Atracurium besilate

Atracurium besilate
Clinical data
Trade names	Tracrium, Acurium
Other names	Atracurium besylate
AHFS/Drugs.com	Monograph
Pregnancy; category	C;
Routes of; administration	IV
ATC code	M03AC04 (WHO) ;
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	100% (IV)
Protein binding	82%
Metabolism	Hofmann elimination (retro-Michael addition) and ester hydrolysis by nonspecific esterases
Elimination half-life	17–21 minutes
Identifiers
	IUPAC name 2,2'-{1,5-Pentanediylbis[oxy(3-oxo-3,1-propanediyl)]}bis[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-1,2,3,4-tetrahydroisoquinolinium] dibenzenesulfonate;
CAS Number	64228-81-5 ;
PubChem CID	47320;
DrugBank	DB00732 ;
ChemSpider	43068 ;
UNII	40AX66P76P;
ChEBI	CHEBI:2915 ;
ChEMBL	ChEMBL1200527 ;
CompTox Dashboard (EPA)	DTXSID6022630 ;
ECHA InfoCard	100.058.840
Chemical and physical data
Formula	C65H82N2O18S2
Molar mass	1243.49 g·mol−1
3D model (JSmol)	Interactive image;
Melting point	85 to 90 °C (185 to 194 °F)
	SMILES C[N+]1(CCc2cc(c(cc2C1Cc3ccc(c(c3)OC)OC)OC)OC)CCC(=O)OCCCCCOC(=O)CC[N+]4(CCc5cc(c(cc5C4Cc6ccc(c(c6)OC)OC)OC)OC)C.c1ccc(cc1)S(=O)(=O)[O-].c1ccc(cc1)S(=O)(=O)[O-];
	InChI InChI=1S/C53H72N2O12.2C6H6O3S/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;27-10(8,9)6-4-2-1-3-5-6/h14-17,30-35,42-43H,11-13,18-29H2,1-10H3;21-5H,(H,7,8,9)/q+2;;/p-2 ; Key:XXZSQOVSEBAPGS-UHFFFAOYSA-L ;
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Atracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.

Common side effects include flushing of the skin and low blood pressure. Serious side effects may include allergic reactions; however, it has not been associated with malignant hyperthermia. Prolonged paralysis may occur in people with conditions like myasthenia gravis. It is unclear if use in pregnancy is safe for the baby. Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.

Atracurium was approved for medical use in the United States in 1983. It is on the World Health Organization's List of Essential Medicines. Atracurium is available as a generic medication.

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