Atracurium Besylate Injection USP 25mg/2.5ml Taj Pharma

NAME OF THE MEDICINAL PRODUCT

Atracurium Besylate Injection USP 100mg/10ml Taj Pharma
Atracurium Besylate Injection USP 50mg/5ml Taj Pharma
Atracurium Besylate Injection USP 25mg/2.5ml Taj Pharma

QUALITATIVE AND QUANTITATIVE COMPOSITION
a) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg
b) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg
c) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg

For a full list of excipients, see section 6.1.

PHARMACEUTICAL FORM

Injection

CLINICAL PARTICULARS

4.1 Therapeutic indications

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is a highly selective, competitive or non-depolarising neuromuscular blocking agent. It is used as an adjunct to general anaesthesia or sedation in the intensive care unit (ICU), to relax skeletal muscles, and to facilitate tracheal intubation and mechanical ventilation.

4.2 Posology and method of administration

Route of administration: Intravenous injection or continuous infusion.

Used by injection in adults: Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is administered by intravenous injection.

The dosage range recommended for adults is 0.3 to 0.6 mg/kg (depending on the duration of full block required) and will provide adequate relaxation for about 15 to 35 minutes.

Endotracheal intubation can usually be accomplished within 90 seconds from the intravenous injection of 0.5 to 0.6 mg/kg.

Full block can be prolonged with supplementary doses of 0.1 to 0.2 mg/kg as required. Successive supplementary dosing does not give rise to accumulation of neuromuscular blocking effect.

Spontaneous recovery from the end of full block occurs in about 35 minutes as measured by the restoration of the tetanic response to 95% of normal neuromuscular function.

The neuromuscular block produced by Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can be rapidly reversed by standard doses of anticholinesterase agents, such as neostigmine and edrophonium, accompanied or preceded by atropine, with no evidence of recurarisation.

Use as an infusion in adults: After an initial bolus dose of 0.3 to 0.6 mg/kg, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can be used to maintain neuromuscular block during long surgical procedures by administration as a continuous infusion at rates of 0.3 to 0.6mg/kg/hour.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can be administered by infusion during cardiopulmonary bypass surgery at the recommended infusion rates. Induced hypothermia to a body temperature of 25° to 26°C reduces the rate of inactivation of atracurium, therefore full neuromuscular block may be maintained by approximately half the original infusion rate at these low temperatures.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is compatible with the following infusion solutions for the times stated below:

Infusion solution	Period of stability
Sodium Chloride Intravenous Infusion British Pharmacopoeia (BP) (0.9% w/v)	24 hours
Glucose Intravenous Infusion BP (5% w/v)	8 hours
Ringer’s Injection United States Pharmacopoeia (USP)	8 hours
Sodium Chloride (0.18%w/v) and Glucose (4% w/v) Intravenous Infusion BP	8 hours
Compound Sodium Lactate Intravenous Infusion BP (Hartmann’s Solution for Injection)	4 hours

When diluted in these solutions to give atracurium besilate concentrations of 0.5 mg/ml and above, the resultant solutions will be stable in daylight for the stated periods at temperatures of up to 30°C.

Use in Children: The dosage in children over the age of one month is similar to that in adults on a bodyweight basis.

Use in Neonates: The use of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is not recommended in neonates since there are insufficient data available (see section 5.1).

Use in the elderly: Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma may be used at standard dosage in elderly patients. It is recommended, however, that the initial dose be at the lower end of the range and that it be administered slowly.

Use in patients with reduced renal and/or hepatic function: Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma may be used at standard dosage at all levels of renal or hepatic function, including end stage failure.

Use in patients with cardiovascular disease: In patients with clinically significant cardiovascular disease, the initial dose of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma should be administered over a period of 60 seconds.

Use in intensive care unit (ICU) patients: After an optional initial bolus dose of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma of 0.3 to 0.6 mg/kg, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can be used to maintain neuromuscular block by administering a continuous infusion at rates of between 11 and 13 micrograms/kg/min (0.65 to 0.78 mg/kg/hr). There may be wide inter-patient variability in dosage requirements and these may increase or decrease with time. Infusion rates as low as 4.5 microgram/kg/min (0.27 mg/kg/hr) or as high as 29.5 microgram/kg/min (1.77 mg/kg/hr) are required in some patients.

The rate of spontaneous recovery from neuromuscular block after infusion of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma in ICU patients is independent of the duration of administration.

Spontaneous recovery to a train-of-four ratio >0.75 (the ratio of the height of the fourth to the first twitch in a train-of-four) can be expected to occur in approximately 60 minutes. A range of 32 to 108 minutes has been observed in clinical trials.

