What Nimbex is used for and how to use it
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Nimbex - Consumer Medicine Information

Manufacture: AbbVie
Country: Canada
Condition: Anesthesia, Light Anesthesia
Class: Neuromuscular blocking agents
Form: Liquid solution, Intravenous (IV)
Ingredients: cisatracurium besylate, benzenesulfonic acid, benzyl alcohol, water for injection


cisatracurium besylate injection

About this Medication

What the medication is used for:

  • NIMBEX is used for providing muscle relaxation during surgery, or during other medical procedures. NIMBEX is only used in conjunction with an anesthetic.

What it does

NIMBEX belongs to a group of medicines called neuromuscular blockers. It works by blocking the effects of acetylcholine, a chemical involved in muscle contraction. This relaxes muscles in the body before surgery or insertion of a breathing tube.

When it should not be used

Nimbex should not be used in neonates (infants less that 1 month of age) or low birth weight infants. Before surgery, be sure to tell all consulting physicians if you:

  • are allergic to cisatracurium besylate;
  • are allergic to any other bis-benzylisoquinolinium agents;
  • are allergic to benzyl alcohol.

What the medicinal ingredient is

cisatracurium besylate

What the non-medicinal ingredients are

NIMBEX also contains benzenesulfonic acid, benzyl alcohol and water for injection.

What dosage forms it comes in

NIMBEX is available as an injection in vials of 2 mg/mL (10 mL multiple-dose vial).

Warnings and Precautions

BEFORE you use NIMBEX talk to your doctor or pharmacist if:

  • You have difficulty with intubations
  • You are susceptible to malignant hyperthermia
  • You have kidney or liver problems
  • You are pregnant, plan to become pregnant, or are breast-feeding
  • You are taking any prescription or non-prescription medications or herbal medicines
  • You are allergic to cisatracurium besylate, other medications or substances (e.g., benzyl alcohol)
  • You have muscle weakness or partial paralysis on one side of the body or partial paralysis affecting the lower limbs (e.g., Lambert-Eaton syndrome, myasthenia gravis)
  • You have an electrolyte disturbance or acid-base imbalance or tissue wasting, or are debilitated
  • You have had a burn injury requiring medical treatment

NIMBEX contains benzyl alcohol, which could be lethal to neonates (infants less than 1 month of age) and low birth weight infants.

Interactions with this Medication

Drugs that may interact with NIMBEX include:

  • succinylcholine
  • inhalation anesthetics (e.g., isoflurane, enflurane)
  • anticonvulsants (e.g., phenytoin, carbamazepine)
  • antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin)
  • anti-arrhythmics (e.g., procainamide and quinidine)
  • lithium and magnesium salts
  • local anesthetics

Proper use of this Medication

Usual dose:

NIMBEX is a medicine that is given by injection. NIMBEX will be administered by an anesthetist or other trained professional during surgery or other medical procedures. The dosage will vary according to many factors such as body weight, age and the duration of the procedure. It will be given to you once you are anesthetised (lost all awareness) for your surgery or procedure.


  • Overdoses of NIMBEX lead to prolonged relaxation of the body’s muscles. This can be readily treated; however, this situation is unlikely to occur because NIMBEX is only administered by an anesthetist or other trained doctor who will closely monitor your progress.

Side Effects and what to do about them

Like all medicines, NIMBEX can cause uncommon side effects which include flushing, skin rashes, feeling agitated, increased cough, nausea, and vomiting.

After exposure to NIMBEX, you should contact your physician or anesthesia professional if you have any of the side effects listed in the table below.

Serious Side Effects, how often they Happen and what to do about them

Symptom/effectTalk with your doctor or anesthesia professionalStop taking drug and call your doctor or pharmacist
Only if severeIn all cases
CommonAllergic Reactions
- Rash
- Hives
- Swelling of the face, throat, lips
- Difficulty breathing
-Difficulty swallowing
Difficulty Breathing/ Choking
Elevated Blood Glucose
High Blood Pressure
Jaundice/Yellowing of the Eyeballs
Low Blood Pressure
Rapid Heartbeat
Seizures/Seizure-like activity
Severe Itching
Slow Heartbeat
Sudden fever with stiffness, pain and weakness in muscles

This is not a complete list of side effects. For any unexpected effects while taking NIMBEX, contact your doctor or pharmacist.

Reporting Suspected Side Effects

You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:

  • Report on line at: www.healthcanada.gc.ca/medeffect
  • Call toll-free at 1-866-234-2345
  • Complete a Canada Vigilance Reporting Form and:
    • Fax toll-free to 1-866-678-6789
    • Mail to: Canada Vigilance Program
      Health Canada
      Postal Locator 0701C
      Ottawa, ON K1A 0K9

Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect Canada Web site at http://www.healthcanada.gc.ca/medeffect

NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice.

More Information

This document plus the full product monograph, prepared for health professionals can be obtained by contacting the sponsor, AbbVie Corporation at 1-800-699-9948.