Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 10mg/mL
Endotracheal Intubation, Mechanical Ventilation
Calculate dose based on ideal body weight
0.4-0.5 mg/kg IVP over 60 seconds, then 0.08-0.1 mg/kg 20-45 minutes after initial dose to maintain neuromuscular block, repeat maintenance dose q15-25min PRN OR
Continuous infusion: 0.005-0.01 mg/kg/min IV (ranges from 0.002-0.015 mg/kg/min) OR
0.2-0.4 mg/kg IVP if following succinylcholine for intubation
Skeletal Muscle Relaxation During Surgery
0.4-0.5 mg/kg IVP over 60 seconds, then 005-010 mg/kg/min; block usually maintained at rate of 0.011-0.013 mg/kg/min
Renal Impairment
Dose adjustment not necessary
Hepatic Impairment
Dose adjustment not necessary
Administration
Reduce dose if given with general anesthetics that potentiate its activity (eg, isoflurane)
Dosage Forms & Strengths
injectable solution
- 10mg/mL
Endotracheal Intubation, Mechanical Ventilation
<1 month old: Safety and efficacy not established
1 month - 2 years: 0.3-0.4 mg/kg IVP under halothane anesthesia
Maintenance dose: Children may need more frequent maintenance doses than adult
>2 years: 0.4-0.5 mg/kg IVP over 60 seconds, then 0.08-0.1 mg/kg 20-45 minutes after initial dose to maintain neuromuscular block, repeat maintenance dose q15-25min PRN
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (29)
- amikacin
amikacin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- amphotericin B deoxycholate
amphotericin B deoxycholate increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, atracurium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- capreomycin
capreomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- clindamycin
clindamycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- colistin
atracurium increases effects of colistin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potentiation of neuromuscular blockade; risk of respiratory arrest.
- demeclocycline
demeclocycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- doxycycline
doxycycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- fentanyl
fentanyl, atracurium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl intranasal
fentanyl intranasal, atracurium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transdermal
fentanyl transdermal, atracurium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transmucosal
fentanyl transmucosal, atracurium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- gentamicin
gentamicin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- hydrocodone
hydrocodone, atracurium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- lincomycin
lincomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- minocycline
minocycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- neomycin PO
neomycin PO increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- omadacycline
omadacycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- oxytetracycline
oxytetracycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- paromomycin
paromomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- polymyxin B
polymyxin B increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- pramlintide
pramlintide, atracurium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- quinine
quinine increases effects of atracurium by pharmacodynamic synergism. Contraindicated. Risk of resp. depression.
- sarecycline
sarecycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- streptomycin
streptomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- sufentanil SL
sufentanil SL, atracurium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tetracycline
tetracycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- tobramycin
tobramycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- valerian
valerian and atracurium both increase sedation. Avoid or Use Alternate Drug.
Monitor Closely (109)
- abobotulinumtoxinA
atracurium increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- aclidinium
atracurium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amitriptyline
atracurium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
atracurium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and atracurium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- aripiprazole
atracurium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine
atracurium and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atracurium and atropine IV/IM both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna alkaloids
atracurium and belladonna alkaloids both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
atracurium and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
atracurium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - betamethasone
atracurium, betamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- bethanechol
bethanechol increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- buprenorphine, long-acting injection
atracurium increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- carbachol
carbachol increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cevimeline
cevimeline increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
atracurium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cisatracurium
atracurium and cisatracurium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clomipramine
atracurium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clozapine
atracurium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - corticotropin
atracurium, corticotropin. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cortisone
atracurium, cortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cyclizine
atracurium and cyclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclobenzaprine
atracurium and cyclobenzaprine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- darifenacin
atracurium and darifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- deflazacort
atracurium, deflazacort. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- dexamethasone
atracurium, dexamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- dicyclomine
atracurium and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diphenhydramine
atracurium and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- donepezil
donepezil increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal and atracurium both increase pharmacodynamic synergism. Use Caution/Monitor. Donepezil transdermal, a cholinesterase inhibitor, may potentiate the effects on muscle relacation during anesthesia.
- dosulepin
atracurium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxapram
doxapram decreases effects of atracurium by pharmacodynamic antagonism. Use Caution/Monitor.
- doxepin
atracurium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- droperidol
atracurium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
atracurium and fesoterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
atracurium and flavoxate both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fludrocortisone
atracurium, fludrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- fluphenazine
atracurium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - galantamine
galantamine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate inhaled
atracurium and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
atracurium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
atracurium and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
atracurium and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
atracurium, hydrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- hyoscyamine
atracurium and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
atracurium and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
atracurium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
atracurium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- incobotulinumtoxinA
atracurium increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance the effects of prabotulinumtoxinA. Closely monitor for increased neuromuscular blockade.
- ipratropium
atracurium and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- lofepramine
atracurium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- loxapine
atracurium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atracurium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - magnesium sulfate
magnesium sulfate increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Interaction occurs with parenteral magnesium.
- magnesium supplement
magnesium supplement, atracurium. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Each enhance the neuromuscular blocking effect of the other; may have negative respiratory effects.
- maprotiline
atracurium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclizine
atracurium and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methscopolamine
atracurium and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylprednisolone
atracurium, methylprednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- neostigmine
neostigmine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
atracurium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- olanzapine
atracurium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oliceridine
oliceridine, atracurium. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- onabotulinumtoxinA
atracurium and onabotulinumtoxinA both decrease cholinergic effects/transmission. Use Caution/Monitor.
