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

6.9603839E11
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
Organophosphorus pesticide-induced butyrylcholinesterase inhibition and potentiation of succinylcholine toxicity in mice.
1999
Is succinylcholine after pretreatment with d-tubocurarine and lidocaine contraindicated for outpatient anesthesia?
2000 Aug
The cardiovascular effects of mivacurium in hypertensive patients.
2002 Aug
Prolonged paralysis related to mivacurium: a case study.
2005 Feb
Naturally occurring mutation Leu307Pro of human butyrylcholinesterase in the Vysya community of India.
2006 Jul
Distinct pharmacologic properties of neuromuscular blocking agents on human neuronal nicotinic acetylcholine receptors: a possible explanation for the train-of-four fade.
2006 Sep
Characterization of a novel BCHE "silent" allele: point mutation (p.Val204Asp) causes loss of activity and prolonged apnea with suxamethonium.
2014
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.
Substance Class Mixture
Created
by admin
on Sat Jun 26 11:05:08 UTC 2021
Edited
by admin
on Sat Jun 26 11:05:08 UTC 2021
Record UNII
77D66S9Q93
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
MIVACURIUM
VANDF   WHO-DD  
Common Name English
MIVACURIUM [WHO-DD]
Common Name English
MIVACURIUM ION
Common Name English
MIVACURIUM [VANDF]
Common Name English
BW-B109OU
Code 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)-, (1R,1'R)-
Common Name English
(1R,1'R)-2,2'-(((4E)-1,8-DIOXOOCT-4-ENE-1,8-DIYL)BIS(OXYPROPANE-3,1-DIYL))BIS(6,7-DIMETHOXY-2-METHYL-1-(3,4,5-TRIMETHOXYBENZYL)-1,2,3,4-TETRAHYDROISOQUINOLINIUM)
Common Name English
ISOQUINOLINIUM, 2,2'-((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)-, (R-(R*,R*-(E)))-
Common Name English
BW B109OU
Code English
MIVACURIUM CATION
Common Name English
(R)-1,2,3,4-TETRAHYDRO-2-(3-HYDROXYPROPYL)-6,7-DIMETHOXY-2-METHYL-1-(3,4,5-TRIMETHOXYBENZYL)ISOQUINOLINIUM, (E)-4-OCTENEDIOATE
Common Name English
Classification Tree Code System Code
WHO-ATC M03AC10
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
NCI_THESAURUS C66886
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
Code System Code Type Description
RXCUI
30077
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY RxNorm
DRUG CENTRAL
1822
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
CAS
106791-40-6
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
NON-SPECIFIC STEREOCHEMISTRY
CAS
133814-19-4
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
DRUG BANK
DB01226
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
IUPHAR
7243
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
MESH
C049430
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
NCI_THESAURUS
C83966
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
PUBCHEM
5281042
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
EPA CompTox
133814-19-4
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
FDA UNII
77D66S9Q93
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
EVMPD
SUB03310MIG
Created by admin on Sat Jun 26 11:05:08 UTC 2021 , Edited by admin on Sat Jun 26 11:05:08 UTC 2021
PRIMARY
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SALT/SOLVATE -> PARENT
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Definition References