Source: Medicines & Healthcare Products Regulatory Agency (GB) Revision Year: 2017 Publisher: Aspen Pharma Trading Limited, 3016 Lake Drive, City West Business Campus, Dublin 24, Ireland, Service-Tel: 0800 008 7392 (+44 1748 828 391)
Pharmacotherapeutic group: Peripherally acting muscle relaxants, other quaternary ammonium compounds
ATC code: M03AC10
Mivacurium is a short-acting, non-depolarising skeletal muscle relaxant which is hydrolysed by plasma cholinesterase. Mivacurium binds competitively with cholinergic receptors on the motor end-plate to prevent the action of acetylcholine, resulting in a blockade of neuromuscular transmission. This is rapidly reversed by the administration of the cholinesterase inhibitors, neostigmine and edrophonium.
Mivacurium chloride is a mixture of three stereoisomers, the trans-trans and cis-trans stereoisomers comprise 92% to 96% of mivacurium chloride and when studied in cats their neuromuscular blocking potencies are not significantly different from each other or from mivacurium chloride. The cis-cis isomer has been estimated from studies in cats to have one-tenth of the neuromuscular blocking potency of the other two stereoisomers. Enzymatic hydrolysis by plasma cholinesterase is the primary mechanism for inactivation of mivacurium and yields a quaternary alcohol and a quaternary monoester metabolite. Pharmacological studies in cats and dogs have shown that metabolites possess insignificant neuromuscular, autonomic or cardiovascular activity at concentrations higher than seen in man.
Mivacurium has been evaluated in four short term mutagenicity tests. Mivacurium was non-mutagenic in the Ames salmonella assay, the mouse lymphoma assay, the human lymphocyte assay and the in vivo rat bone marrow cytogenetic assay.
There is no information available on whether Mivacurium has carcinogenic potential.
Fertility studies have not been performed.
Animal studies have indicated that mivacurium has no adverse effect on foetal development.
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