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Details

Stereochemistry MIXED
Molecular Formula C58H80N2O14.2HO
Molecular Weight 1063.2755
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 4
E/Z Centers 1
Charge 0

SHOW SMILES / InChI
Structure of MIVACURIUM HYDROXIDE

SMILES

[OH-].[OH-].COC1=CC(C[C@H]2C3=CC(OC)=C(OC)C=C3CC[N+]2(C)CCCOC(=O)CC\C=C\CCC(=O)OCCC[N+]4(C)CCC5=CC(OC)=C(OC)C=C5[C@H]4CC6=CC(OC)=C(OC)C(OC)=C6)=CC(OC)=C1OC

InChI

InChIKey=FXHLWQXSTCTSDZ-VBBWHNEHSA-L
InChI=1S/C58H80N2O14.2H2O/c1-59(25-21-41-35-47(63-3)49(65-5)37-43(41)45(59)29-39-31-51(67-7)57(71-11)52(32-39)68-8)23-17-27-73-55(61)19-15-13-14-16-20-56(62)74-28-18-24-60(2)26-22-42-36-48(64-4)50(66-6)38-44(42)46(60)30-40-33-53(69-9)58(72-12)54(34-40)70-10;;/h13-14,31-38,45-46H,15-30H2,1-12H3;2*1H2/q+2;;/p-2/b14-13+;;/t45-,46+,59?,60?;;

HIDE SMILES / InChI
Mivacurium chloride (Mivacron) is a new benzylisoquinolinium choline-like diester neuromuscular blocking drug with an onset of action at equipotent doses that is comparable to atracurium and vecuronium but slower than succinylcholine. MIVACRON (a mixture of three stereoisomers) binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in a block of neuromuscular transmission. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine. MIVACRON is a short-acting 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.

Originator

Curator's Comment: The development of mivacurium represents a collaboration between industrial pharmacologists and chemists at Burroughs Wellcome Co. (USA) and investigators at the Massachusetts General Hospital, Boston, MA, USA.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
MIVACRON

Approved Use

MIVACRON is a short-acting 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.

Launch Date

1992
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
504 ng/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-CIS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
2198 ng/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-TRANS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
4486 ng/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, TRANS-TRANS- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
1.295 μg × min/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-CIS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
1.178 μg × min/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-TRANS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
2.932 μg × min/mL
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, TRANS-TRANS- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
28.5 min
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-CIS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
2 min
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, CIS-TRANS- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
2.4 min
0.15 mg/kg single, intravenous
dose: 0.15 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MIVACURIUM, TRANS-TRANS- plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
0.2 mg/kg single, intravenous
Recommended
Dose: 0.2 mg/kg
Route: intravenous
Route: single
Dose: 0.2 mg/kg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Skeletal muscle relaxation during surgery
Sources: Page: p.12
Other AEs: Anaphylactic reaction...
Other AEs:
Anaphylactic reaction (grade 3-5)
Sources: Page: p.12
AEs

AEs

AESignificanceDosePopulation
Anaphylactic reaction grade 3-5
0.2 mg/kg single, intravenous
Recommended
Dose: 0.2 mg/kg
Route: intravenous
Route: single
Dose: 0.2 mg/kg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Skeletal muscle relaxation during surgery
Sources: Page: p.12
PubMed

PubMed

TitleDatePubMed
The effect of mivacurium pretreatment on intra-ocular pressure changes induced by suxamethonium.
1998 May
Suxamethonium and mivacurium sensitivity from pregnancy-induced plasma cholinesterase deficiency.
1998 Nov
Organophosphorus pesticide-induced butyrylcholinesterase inhibition and potentiation of succinylcholine toxicity in mice.
1999
Intubation conditions and postoperative myalgia in outpatient dental surgery: a comparison of succinylcholine with mivacurium.
2000 Apr
Is succinylcholine after pretreatment with d-tubocurarine and lidocaine contraindicated for outpatient anesthesia?
2000 Aug
Nondepolarizing neuromuscular blockers inhibit the serotonin-type 3A receptor expressed in Xenopus oocytes.
2000 Feb
The cardiovascular effects of mivacurium in hypertensive patients.
2002 Aug
[Plasma cholinesterase variations as a result of prolonged neuromuscular blockade. Review and problems encountered in two cases of prolonged neuromuscular blockade after muscle relaxation with succinylcholine as compared to mivacurium].
2002 Feb
Prevention of succinylcholine-induced fasciculation and myalgia: a meta-analysis of randomized trials.
2005 Oct
Unexpected prolonged paralysis after mivacurium in a patient with Bamforth syndrome.
2006 Aug
Distinct pharmacologic properties of neuromuscular blocking agents on human neuronal nicotinic acetylcholine receptors: a possible explanation for the train-of-four fade.
2006 Sep
Fresh frozen plasma transfusion for reversal of prolonged post-anaesthesia apnoea.
2008 Apr
Patents

Sample Use Guides

Adults Initial Doses Doses of 0.15 mg/kg administered over 5 to 15 seconds, 0.20 mg/kg administered over 30 seconds, or 0.25 mg/kg administered in divided doses (0.15 mg/kg followed in 30 seconds by 0.10 mg/kg) are recommended for facilitation of tracheal intubation for most patients
Route of Administration: Intravenous
In Vitro Use Guide
Curator's Comment: Left atrial preparations were stimulated by electrical field stimulation using a bipolar platinum electrode, and the effects of cumulative concentrations of nondepolarizing neuromuscular blocking agents on the developed force in the presence and absence of propranolol (10(-8) M) and desipramine (10(-7) M) were recorded.
The left or right atria of rats were removed and suspended in organ baths. Mivacurium was added cumulatively (10(-9)-10(-5) M) in the presence and absence of the nonselective β-blocker propranolol (10(-8) M) and the noradrenaline reuptake inhibitor desipramine (10(-7) M), and heart rate changes were recorded in spontaneously beating right atria. Mivacurium increased developed force in a dose-dependent manner; the increases were significant at 10(-5) M concentration for mivacurium.
Name Type Language
MIVACURIUM HYDROXIDE
Common Name English
ISOQUINOLINIUM, 2,2'-(((4E)-1,8-DIOXO-4-OCTENE-1,8-DIYL)BIS(OXY-3,1-PROPANEDIYL))BIS(1,2,3,4-TETRAHYDRO-6,7-DIMETHOXY-2-METHYL-1-((3,4,5-TRIMETHOXYPHENYL)METHYL)-, HYDROXIDE (1:2), (1R,1'R)-
Common Name English
Code System Code Type Description
PUBCHEM
135390842
Created by admin on Fri Dec 15 15:36:25 GMT 2023 , Edited by admin on Fri Dec 15 15:36:25 GMT 2023
PRIMARY
FDA UNII
FM8VA7ORPP
Created by admin on Fri Dec 15 15:36:25 GMT 2023 , Edited by admin on Fri Dec 15 15:36:25 GMT 2023
PRIMARY