Monitoring: In common with all neuromuscular blocking agents, monitoring of neuromuscular function is recommended during the use of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma in order to individualise dosage requirements.

4.3 Contraindications

Atracurium is contraindicated in patients known to be hypersensitive to atracurium, cisatracurium or benzenesulfonic acid.

4.4 Special warnings and precautions for use

Precautions: In common with all the other neuromuscular blocking agents, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma paralyses the respiratory muscles as well as other skeletal muscles but has no effect on consciousness. Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma should be administered only with adequate general anaesthesia and only by or under the close supervision of an experienced anaesthetist with adequate facilities for endotracheal intubation and artificial ventilation.

The potential for histamine release exists in susceptible patients during Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma administration. Caution should be exercised in administering Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma to patients with a history suggestive of an increased sensitivity to the effects of histamine. In particular, bronchospasm may occur in patients with a history of allergy and asthma.

High rates of cross-sensitivity between neuromuscular blocking agents have been reported. Therefore, where possible, before administering atracurium, hypersensitivity to other neuromuscular blocking agents should be excluded. Atracurium should only be used when absolutely essential in susceptible patients. Patients who experience a hypersensitivity reaction under general anaesthesia should be tested subsequently for hypersensitivity to other neuromuscular blockers.

Monitoring of serial creatinine phosphate (cpk) values should be considered in asthmatic patients receiving high dose corticosteroids and neuromuscular blocking agents in ICU.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma does not have significant vagal or ganglionic blocking properties in the recommended dosage range. Consequently, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma has no clinically significant effects on heart rate in the recommended dosage range and it will not counteract the bradycardia produced by many anaesthetic agents or by vagal stimulation during surgery.

In common with other non-depolarising neuromuscular blocking agents, increased sensitivity to atracurium may be expected in patients with myasthenia gravis and other forms of neuromuscular disease.

As with other neuromuscular blocking agents severe acid-base and/or serum electrolyte abnormalities may increase or decrease the sensitivity of patients to aAtracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma .

As with other non-depolarising neuromuscular blockers hypophosphataemia may prolong recovery. Recovery may be hastened by correcting this condition.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma should be administered over a period of 60 seconds to patients who may be unusually sensitive to falls in arterial blood pressure, for example those who are hypovolaemic.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is inactivated by high pH and so must not be mixed in the same syringe with thiopental or any alkaline agent.

When a small vein is selected as the injection site, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma should be flushed through the vein with physiological saline after injection. When other anaesthetic drugs are administered through the same in-dwelling needle or cannula as Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma it is important that each drug is flushed through with an adequate volume of physiological saline. Atracurium besilate is hypotonic and must not be administered into the infusion line of a blood transfusion.

Studies in malignant hyperthermia in susceptible animals (swine), and clinical studies in patients susceptible to malignant hypothermia indicate that Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma does not trigger this syndrome.

In common with other non-depolarising neuromuscular blocking agents, resistance may develop in patients suffering from burns. Such patients may require increased doses, dependent on the time elapsed since the burn injury and the extent of the burn.

Intensive Care Unit (ICU) patients: When administered to laboratory animals in high doses, Laudanosine, a metabolite of aAtracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma has been associated with transient hypotension and, in some species, cerebral excitatory effects. Although seizures have been seen in ICU patients receiving atracurium, a causal relationship to laudanosine has not been established (see Undesirable Effects).

4.5 Interaction with other medicinal products and other forms of interaction

The neuromuscular block produced by Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma may be increased by the concomitant use of inhalational anaesthetics such as halothane, isoflurane and enflurane.

In common with all non-depolarising neuromuscular blocking agents the magnitude and/or duration of a non-depolarising neuromuscular block may be increased as a result of interaction with:

– antibiotics, including the aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin and clindamycin

– anti-arrhythmic drugs: propranolol, calcium channel blockers, lidocaine, procainamide and quinidine

– diuretics: furosemide and possibly mannitol, thiazide diuretics and acetazolamide

– magnesium sulfate

– ketamine

– lithium salts

– ganglion blocking agents, trimetaphan, hexamethonium.

Rarely certain drugs may aggravate or unmask latent myasthenia gravis or actually induce a myasthenic syndrome; increased sensitivity to Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma would be consequent on such a development. Such drugs include various antibiotics, β-blockers (propranolol, oxprenolol), antiarrhythmic drugs (procainamide, quinidine), antirheumatic drugs (chloroquine, D-penicillamine), trimetaphan, chlorpromazine, steroids, phenytoin and lithium.

