Cisatra Injection: Complete Medicine Guide
When to Call Your Doctor IMMEDIATELY
- Sudden difficulty breathing or wheezing
- Severe drop in blood pressure
- Facial or throat swelling
- Persistent muscle paralysis beyond expected duration
- Signs of anaphylaxis such as rash, hives, or shock
- Seizures or unusual movements
- Decreased urine output
If experiencing severe symptoms, call emergency services immediately.
What is cisatra injection used for?
This medicine is a neuromuscular blocking agent used in hospitals to relax muscles during surgery or mechanical ventilation. It is given intravenously by a doctor and requires close monitoring.
- Generic Name: Cisatracurium
- Manufacturer: Themis Medicare Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 cisatra injection के बारे में (Hindi Summary)
उपयोग: यह दवा सिसैट्राक्यूरियम इंजेक्शन एक मांसपेशियों को शिथिल करने वाली दवा है जिसका उपयोग अस्पतालों में सर्जरी के दौरान या वेंटिलेटर पर रखे मरीजों में किया जाता है। यह दवा केवल डॉक्टर द्वारा नस में दी जाती है और इसके प्रभाव की निगरानी की जाती है। यह दवा मरीज को बेहोश करने के बाद ही दी जाती है क्योंकि इससे पूरे शरीर की मांसपेशियां ढीली हो जाती हैं और मरीज खुद सांस नहीं ले पाता। इसलिए इसका उपयोग केवल आईसीयू या ऑपरेशन थियेटर में ही किया जाता है।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में रक्तचाप कम होना, चेहरे पर लालिमा, और हृदय गति धीमी होना शामिल है। कभी-कभी मांसपेशियों में लंबे समय तक पक्षाघात रह सकता है। गंभीर दुष्प्रभावों में एनाफिलेक्सिस (अचानक एलर्जी प्रतिक्रिया) और सांस लेने में कठिनाई हो सकती है। ये सभी प्रभाव अस्पताल में डॉक्टर की निगरानी में ही होते हैं और तुरंत इलाज किया जाता है।
सुरक्षा सलाह: यह दवा केवल अस्पताल में प्रशिक्षित डॉक्टर द्वारा ही दी जानी चाहिए। मरीज को इससे पहले कि वह कोई भी दवा ले, अपने डॉक्टर को अपनी सभी दवाओं और बीमारियों के बारे में बताना चाहिए। गर्भवती महिलाओं को यह दवा केवल तभी दी जाती है जब डॉक्टर को लगता है कि लाभ जोखिम से अधिक है। इस दवा को लेने के बाद मरीज को तब तक वेंटिलेटर पर रखा जाता है जब तक कि उसकी मांसपेशियां पूरी तरह से काम करना शुरू न कर दें।
💊 cisatra injection Uses & Benefits
[{"condition":"Surgical muscle relaxation","description":"This medicine is used to provide skeletal muscle relaxation during surgical procedures, including abdominal, cardiac, and orthopedic surgeries, to facilitate intubation and mechanical ventilation.","evidence":"Well-established"},{"condition":"Mechanical ventilation in ICU","description":"It is used in intensive care units to facilitate mechanical ventilation in critically ill patients who require prolonged muscle paralysis, such as those with acute respiratory distress syndrome.","evidence":"Well-established"},{"condition":"Endotracheal intubation","description":"This medicine helps in placing an endotracheal tube by relaxing the vocal cords and throat muscles.","evidence":"Well-established"}]
Off-label uses: [{"condition":"Management of tetanus-induced muscle spasms","description":"In some cases, this medicine may be used off-label to control severe muscle spasms associated with tetanus, but this requires careful monitoring in an ICU setting.","evidence":"Limited"},{"condition":"Treatment of severe spasticity in palliative care","description":"Rarely, it may be used off-label for short-term management of severe spasticity in palliative care when other treatments are ineffective.","evidence":"Limited"}]
Primary treatment for: Surgical procedures requiring muscle relaxation
Also treats: Mechanical ventilation in ICU, Endotracheal intubation
📋 Drug Information
| Generic Name(s) | Cisatracurium |
| Brand Name | Cisatra Injection |
| Manufacturer | Themis Medicare Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | PAIN ANALGESICS |
| Action Class | Skeletal muscle relaxant- Peripherally acting |
| Route of Administration | Intravenous |
| Storage | This medicine should be stored refrigerated at 2°C to 8°C (36°F to 46°F). It should not be frozen. Once removed from refrigeration, it should be used within a specified time as per the manufacturer's instructions. Protect from light. |
| Shelf Life | The shelf life of this medicine is typically 24 months from the date of manufacture when stored under recommended conditions. Refer to the product label for the exact expiry date. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine works by binding competitively to nicotinic acetylcholine receptors located on the motor endplate of skeletal muscle. By occupying these receptors, it prevents acetylcholine, the natural neurotransmitter, from binding and triggering muscle contraction. This blockade results in muscle relaxation and paralysis. Because the block is competitive, increasing acetylcholine levels can overcome it, but in clinical practice, the effect is controlled by careful dosing. This medicine does not cause depolarization of the muscle membrane, which distinguishes it from depolarizing agents like succinylcholine. It has a rapid onset and intermediate duration of action, making it suitable for continuous infusion or intermittent bolus dosing during surgery and critical care.
