Alternate Name(s):
NIMBEX®
Classification:
Non-depolarizing skeletal neuromuscular blocking agent
Original Date:
August 2005
Revised Date:
December 2020
Indications:
- To ease endotracheal intubation
- Adjunct to general anaesthesia and relaxes skeletal muscle during surgery or mechanical ventilation
Reconstitution and Stability:
- Available as 2 mg/mL in 10 mL multidose vial or 10 mg/mL in 20 mL single dose vial
- Refrigerate and protect from light. Stable 21 days at room temperature
- Diluted solutions (0.1 - 0.4 mg/mL ,2 or 5mg/mL in D5W or NS) stable 24 hours at room temperature
- Undiluted solutions stable 21 days at room temperature in original vial even if re-refrigerated
Compatibility:
- Solutions Compatible: D5W, 0.9% NaCl, D5NS
- Additives/Above Cassette Compatible: no information
- Y-site Compatible: alfentanil, fentanyl, droperidol, midazolam, sufentanil,
Incompatible: alkaline solutions (e.g. barbiturate solutions), ketorolac, ringer's lactate, propofol
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
YES |
| IV Intermittent Infusion | YES Usual dilution: 0.1-0.4 mg/mL |
| IV Continuous Infusion |
YES - FOR CRITICAL CARE AREAS ONLY Usual dilution: 0.1-0.4 mg/mL or 2mg/mL |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
IV:
- 2-12 years: 0.1 mg/kg followed by maintenance dose of 0.03 mg/kg as needed to maintain neuromuscular blockade
- > 12 years- Adult: 0.15-0.2 mg/kg followed by maintenance dose of 0.03 mg/kg 40-65 minutes later or as needed
Continuous Infusion:
- Children >2 years: 1-4 mcg/kg/minute
- Adult: 1-4 mcg/kg/minute [up to 10 mcg/kg/minutes]
Potential hazards of parenteral administration:
- Hypersensitivity
- Rash
- Side effects of rash, bronchospasm, hypersensitivity
Notes:
- Many drug interactions- check with pharmacy
- Monitor muscle twitch response to peripheral nerve stimulation, heart rate, blood pressure