- orphenadrine
atracurium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin
atracurium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
atracurium and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
atracurium and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone increases effects of atracurium by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Oxycodone may enhance the neuromuscular blocking action of true skeletal muscle relaxants and produce an increased degree of respiratory depression.
- paliperidone
atracurium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
atracurium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- perphenazine
atracurium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - physostigmine
physostigmine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
atracurium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pralidoxime
atracurium and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.
- prednisolone
atracurium, prednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prednisone
atracurium, prednisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prochlorperazine
atracurium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
atracurium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
atracurium and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- protriptyline
atracurium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
atracurium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rapacuronium
atracurium and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- rimabotulinumtoxinB
atracurium, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- risperidone
atracurium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rocuronium
atracurium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scopolamine
atracurium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of atracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of atracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- solifenacin
atracurium and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- succinylcholine
succinylcholine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
atracurium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
atracurium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
atracurium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tobramycin inhaled
tobramycin inhaled increases effects of atracurium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Aminoglycosides may aggravate muscle weakness because of a curare-like effect.
- tolterodine
atracurium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trazodone
atracurium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
- triamcinolone acetonide injectable suspension
atracurium, triamcinolone acetonide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- trifluoperazine
atracurium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trimipramine
atracurium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trospium chloride
atracurium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- vecuronium
atracurium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ziprasidone
atracurium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
atracurium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (41)
- acetazolamide
acetazolamide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- amlodipine
amlodipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- carbamazepine
carbamazepine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- clevidipine
clevidipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- clonazepam
clonazepam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- desipramine
atracurium and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.
- diazepam
diazepam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- diltiazem
diltiazem increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- dimenhydrinate
dimenhydrinate increases toxicity of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethosuximide
ethosuximide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felbamate
felbamate decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felodipine
felodipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- fosphenytoin
fosphenytoin decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- gabapentin
gabapentin decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- gabapentin enacarbil
gabapentin enacarbil decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- isradipine
isradipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- lacosamide
lacosamide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lamotrigine
lamotrigine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- levetiracetam
levetiracetam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lithium
lithium increases effects of atracurium by unknown mechanism. Minor/Significance Unknown.
- lorazepam
lorazepam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- methsuximide
methsuximide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- nicardipine
nicardipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nifedipine
nifedipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nisoldipine
nisoldipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- oxcarbazepine
oxcarbazepine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- phenytoin
phenytoin decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- primidone
primidone decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown.
- rufinamide
rufinamide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- sevoflurane
sevoflurane increases levels of atracurium by pharmacodynamic synergism. Minor/Significance Unknown.
- thiamine
thiamine increases effects of atracurium by unspecified interaction mechanism. Minor/Significance Unknown.
- tiagabine
tiagabine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- topiramate
topiramate decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- valproic acid
valproic acid decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- verapamil
verapamil increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- zonisamide
zonisamide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
1-10%
Skin flush (5%)
<1%
Erythema (0.6%)
Wheezing (0.2%)
Increased bronchial secretions (0.2%)
Pruritus (0.2%)
Urticaria (0.1%)
Postmarketing Reports
Wheals
Erythema at injection site
Bronchospasm (0.01%)
Cyanosis (0.001%)
Changes in heart rate (0.6-2.1%)
Mean arterial pressure (1.9%)
Diastolic arterial pressure changes
Systemic vascular resistance changes
Cardiac index changes
Cardiac output changes
Cardiac arrest (0.001%)
Warnings
Contraindications
Hypersensitivity to drug or components; lack of ventilatory support, neuromuscular disease
Cautions
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
Closely monitor patients with bronchogenic carcinoma, dehydration, electrolyte imbalance, hypotension, hypothermia, myasthenia gravis, pulmonary disease
Adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist
Pharmacokinetics
Onset: 2-3 min; may be slightly delayed in patients with renal failure
Duration: 20-35 min
Half-Life: 2-3.4 min (distribution); 20 min (terminal)
Protein bound: 82%
Vd: 160 mL/kg (range: 120-188 mL/kg)
Metabolism: Metabolized to laudanoside by non-enzymatic cleavage independent of hepatic/renal function
Excretion: Urine (5%) & also in feces via biliary elimination
Administration
IV Compatibilities
Solution: D5/NS, D5W(?), NS(?)
Additive: bretylium, cimetidine, ciprofloxacin, dobutamine, dopamine, esmolol, gentamicin, isoproterenol, lidocaine, morphine, KCl, procainamide, vancomycin
Syringe: alfentanil, fentanyl, midazolam, sufentanil
Y-site: amiodarone, cefazolin, cefuroxime, cimetidine, clarithromycin, dobutamine, dopamine, epinephrine, esmolol, etomidate, fenoldopam, fentanyl, gentamicin, heparin, Hextend, hydrocortisone, isoproterenol, lorazepam, midazolam, milrinone, morphine, nitroglycerin, ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin
IV Incompatibilities
Solution: LR
Additive: aminophylline, cefazolin, heparin, quinidine gluconate, ranitidine, sodium nitroprusside
Syringe: alkaline solutions
Y-site: diazepam, propofol(?), thiopental
IV Preparation
Add to an empty Viaflex bag & infuse undiluted (10 mg/mL); however, if necessary, may be diluted in D5W, NS or dextrose-saline combinations
Dilution in LR not recommended
IV Administration
Not for IM injection due to tissue irritation
May be given undiluted as bolus injection
Administration via infusion requires use of an infusion pump
Use infusion solutions within 24 hr of preparation
Storage
Refrigerate
Unstable in alkaline solutions
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() | |
atracurium intravenous - | 10 mg/mL vial | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
atracurium intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.