Mechanism Steps
💡 How to Take cisatra injection
Strength: Injection: 2 mg/mL in a 5 mL or 10 mL vial, containing cisatracurium besylate equivalent to 2 mg/mL of cisatracurium.
Dosage Information
| Adult Dosage | The dosage of this medicine must be individualized by a qualified clinician based on the patient's condition, weight, and response. For endotracheal intubation, a common initial dose is 0.15 mg/kg administered intravenously over 5 to 10 seconds. For maintenance, doses of 0.03 mg/kg may be given as needed. For continuous infusion in ICU, the rate is typically 1 to 3 mcg/kg/min, adjusted according to neuromuscular monitoring. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. In some clinical settings, doses similar to adults on a mg/kg basis have been used, but this must be determined by a pediatric anesthesiologist. |
| Elderly Dosage | Elderly patients may have a slightly prolonged duration of action. Doses should be individualized based on neuromuscular monitoring. No specific dose adjustment is generally required, but caution is advised. |
| Renal Impairment | No dose adjustment is required for renal impairment, as this medicine undergoes organ-independent Hofmann elimination. However, the metabolite laudanosine may accumulate, so monitoring is advised in severe renal impairment. |
| Hepatic Impairment | No dose adjustment is required for hepatic impairment, as this medicine undergoes organ-independent Hofmann elimination. However, monitoring is advised in severe hepatic impairment due to potential laudanosine accumulation. |
| Maximum Daily Dose | Not established from the available information. Dosing is titrated to effect under medical supervision. |
Dosage Timeline
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of cisatra injection
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Inhalational anesthetics | Major | |
| Aminoglycosides | Major | |
| Magnesium sulfate | Major | |
| Loop diuretics | Moderate | |
| Calcium channel blockers | Moderate | |
| Lithium | Moderate | |
| Corticosteroids | Minor | |
| Azathioprine | Minor |
🚨 Major Interactions
- Inhalational anesthetics (e.g., isoflurane, sevoflurane)
- Aminoglycoside antibiotics (e.g., gentamicin, tobramycin)
- Magnesium sulfate
⚡ Moderate Interactions
- Loop diuretics (e.g., furosemide)
- Calcium channel blockers (e.g., verapamil)
- Lithium
🍷 Alcohol Interaction
Alcohol may enhance the sedative and cardiovascular effects of this medicine. Patients should avoid alcohol before and after receiving this medicine, as it can increase the risk of hypotension and prolonged recovery.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to cisatracurium or any component of the formulation","Use in patients who cannot be adequately ventilated","Use without appropriate sedation or anesthesia"]
⚠️ Warnings & Precautions
["This medicine should only be administered by experienced clinicians in a setting with facilities for intubation and mechanical ventilation.","Patients with neuromuscular disorders such as myasthenia gravis may have increased sensitivity and require reduced doses.","Prolonged use in ICU may lead to critical illness polyneuropathy and myopathy.","Use with caution in patients with severe renal or hepatic impairment due to potential accumulation of laudanosine.","This medicine may cause histamine release; monitor for signs of anaphylaxis.","Ensure adequate sedation and analgesia before administering this medicine, as it has no sedative or analgesic properties."]
🤱 Lactation Safety
It is not known whether this medicine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this medicine is administered to a nursing woman. Breastfeeding may be withheld for a short period after administration as advised by the doctor.
💊 Overdose Management
Overdose of this medicine can lead to prolonged muscle paralysis and respiratory depression. Management includes continued mechanical ventilation and sedation until full recovery of neuromuscular function. Reversal agents such as neostigmine or edrophonium may be used, but they may not be fully effective. Supportive care with monitoring of vital signs and neuromuscular function is essential. There is no specific antidote for cisatracurium overdose.
