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Atracurium Besylate Injection

Last reviewed on RxList: 3/20/2017
Atracurium Besylate Injection Side Effects Center

Last reviewed on RxList 5/12/2016

Atracurium Besylate Injection is a skeletal muscle relaxant used in addition to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Atracurium besylate injection is available in generic form. Common side effects of atracurium besylate injection include:

  • skin flushing or redness
  • injection site reactions
  • hives
  • itching
  • wheezing
  • shortness of breath
  • allergic reactions
  • inadequate musculoskeletal block
  • low blood pressure, and
  • fast or slow heart rate

An atracurium besylate dose of 0.4 to 0.5 mg/kg (1.7 to 2.2 times the ED95), given as an intravenous bolus injection, is the recommended initial dose for most patients. Atracurium besylate injection may interact with enflurane, isoflurane, halothane, antibiotics, lithium, magnesium salts, procainamide, quinidine, other muscle relaxants, and succinylcholine. Tell your doctor all medications and supplements you use. During pregnancy, atracurium besylate should be used only if prescribed It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Our Atracurium Besylate Injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Atracurium Besylate Injection Professional Information


Observed in Controlled Clinical Studies: Atracurium was well tolerated and produced few adverse reactions during extensive clinical trials. Most adverse reactions were suggestive of histamine release. In studies including 875 patients, atracurium was discontinued in only one patient (who required treatment for bronchial secretions) and six other patients required treatment for adverse reactions attributable to atracurium (wheezing in one, hypotension in five). Of the five patients who required treatment for hypotension, three had a history of significant cardiovascular disease. The overall incidence rate for clinically important adverse reactions, therefore, was 7/875 or 0.8%.

Table 1 includes all adverse reactions reported attributable to atracurium during clinical trials with 875 patients.

TABLE 1: PERCENT OF PATIENTS REPORTING ADVERSE REACTIONS Adverse Reaction Initial Atracurium Dose (mg/kg)

  0.00 - 0.30
(n = 485)
0.31 - 0.50*
(n = 366)
≥ 0.60
(n = 24)
(n = 875)
Skin Flush 1.0% 8.7% 29.2% 5.0%
Erythema 0.6% 0.5% 0% 0.6%
Itching 0.4% 0% 0% 0.2%
Wheezing/Bronchial Secretions 0.2% 0.3% 0% 0.2%
Hives 0.2% 0% 0% 0.1%
*Includes the recommended initial dosage range for most patients.

Most adverse reactions were of little clinical significance unless they were associated with significant hemodynamic changes. Table 2 summarizes the incidences of substantial vital sign changes noted during atracurium clinical trials with 530 patients, without cardiovascular disease, in whom these parameters were assessed.


Vital Sign Change Initial
0.00 - 0.30
(n = 365)
0.31 - 0.50*
(n = 144)
≥ 0.60
(n = 21)
(n = 530)
Mean Arterial Pressure
  Increase 1.9% 2.8% 0% 2.1%
  Decrease 1.1% 2.1% 14.3% 1.9%
Heart Rate
  Increase 1.6% 2.8% 4.8% 2.1%
  Decrease 0.8% 0% 0% 0.6%

*Includes the recommended initial dosage range for most patients.

Observed in Clinical Practice: Based on initial clinical practice experience in approximately 3 million patients who received atracurium in the U.S. and in the United Kingdom, spontaneously reported adverse reactions were uncommon (approximately 0.01% to 0.02%). The following adverse reactions are among the most frequently reported, but there are insufficient data to support an estimate of their incidence:

General: Allergic reactions (anaphylactic or anaphylactoid responses) which, in rare instances, were severe (e.g., cardiac arrest)

Musculoskeletal: Inadequate block, prolonged block

Cardiovascular: Hypotension, vasodilatation (flushing), tachycardia, bradycardia

Respiratory: Dyspnea, bronchospasm, laryngospasm

Integumentary: Rash, urticaria, reaction at injection site

There have been rare spontaneous reports of seizures in ICU patients following long-term infusion of atracurium to support mechanical ventilation. There are insufficient data to define the contribution, if any, of atracurium and/or its metabolite laudanosine. (See PRECAUTIONS: Long-Term Use in Intensive Care Unit [lCU]).

Read the entire FDA prescribing information for Atracurium Besylate Injection (Atracurium Besylate Injection)

Related Resources for Atracurium Besylate Injection

© Atracurium Besylate Injection Patient Information is supplied by Cerner Multum, Inc. and Atracurium Besylate Injection Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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