Details of the Drug

General Information of Drug (ID: DMUZPJ5)

Drug Name
Cisatracurium
Synonyms Cisatracurium Besylate; Cisatracurium Besylate Preservative Free; Nimbex; Nimbex Preservative Free
Indication
Disease Entry ICD 11 Status REF
Muscle spasm MB47.3 Approved [1]
Drug Type
Small molecular drug
Structure
3D MOL is unavailable 2D MOL
#Ro5 Violations (Lipinski): 4 Molecular Weight (mw) 929.1
Logarithm of the Partition Coefficient (xlogp) 7.9
Rotatable Bond Count (rotbonds) 26
Hydrogen Bond Donor Count (hbonddonor) 0
Hydrogen Bond Acceptor Count (hbondacc) 12
ADMET Property
Clearance
The drug present in the plasma can be removed from the body at the rate of 5.4 mL/min/kg [2]
Elimination
8.5% of drug is excreted from urine in the unchanged form [3]
Half-life
The concentration or amount of drug in body reduced by one-half in 22 minutes [2]
Metabolism
The drug is metabolized via the liver []
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.6457 micromolar/kg/day [4]
Unbound Fraction
The unbound fraction of drug in plasma is 0.62% [2]
Vd
Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.14 L/kg [2]
Chemical Identifiers
Formula
C53H72N2O12+2
IUPAC Name
5-[3-[(1R,2R)-1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propanoyloxy]pentyl 3-[(1R,2R)-1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propanoate
Canonical SMILES
C[N@@+]1(CCC2=CC(=C(C=C2[C@H]1CC3=CC(=C(C=C3)OC)OC)OC)OC)CCC(=O)OCCCCCOC(=O)CC[N@+]4(CCC5=CC(=C(C=C5[C@H]4CC6=CC(=C(C=C6)OC)OC)OC)OC)C
InChI
InChI=1S/C53H72N2O12/c1-54(22-18-38-32-48(62-7)50(64-9)34-40(38)42(54)28-36-14-16-44(58-3)46(30-36)60-5)24-20-52(56)66-26-12-11-13-27-67-53(57)21-25-55(2)23-19-39-33-49(63-8)51(65-10)35-41(39)43(55)29-37-15-17-45(59-4)47(31-37)61-6/h14-17,30-35,42-43H,11-13,18-29H2,1-10H3/q+2/t42-,43-,54-,55-/m1/s1
InChIKey
YXSLJKQTIDHPOT-LJCJQEJUSA-N
Cross-matching ID
PubChem CID
62887
ChEBI ID
CHEBI:140621
CAS Number
96946-41-7
DrugBank ID
DB00565
TTD ID
D08ALK
ACDINA ID
D00949
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Cholinergic receptor unspecific (CHR) TTUPDWN NOUNIPROTAC Antagonist [5]
Neuronal acetylcholine receptor alpha-2 (CHRNA2) TTF4E0J ACHA2_HUMAN Antagonist [6]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Cisatracurium
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Vecuronium DMP0UK2 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Vecuronium. Tonus and reflex abnormality [MB47] [7]
Coadministration of a Drug Treating the Disease Different from Cisatracurium (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Clindamycin DM15HL8 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Clindamycin. Acne vulgaris [ED80] [8]
Magnesium Sulfate DMVEK07 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Magnesium Sulfate. Acute pain [MG31] [9]
Framycetin DMF8DNE Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Framycetin. Alcoholic liver disease [DB94] [10]
Paromomycin DM1AGXN Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Paromomycin. Amoebiasis [1A36] [10]
Trimethaphan DMHF4IQ Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Trimethaphan. Aneurysm/dissection [BD50] [11]
Terbutaline DMD4381 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Terbutaline. Asthma [CA23] [11]
Spectinomycin DM0MQ35 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Spectinomycin. Bacterial infection [1A00-1C4Z] [11]
Kanamycin DM2DMPO Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Kanamycin. Bacterial infection [1A00-1C4Z] [10]
Streptomycin DME1LQN Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Streptomycin. Bacterial infection [1A00-1C4Z] [10]
Gentamicin DMKINJO Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Gentamicin. Bacterial infection [1A00-1C4Z] [10]
Oxytetracycline DMOVH1M Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Oxytetracycline. Bacterial infection [1A00-1C4Z] [11]
Netilmicin DMRD1QK Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Netilmicin. Bacterial infection [1A00-1C4Z] [10]
Tobramycin DMUI0CH Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Tobramycin. Bacterial infection [1A00-1C4Z] [10]
Minocycline DMVN5OH Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Minocycline. Bacterial infection [1A00-1C4Z] [11]
Tetracycline DMZA017 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Tetracycline. Bacterial infection [1A00-1C4Z] [11]
Demeclocycline DMZEPFJ Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Demeclocycline. Bronchitis [CA20] [11]
Irinotecan DMP6SC2 Minor Antagonize the effect of Cisatracurium when combined with Irinotecan. Colorectal cancer [2B91] [12]
Procaine DM4LSNE Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Procaine. Corneal disease [9A76-9A78] [11]
Alfentanil DMVO0UB Moderate Increased risk of bradycardia by the combination of Cisatracurium and Alfentanil. Corneal disease [9A76-9A78] [13]
Fosphenytoin DMOX3LB Moderate Increased metabolism of Cisatracurium caused by Fosphenytoin mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [14]
Ethotoin DMXWOCP Moderate Increased metabolism of Cisatracurium caused by Ethotoin mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [14]
Nadolol DMW6GVL Moderate Additive cardiorespiratory depression effects by the combination of Cisatracurium and Nadolol. Essential hypertension [BA00] [15]