⏰ Missed Dose
This medicine is administered by healthcare professionals in a controlled setting. Missed doses are not applicable for patients. If a scheduled dose is missed in a continuous infusion, the medical team will adjust the infusion rate accordingly.
Additional Safety Advice
This medicine must only be administered by a qualified anesthesiologist or critical care specialist in a hospital setting equipped with facilities for intubation, mechanical ventilation, and resuscitation. Patients should inform their doctor about all medications they are taking, especially antibiotics, anti-seizure drugs, and magnesium supplements, as these can interact and prolong paralysis. Anyone with a history of neuromuscular disorders, such as myasthenia gravis, must disclose this before receiving this medicine. It is essential to have a reversal agent available, and the doctor will monitor neuromuscular function using a nerve stimulator. This medicine should not be used during pregnancy unless clearly needed, and breastfeeding should be avoided for a short period after administration. Patients should not attempt to move or breathe on their own until the doctor confirms full recovery of muscle function.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may have a slightly prolonged duration of action due to age-related changes in organ function. Doses should be individualized based on neuromuscular monitoring. No specific dose adjustment is generally required, but caution is advised.
🤰 Pregnancy Planning (TTC)
If you are planning pregnancy, discuss with your doctor before receiving this medicine. It should be used during pregnancy only if clearly needed. There is no evidence to suggest it affects fertility.
🏥 Post-Surgery Considerations
After surgery, patients may experience residual muscle weakness. Monitoring in the recovery room is essential until full neuromuscular function returns. Pain management should be addressed separately, as this medicine does not provide pain relief.
🦷 Dental Procedures
This medicine is not used in dental procedures. If you have received this medicine recently, inform your dentist before any dental work, as you may still have some muscle weakness.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
After receiving this medicine, patients may experience muscle weakness for some time. Avoid strenuous exercise until fully recovered and cleared by your doctor. Physical therapy may be recommended to regain strength.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine is used in hospital settings, so it does not directly impact daily work life. However, after discharge, patients may need time to recover from the effects of surgery or critical illness. Driving and operating machinery should be avoided until fully recovered and cleared by a doctor.
🛑 When to Stop This Medicine
This medicine is stopped by the healthcare team when muscle relaxation is no longer needed or when the patient is ready to be weaned off the ventilator. Patients should not make decisions about stopping this medicine themselves.
📅 Long-Term Use Effects
Long-term use of this medicine in intensive care settings has been associated with critical illness polyneuropathy and myopathy, leading to prolonged muscle weakness. Monitoring of neuromuscular function and early mobilization are important. The medicine itself does not cause organ damage, but prolonged paralysis can have significant effects on recovery.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Rocuronium or vecuronium may be used as alternatives, but they have different durations and metabolisms.
Evidence: Well-establishedIn some cases, deep sedation alone may be sufficient, avoiding the need for neuromuscular blockade.
Evidence: Limited💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Not established from the available information. There are no known interactions between this medicine and vaccines. However, vaccination should be timed according to the patient's clinical condition and doctor's advice.
📦 Storage Guide
✅ DO
Store refrigerated at 2°C to 8°C
❌ DON'T
Do not freeze
✅ DO
Keep in original carton to protect from light
❌ DON'T
Do not use if solution is discolored or contains particles
✅ DO
Use within the specified time after removal from refrigeration
❌ DON'T
Do not store at room temperature for prolonged periods
✈️ Traveling with This Medicine
This medicine is administered only in hospital settings, so travel advice is not applicable for patients. Healthcare professionals transporting this medicine should keep it refrigerated at 2°C to 8°C, carry it in its original packaging with prescription documentation, and avoid freezing. For air travel, use a validated cold chain container and inform security about the medication.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine starts working within 2 to 3 minutes after intravenous administration.
A: The effect typically lasts 45 to 60 minutes after a standard dose, but this can vary based on dose and individual factors.
A: No, this medicine paralyses the breathing muscles, so you will need a ventilator until the effect wears off.
A: This medicine is generally safe for kidneys, but monitoring is advised in severe kidney disease.
🤔 Common Patient Concerns
🛑 Myths vs. Facts
- Myth: Cisatracurium is a painkiller.
Fact: This medicine is a muscle relaxant and has no pain-relieving properties. It is used only in controlled medical settings. - Myth: Cisatracurium can be taken at home.
Fact: This medicine must only be administered by healthcare professionals in a hospital setting with resuscitation equipment.
🔄 Alternative Options
Generic Alternatives
- Cisatracurium besylate injection
Brand Alternatives
- Cisatra injection