" assists in weaning from sedation and withdrawal following extended use of inhaled isoflurane.
2007 Jan
Acute coronary syndrome in cisatracurium-induced anaphylactic shock: Kounis syndrome.
2008 Dec
[Type IV anaphylactic reaction and ST-elevation acute coronary syndrome due to coronary vasospasm secondary to administration of cisatracurium].
2008 Jun-Jul
Patents

Sample Use Guides

The recommended initial doses is 0.2 mg/kg, however it should be individualized. A dose of 0.03 mg/kg is recommended for maintenance of neuromuscular block during prolonged surgical procedures.
Route of Administration: Intravenous
Human umbilical vein endothelial cells were incubated with 0, 0.96, 3.2, 9.6, 32, and 96 microM of cisatracurium for 72 h and the drug (3.2 microM) decreased the cell count to 50% (SD, 8.6%).
Name Type Language
CISATRACURIUM BESYLATE
MI   ORANGE BOOK   USAN   USP-RS   VANDF  
USAN  
Official Name English
CISATRACURIUM BESILATE
INN   MART.   WHO-DD  
INN  
Official Name English
ISOQUINOLINIUM, 2,2'-(1,5-PENTANEDIYLBIS(OXY(3-OXO-3,1-PROPANEDIYL)))BIS(1-((3,4-DIMETHOXYPHENYL)METHYL)-1,2,3,4-TETRAHYDRO-6,7-DIMETHOXY-2-METHYL-, (1R,1'R,2R,2'R)-, BENZENESULFONATE (1:2)
Common Name English
ISOQUINOLINIUM, 2,2'-(1,5-PENTANEDIYLBIS(OXY(3-OXO-3,1-PROPANEDIYL)))BIS(1-((3,4-DIMETHOXYPHENYL)METHYL)-1,2,3,4-TETRAHYDRO-6,7-DIMETHOXY-2-METHYL-, (1R,1'R,2R,2'R)-, DIBENZENESULFONATE
Common Name English
CISATRACURIUM BESILATE [MART.]
Common Name English
CISATRACURIUM BESYLATE [MI]
Common Name English
CISATRACURIUM BESILATE [EP MONOGRAPH]
Common Name English
51W89
Code English
ISOQUINOLINIUM, 2,2'-(1,5-PENTANEDIYLBIS(OXY(3-OXO-3,1-PROPANEDIYL)))BIS(1-((3,4-DIMETHOXYPHENYL)METHYL)-1,2,3,4-TETRAHYDRO-6,7-DIMETHOXY-2-METHYL-, DIBENZENESULPHONATE, (1R-(1.ALPHA.,2.ALPHA.(1'R*,2'R*)))-
Common Name English
ISOQUINOLINIUM, 2,2'-(1,5-PENTANEDIYLBIS(OXY(3-OXO-3,1-PROPANEDIYL)))BIS(1-((3,4-DIMETHOXYPHENYL)METHYL)-1,2,3,4-TETRAHYDRO-6,7-DIMETHOXY-2-METHYL-, DIBENZENESULFONATE, (1R-(1.ALPHA.,2.ALPHA.(1'R*,2'R*)))-
Common Name English
CISATRACURIUM (AS BESILATE)
Common Name English
CISATRACURIUM BESYLATE [VANDF]
Common Name English
51W-89
Code English
Cisatracurium besilate [WHO-DD]
Common Name English
CISATRACURIUM BESYLATE [USP MONOGRAPH]
Common Name English
CISATRACURIUM BESYLATE [USAN]
Common Name English
CISATRACURIUM BESYLATE [USP-RS]
Common Name English
CISATRACURIUM BESYLATE [ORANGE BOOK]
Common Name English
51-W89
Code English
NIMBEX
Brand Name English
(1R,2R)-2-(2-Carboxyethyl)-1,2,3,4-tetrahydro-6,7-dimethoxy-2-methyl-1-veratrylisoquinolinium benzenesulfonate, pentamethylene ester
Common Name English
cisatracurium besilate [INN]
Common Name English
51-W-89
Code English
Classification Tree Code System Code
NCI_THESAURUS C66886
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Code System Code Type Description
MERCK INDEX
m2129
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PRIMARY Merck Index
USAN
FF-81
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PRIMARY
SMS_ID
100000090476
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PRIMARY
FDA UNII
80YS8O1MBS
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WIKIPEDIA
CISATRACURIUM BESILATE
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PRIMARY
EPA CompTox
DTXSID10895045
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DRUG BANK
DB00565
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PRIMARY
RXCUI
136561
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PRIMARY RxNorm
EVMPD
SUB07480MIG
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PRIMARY
NCI_THESAURUS
C47451
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PRIMARY
DAILYMED
80YS8O1MBS
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PRIMARY
PUBCHEM
62886
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PRIMARY
CAS
96946-42-8
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PRIMARY
CHEBI
3721
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PRIMARY
ChEMBL
CHEMBL1201248
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PRIMARY
INN
7389
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PRIMARY
RS_ITEM_NUM
1134118
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PRIMARY