The onset of non-depolarising neuromuscular block is likely to be lengthened and the duration of block shortened in patients receiving chronic anticonvulsant therapy.

The administration of combinations of non-depolarising neuromuscular blocking agents in conjunction with Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma may produce a degree of neuromuscular blockage in excess of that which might be expected were an equipotent total dose of Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma administered. Any synergistic effect may vary between different drug combinations.

A depolarising muscle relaxant such as suxamethonium chloride should not be administered to prolong the neuromuscular blocking effects of non-depolarising blocking agents such as atracurium, as this may result in a prolonged and complex block which can be difficult to reverse with anticholinesterase drugs.

Treatment with anticholinesterases, commonly used in the treatment of Alzheimer’s disease e.g. donepezil, may shorten the duration and diminish the magnitude of neuromuscular blockade with atracurium.

4.6 Fertility, pregnancy and lactation

Fertility

Fertility studies have not been performed

Pregnancy

Animal studies have indicated that Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma has no significant effects on foetal development.

In common with all neuromuscular blocking agents, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma should be used during pregnancy only if the potential benefit to the mother outweighs any potential risk to the foetus.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is suitable for maintenance of muscle relaxation during Caesarean section as it does not cross the placenta in clinically significant amounts following recommended doses.

Breast-feeding

It is not known whether Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is excreted in human milk.

4.7 Effects on ability to drive and use machines

This precaution is not relevant to the use of atracurium. Atracurium will always be used in combination with a general anaesthetic and therefore the usual precautions relating to performance of tasks following general anaesthesia apply.

4.8 Undesirable effects

The most commonly reported adverse reactions during treatment are hypotension (mild, transient) and skin flushing, these events are attributed to histamine release. Very rarely, severe anaphylactoid or anaphylactic reactions have been reported in patients receiving atracurium in conjunction with one or more anaesthetic agents.

Adverse reactions are listed below by system organ class and frequency. Frequencies are defined as: very common > 1/10, common >1/100 and < 1/10, uncommon >1/1000 and < 1/100, rare >1/10,000 and < 1/1000, very rare < 1/10,000.

Very common, common and uncommon frequencies were determined from clinical trial data. Rare and very rare frequencies were generally derived from spontaneous data. The frequency classification “Not known” has been applied to those reactions where a frequency could not be estimated from the available data.

Clinical Trial Data

Vascular Disorders
Common	Hypotension (mild, transient)#, Skin flushing#
Respiratory, thoracic and mediastinal disorders
Uncommon	Bronchospasm#

Post-Marketing Data

Immune system disorders
Very rare	Anaphylactic reaction, anaphylactoid reaction including shock, circulatory failure and cardiac arrest
Very rarely, severe anaphylactoid or anaphylactic reactions have been reported in patients receiving atracurium in conjunction with one or more anaesthetic agents.
Nervous system disorder
Not known	Seizures
There have been reports of seizures in ICU patients who have been receiving atracurium concurrently with several other agents. These patients usually had one or more medical conditions predisposing to seizures (e.g. cranial trauma, cerebral oedema, viral encephalitis, hypoxic encephalopathy, uraemia). A causal relationship to laudanosine has not been established. In clinical trials, there appears to be no correlation between plasma laudanosine concentration and the occurrence of seizures.
Skin and subcutaneous tissue disorders
Rare	Urticaria
Musculoskeletal and connective tissue disorders
Not known	Myopathy, muscle weakness
There have been some reports of muscle weakness and/or myopathy following prolonged use of muscle relaxants in severely ill patients in the ICU. Most patients were receiving concomitant corticosteroids. These events have been seen infrequently in association with atracurium and a causal relationship has not been established.

Events which have been attributed to histamine release are indicated by a hash (#)

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important.

4.9 Overdose

Symptoms: Prolonged muscle paralysis and its consequences are the main signs of overdosage.

Management: It is essential to maintain a patient airway together with assisted positive pressure ventilation until spontaneous respiration is adequate. Full sedation will be required since consciousness is not impaired. Recovery may be hastened by the administration of anticholinesterase agents accompanied by atropine or glycopyrrolate, once evidence of spontaneous recovery is present.

PHARMACOLOGICAL PROPERTIES

5.1 Pharmacodynamic properties

Pharmacotherapeutic group: Peripherally acting muscle relaxants: Other quaternary ammonium compounds.

Atracurium is a highly selective competitive (non-depolarising) neuromuscular blocking agent with an intermediate duration of action. Non-depolarising agents antagonise the neurotransmitter action of acetylcholine by binding with receptor sites on the motor-end-plate. Atracurium can be used in a wide range of surgical procedures and to facilitate controlled ventilation.

