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Nimbex (Cisatracurium Besylate)
Nimbex works by blocking the action of acetylcholine at the neuromuscular junction, preventing muscle contraction.
Cisatracurium Besylate (Nimbex), marketed by AbbVie, is a neuromuscular blocking agent primarily indicated for tracheal intubation in adults, competing in a market with several off-patent generics including pancuronium, gallamine, vecuronium, and atracurium. A key strength of Nimbex is its mechanism of action, which effectively blocks acetylcholine at the neuromuscular junction, providing reliable muscle relaxation for surgical procedures. The primary risk to Nimbex's market position is the expiration of its key composition patent in 2028, which could lead to increased competition from generics.
At a glance
| Generic name | Cisatracurium Besylate |
|---|---|
| Sponsor | AbbVie |
| Drug class | Nondepolarizing Neuromuscular Blocker |
| Target | Acetylcholine receptor |
| Modality | Small molecule |
| Therapeutic area | Neuroscience |
| Phase | FDA-approved |
| First approval | 1995 |
Mechanism of action
Cisatracurium besylate binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in blockade of neuromuscular transmission. This action is antagonized by acetylcholinesterase inhibitors such as neostigmine.
Approved indications
- Tracheal intubation in adults
- Tracheal intubation in pediatric patients
- Skeletal muscle relaxation during surgery in adults
- Skeletal muscle relaxation during surgery in pediatric patients
- Mechanical ventilation in the ICU in adults
Common side effects
- hypotension
- flushing
- bronchospasm
- rash
- bradycardia
- histamine release
- hypersensitivity reactions
- anaphylactic or anaphylactoid reactions
- wheezing
- laryngospasm
- itching
- prolonged neuromuscular block
Drug interactions
- kanamycin
- neomycin
- netilmicin
- streptomycin
- tobramycin
Key clinical trials
- Propofol Versus Sevoflurane Anesthesia on the Intraocular Pressure and Hemodynamics in Patient Undergoing Cyclophotocoagulation (NA)
- Safety and Efficacy of HRS-9190 Compared to Cisatracurium for Continuous Intravenous Infusion in Adults (PHASE2)
- Risk of Acute Complications With Rocuronium vs Cisatracurium in Patients With Chronic Kidney Disease (PHASE4)
- Continuous Versus 1-min Oscillometric Arterial BP Monitoring (NA)
- Tubeless Spontaneous Ventilation Anesthesia in Kidney Transplantation (NA)
- Partial Neuromuscular Blockade in Acute Hypoxemic Respiratory Failure (NA)
- Differences in Speed of Recovery From Anesthesia for Intraoral Surgery (NA)
- Comparison for the Effect of Neuromuscular Blocking Agents Versus Sedation Alone on Severe ARDS Patients Due to COVID-19 (NA)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| FDA label | Mechanism, indications, dosing, boxed warnings, drug interactions |
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
Competitive intelligence
For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:
- Nimbex CI brief — competitive landscape report
- Nimbex updates RSS · CI watch RSS
- AbbVie portfolio CI