Amphotericin B DMTAJQE Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Amphotericin B. Fungal infection [1F29-1F2F] [16]
Metipranolol DMJMVKI Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Metipranolol. Glaucoma [9C61] [17]
Levobetaxolol DMSREPX Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Levobetaxolol. Glaucoma [9C61] [17]
Levobunolol DMTNFCQ Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Levobunolol. Glaucoma [9C61] [17]
Lincomycin DMVTHER Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Lincomycin. Gram-positive bacterial infection [1B74-1F40] [8]
Carvedilol DMHTEAO Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Carvedilol. Heart failure [BD10-BD1Z] [15]
Acebutolol DM0TI4U Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Acebutolol. Hypertension [BA00-BA04] [15]
Bisoprolol DM3UZ95 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Bisoprolol. Hypertension [BA00-BA04] [15]
Penbutolol DM4ES8F Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Penbutolol. Hypertension [BA00-BA04] [15]
Nebivolol DM7F1PA Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Nebivolol. Hypertension [BA00-BA04] [15]
Pindolol DMD2NV7 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Pindolol. Hypertension [BA00-BA04] [15]
Labetalol DMK8U72 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Labetalol. Hypertension [BA00-BA04] [15]
Chloroquine DMSI5CB Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Chloroquine. Malaria [1F40-1F45] [11]
Propranolol DM79NTF Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Propranolol. Migraine [8A80] [15]
Metoclopramide DMFA5MY Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Metoclopramide. Nausea/vomiting [MD90] [11]
Ranitidine DM0GUSX Minor Antagonize the effect of Cisatracurium when combined with Ranitidine. Peptic ulcer [DA61] [18]
Colistimethate DMZ9BMU Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Colistimethate. Respiratory infection [CA07-CA4Z] [19]
Fentanyl DM8WAHT Moderate Additive hypotensive effects by the combination of Cisatracurium and Fentanyl. Sensation disturbance [MB40] [13]
Bacitracin DM5OHYE Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Bacitracin. Skin and skin-structure infection [1F28-1G0Z] [20]
Plazomicin DMKMBES Major Additive neuromuscular blocking effects by the combination of Cisatracurium and Plazomicin. Urinary tract infection [GC08] [10]
Procainamide DMNMXR8 Moderate Additive neuromuscular blocking effects by the combination of Cisatracurium and Procainamide. Ventricular tachyarrhythmia [BC71] [11]
⏷ Show the Full List of 43 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
Benzyl alcohol E00010 244 Antimicrobial preservative; Solvent
Benzenesulfonic acid E00147 7371 Acidulant
Water E00035 962 Solvent
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Cisatracurium 20mg/10ml injectable 20mg/10ml Injectable Injection
Cisatracurium 10mg/5ml injectable 10mg/5ml Injectable Injection
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
2 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
3 BDDCS applied to over 900 drugs
4 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
5 Bradycardia produced by pyridostigmine and physostigmine. Can J Anaesth. 1997 Dec;44(12):1286-92.
6 Pharmacological characteristics of the inhibition of nondepolarizing neuromuscular blocking agents at human adult muscle nicotinic acetylcholine receptor. Anesthesiology. 2009 Jun;110(6):1244-52.
7 Pandit SK, Ferres CJ, Gibson FM, Mirakhur RK "Time course of action of combinations of vecuronium and pancuronium." Anaesthesia 41 (1986): 151-4. [PMID: 2869710]
8 Alahdal O, Bevan DR "Clindamycin-induced neuromuscular blockade." Can J Anaesth 42 (1995): 614-7. [PMID: 7553999]
9 Fuchs-Buder T, Wilder-Smith OH, Borgeat A, Tassonyi E "Interaction of magnesium sulphate with vecuronium-induced neuromuscular block." Br J Anaesth 74 (1995): 405-9. [PMID: 7734259]
10 Burkett L, Bikhazi GB, Thomas KC Jr, Rosenthal DA, Wirta MG, Foldes FF "Mutual potentiation of the neuromuscular effects of antibiotics and relaxants." Anesth Analg 58 (1979): 107-15. [PMID: 571233]
11 Multum Information Services, Inc. Expert Review Panel.
12 Product Information. Camptosar (irinotecan). Pharmacia and Upjohn, Kalamazoo, MI.
13 Product Information. Alfenta (alfentanil). Janssen Pharmaceutica, Titusville, NJ.
14 Liberman BA, Norman P, Hardy BG "Pancuronium-phenytoin interaction: a case of decreased duration of neuromuscular blockade." Int J Clin Pharmacol Ther Toxicol 26 (1988): 371-4. [PMID: 3220609]
15 Chapple DJ, Clark JS, Hughes R "Interaction between atracurium and drugs used in anaesthesia." Br J Anaesth 55 Suppl 1 (1983): s17-22. [PMID: 6688011]
16 Cushard WG, Kohanim M, Lantis LR "Blastomycosis of bone." J Bone Joint Surg Am 51A (1969): 704-12. [PMID: 5819086]
17 Harrah MD, Way WL, Katzung BG "The interaction of d-tubocurarine with antiarrhythmic drugs." Anesthesiology 33 (1970): 406-10. [PMID: 5512329]
18 Katende RS, Dimich I "Resistance to nondepolarizing muscle relaxants in a patient treated with ranitidine." Mt Sinai J Med 54 (1987): 330-1. [PMID: 2955219]
19 Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
20 Huang KC, Heise A, Shrader AK, Tsueda K "Vancomycin enhances the neuromuscular blockade of vecuronium." Anesth Analg 71 (1990): 194-6. [PMID: 1973882]