Paediatric population:

The limited data in neonates from literature reports suggest variability in the time to onset and duration of action of atracurium in this population as compared to children (see section 4.2).

5.2 Pharmacokinetic properties

The pharmacokinetics of Atracurium in man are essentially linear with the 0.3-0.6 mg/kg dose range. The elimination half-life is approximately 20 minutes, and the volume of distribution is 0.16 L/kg. Atracurium is 82% bound to plasma proteins.

Atracurium is degraded spontaneously mainly by a non-enzymatic decomposition process (Hofmann elimination) which occurs at plasma pH and at body temperature and produces breakdown products which are inactive. Degradation also occurs by ester hydrolysis catalysed by non-specific esterases. Elimination of atracurium is not dependent on kidney or liver function.

The main breakdown products are laudanosine and a monoquaternary alcohol which have no neuromuscular blocking activity. The monoquaternary alcohol is degraded spontaneously by hofmann elimination and excreted by the kidney. Laudanosine is excreted by the kidney and metabolised by the liver. The half-life of laudanosine ranges from 3-6h in patients with normal kidney and liver function. It is about 15h in renal failure and is about 40h in renal and hepatic failure. Peak plasma levels of laudanosine are highest in patients without kidney or liver function and average 4 μg/ml with wide variation.

Concentration of metabolites are higher in ICU patients with abnormal renal and/or hepatic function (see Special Warnings and Special Precautions for Use). These metabolites do not contribute to neuromuscular block.

5.3 Preclinical safety data

Carcinogenicity: Carcinogenicity studies have not been performed.

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SmPC.

PHARMACEUTICAL PARTICULARS

6.1 List of excipients

Benzene Sulfonic acid, Water for Injections

6.2 Incompatibilities

None

6.3 Shelf life

24 months

6.4 Special precautions for storage

Store at temperatures between 2 and 8°C. Do not freeze. Keep container in the outer carton in order to protect from light.

Any unused Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma from opened ampoules or vials should be discarded.

6.5 Nature and contents of container

Neutral glass ampoules or vials. Vials are closed with a rubber stopper, sealed with an aluminium collar and fitted with a plastic flip-off top. Pack sizes: Boxes of 5 x 2.5 ml ampoules, 5 x 5 ml ampoules and 2 x 25 ml vials.

6.6 Special precautions for disposal and other handling

None

MANUFACTURED IN INDIA BY:

TAJ PHARMACEUTICALS LTD.
Mumbai, India
Unit No. 214.Old Bake House,
Maharashtra chambers of Commerce Lane,
Fort, Mumbai – 400001
at:Gujarat, INDIA.
Customer Service and Product Inquiries:
1-800-TRY-FIRST (1-800-222-434 & 1-800-222-825)
Monday through Saturday 9:00 a.m. to 7:00 p.m. EST
E-mail: tajgroup@tajpharma.com

PACKAGE LEAFLET: INFORMATION FOR THE PATIENT

ATRACURIUM BESYLATE INJECTION USP 100MG/10ML / 50MG/5ML / 25MG/2.5ML TAJ PHARMA

atracurium besilate

Read all of this leaflet carefully before you start having this medicine because it contains important information for you.

Keep this leaflet. You may need to read it again.
If you have any further questions ask your doctor, pharmacist or nurse.
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

WHAT IS IN THIS LEAFLET:

What Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is and what it is used for
What you need to know before you have Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma
How to have Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma
Possible side effects
How to store Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma
Contents of the pack and other information1. WHAT ATRACURIUM BESYLATE INJECTION USP 100MG/10ML / 50MG/5ML / 25MG/2.5ML TAJ PHARMA IS AND WHAT IT IS USED FOR

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma contains a medicine called atracurium besilate. This belongs to a group of medicines called muscle relaxants.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is used:

to relax muscles during operations on adults and children over 1 month of age
to help insert a tube into the windpipe (tracheal intubation), if a person needs help to breathe
To relax the muscles of adults in intensive care.

Ask your doctor if you would like more explanation about this medicine.

WHAT YOU NEED TO KNOW BEFORE YOU HAVE ATRACURIUM BESYLATE INJECTION USP 100MG/10ML / 50MG/5ML / 25MG/2.5ML TAJ PHARMA

Do not have Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma if:

you are allergic to atracurium besilate, any other muscle relaxant or any of the other ingredients in Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma (listed in section 6)
you have reacted badly to an anaesthetic before.

