Parenteral Manual

Mivacurium (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
MIVACRON®
Classification: 
Nondepolarizing neuromuscular blocking agent
Original Date: 
August 2005
Indications: 
  • Facilitates endotracheal intubations
  • Provides skeletal muscle relaxation during short surgical procedures
Reconstitution and Stability: 
  • Available as a 2 mg/mL injection
  • Store at room temperature; protect from freezing
  • Diluted solutions stable 24 hrs at room temperature at a concentration of 0.5 mg/mL
  • pH = 3.5-5 (acidic)
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: alfentanil, droperidol, etomidate, fentanyl, midazolam, sufentanil, thiopental

Incompatible: alkaline solutions (e.g. sodium bicarbonate)

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
Usual dilution: <2 mg/mL
Infusion time: 15-30 seconds
IV Intermittent Infusion NO
IV Continuous Infusion YES
Usual dilution: 0.5 mg/mL
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric (2 - 12 years):   

  • Initial: 0.2 mg/kg IV over 5-15 seconds, maintenance dose generally required 10 minutes after  initial dose
  • Infusion: 5-31 mcg/kg/minute IV

Adolescent/Adult:    

  • Initial: 0.15 mg/kg IV over 5-15 seconds; maintenance dose of 0.1 mg/kg IV generally required 15 minutes after initial dose
  • Infusion:
    - Initial: 9-10 mcg/kg/minute IV
    - Maintenance: 6-7 mcg/kg/minute IV
    - Range: 1-15 mcg/kg/minute IV
Potential hazards of parenteral administration: 
  • Flushing of head and neck
  • Hypotension, bradycardia, tachycardia, cardiac arrhythmias
  • Phlebitis, injection site reaction
  • Bronchospasm, wheezing, hypoxemia
  • Histamine release can occur at usual doses
Notes: 
  • Peak neuromuscular blockade: 1-3 minutes
  • Duration of action: short-10 minutes
  • Time to recovery is 15-30 minutes
  • Onset and recovery are usually more rapid in children; therefore, doses are higher than in adults
  • Monitor heart rate, blood pressure, ventilation status

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