Do not have Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma if any of the above apply to you. If you are not sure, talk to your doctor, nurse or pharmacist before you have Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma .

Warnings and precautions

Talk to your doctor, pharmacist or nurse before having Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma if:

you have muscle weakness, tiredness or difficulty in co-ordinating your movements (myasthenia gravis)
you have a neuromuscular disease, such as a muscle wasting disease, paralysis, motor neurone disease or cerebral palsy
you have a severe electrolyte imbalance
you have a lower than normal volume of blood (hypovolaemia)
you have a burn which requires medical treatment
you have ever had an allergic reaction to any muscle relaxant which was given as part of an operation
you have a history of sensitivity to histamine. In particular, spasm of the airways may occur if you have a history of allergy or asthma.

If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before you are given Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma .

Other medicines and Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma

Tell your doctor, nurse or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because these medicines can affect how well Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma works or can cause side effects.

In particular tell your doctor, nurse or pharmacist if you are taking any of the following:

anaesthetics (used to reduce sensation and pain during surgical procedures)
antibiotics (used to treat infections)
medicines for heart conditions
medicines for high blood pressure
water tablets (diuretics), such as furosemide
medicines for fits (epilepsy), such as phenytoin or carbamazepine
medicines containing magnesium, such as those to treat indigestion and heart burn
drugs for Alzheimer’s disease (anticholinesterases e.g. donepezil)
medicines for mental illness, such as lithium
medicines for inflammation of the joints, such as chloroquine or D-penicillamine

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before having this medicine.

Driving and using machines

It can be dangerous to drive or operate machinery too soon after having had an operation. Your doctor will tell you how long to wait before you can drive and use machinery.

HOW TO HAVE ATRACURIUM BESYLATE INJECTION USP 100MG/10ML / 50MG/5ML / 25MG/2.5ML TAJ PHARMA

How your injection is given

You will never be expected to give yourself this medicine. It will always be given to you by a person who is qualified to do so.

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can be given:

as a single injection into your vein (intravenous bolus injection)
as a continuous infusion into your vein. This is where the drug is slowly given to you over a long period of time.

Your doctor will decide the way you are given the drug and the dose you will receive. It will depend on:

your body weight
the amount and duration of muscle relaxation required
your expected response to the medicine.

Children less than 1 month old should not have this medicine.

If you receive more Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Parma than you should

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma will always be given under carefully controlled conditions. However, if you think that you have been given more than you should tell your doctor or nurse immediately.

POSSIBLE SIDE EFFECTS

Like all medicines, Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma can cause side effects, although not everybody gets them. The following effects may happen with this medicine:

Allergic reactions

If you have an allergic reaction, tell your doctor or nurse straight away. The signs may include:

Common side effects (may affect up to 1 in 10 people)

decrease in blood pressure
reddening of your skin

Uncommon side effects (may affect up to 1 in 100 people)

wheezing or coughing

Rare side effects (may affect up to 1 in 1,000 people)

a lumpy skin rash or ‘hives’ anywhere on your body

Very Rare side effects (may affect up to 1 in 10,000 people)

sudden wheeziness, chest pain or chest tightness
swelling of your eyelids, face, lips, mouth or tongue
decrease in heart rate
shock, circulatory failure, cardiac arrest

Very rarely a severe allergic reaction can occur when given one or more anaesthetic agent.

Other side effects (unknown frequency) that you may experience are:

seizures
muscle disease (myopathy) or muscle weakness

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.

HOW TO STORE ATRACURIUM BESYLATE INJECTION USP 100MG/10ML / 50MG/5ML / 25MG/2.5ML TAJ PHARMA

Keep out of the sight and reach of children
Do not use Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma after the expiry date which is stated on the pack after EXP. The expiry date refers to the last day of that month
Store between 2 and 8°C. Do not freeze
Keep in the outer carton in order to protect from light
When Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma is made up it should be used straight away. Any unused solution should be thrown away

CONTENTS OF THE PACK AND OTHER INFORMATION

What Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma contains

a) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg

b) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg

c) Each ml of Injection contains:
Atracurium Besylate equivalent to
Atracurium USP………………………..10mg

The other ingredients are benzene sulfonic acid and Water for Injections.

What Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma looks like and contents of the pack

Atracurium Besylate Injection USP 100mg/10ml / 50mg/5ml / 25mg/2.5ml Taj Pharma injection comes in boxes of 5 by 2.5 ml and 5 ml glass ampoules or 2 by 25 ml glass vials.

Each vial/ampoule contains 10 mg/ml of the active ingredient atracurium besilate.