Mivacurium - DrugBank

ID Pharmacology Interactions References Trials Economics Properties Spectra Taxonomy

Targets (4)

Targets (4)Biointeractions (4)

Identification

Name

Mivacurium

Accession Number

DB01226 (APRD01119)

Type

Small Molecule

Groups

Approved

Description

Mivacurium is a bisbenzylisoquinolinium based neuromuscular blocker or muscle relaxant. It binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in a block of neuromuscular transmission.

Structure

MOL SDF PDB SMILES InChI

Synonyms

Mivacurium

External IDs

Not Available

Product Ingredients

Ingredient	UNII	CAS	InChI Key	Details
Mivacurium chloride	600ZG213C3	106861-44-3	WMSYWJSZGVOIJW-ONUALHDOSA-L	Details

Approved Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Mivacron	Solution	2 mg/mL	Intravenous	Abbvie	2015-01-30	2017-04-21	US
Mivacron	Liquid	2 mg	Intravenous	Abbvie	1994-12-31	2012-11-03	Canada

Approved Generic Prescription Products

Not Available

Approved Over the Counter Products

Not Available

Unapproved/Other Products

Not Available

International Brands

Not Available

Brand mixtures

Not Available

Categories

UNII

77D66S9Q93

CAS number

133814-19-4

Weight

Average: 1029.2608
Monoisotopic: 1028.560955278

Chemical Formula

C₅₈H₈₀N₂O₁₄

InChI Key

ILVYCEVXHALBSC-OTBYEXOQSA-N

InChI

InChI=1S/C58H80N2O14/c1-59(25-21-41-35-47(63-3)49(65-5)37-43(41)45(59)29-39-31-51(67-7)57(71-11)52(32-39)68-8)23-17-27-73-55(61)19-15-13-14-16-20-56(62)74-28-18-24-60(2)26-22-42-36-48(64-4)50(66-6)38-44(42)46(60)30-40-33-53(69-9)58(72-12)54(34-40)70-10/h13-14,31-38,45-46H,15-30H2,1-12H3/q+2/b14-13+/t45-,46-,59?,60?/m1/s1

IUPAC Name

(1R)-2-(3-{[(4E)-8-{3-[(1R)-6,7-dimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-1,2,3,4-tetrahydroisoquinolin-2-ium-2-yl]propoxy}-8-oxooct-4-enoyl]oxy}propyl)-6,7-dimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-1,2,3,4-tetrahydroisoquinolin-2-ium

SMILES

COC1=CC(C[C@@H]2C3=CC(OC)=C(OC)C=C3CC[N+]2(C)CCCOC(=O)CC\C=C\CCC(=O)OCCC[N+]2(C)CCC3=CC(OC)=C(OC)C=C3[[email protected]]2CC2=CC(OC)=C(OC)C(OC)=C2)=CC(OC)=C1OC

Pharmacology

Indication

For inpatients and outpatients, as an adjunct to general anesthesia, to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Structured Indications

Not Available

Pharmacodynamics

Mivacurium is a short-acting, nondepolarizing skeletal neuromuscular blocking agent which is hydrolyzed by plasma cholinesterase. Mivacurium results in a blockade of neuromuscular transmission by binding competitively with cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine. The neuromuscular block produced by mivacurium is readily antagonized by anticholinesterase agents. The deeper the level of neuromuscular block at reversal, the longer the time required for recovery of neuromuscular function and the greater the dose of anticholinesterase agent required. Because spontaneous recovery after mivacurium is rapid, routine reversal may not always result in a clinical benefit.

Mechanism of action

Mivacurium binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in a block of neuromuscular transmission. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine.

Target	Kind	Pharmacological action	Actions	Organism	UniProt ID
Neuronal acetylcholine receptor subunit alpha-2	Protein	yes	antagonist	Human	Q15822	details
Muscarinic acetylcholine receptor M2	Protein	no	antagonist partial agonist	Human	P08172	details
Muscarinic acetylcholine receptor M3	Protein	no	antagonist	Human	P20309	details
Cholinesterase	Protein	unknown	Not Available	Human	P06276	details

Absorption

Not Available

Volume of distribution

Not Available

Protein binding

The protein binding of mivacurium has not been determined due to its rapid hydrolysis by plasma cholinesterase.

Metabolism

Extensive and rapid via enzymatic hydrolysis catalyzed by plasma cholinesterase. Biotransformation may be significantly slowed in patients with abnormal or decreased plasma cholinesterase activity, especially individuals with a homozygous atypical cholinesterase gene abnormality.

Route of elimination

Not Available

Half life

The mean elimination half-life ranges from 1.7 to 2.6 minutes in healthy, young adults administered 0.1 to 0.25 mg/kg mivacurium. In 9 patients with end-stage liver disease undergoing liver transplant surgery, plasma clearance was approximately 50% lower than that in 8 control patients with normal hepatic function, while the elimination half-life increased to 4.4 minutes from the 1.8 minute control value.

Clearance

Not Available

Toxicity

Overdosage with neuromuscular blocking agents may result in neuromuscular block beyond the time needed for surgery and anesthesia.

Affected organisms

Humans and other mammals

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

Drug	Interaction	Drug group
1,10-Phenanthroline	1,10-Phenanthroline may decrease the neuromuscular blocking activities of Mivacurium.	Experimental
16-Bromoepiandrosterone	Mivacurium may increase the adverse neuromuscular activities of 16-Bromoepiandrosterone.	Investigational
19-norandrostenedione	Mivacurium may increase the adverse neuromuscular activities of 19-norandrostenedione.	Experimental, Illicit
5-androstenedione	Mivacurium may increase the adverse neuromuscular activities of 5-androstenedione.	Experimental, Illicit
Acetyldigitoxin	Mivacurium may increase the arrhythmogenic activities of Acetyldigitoxin.	Approved
Aclarubicin	Aclarubicin may increase the respiratory depressant activities of Mivacurium.	Investigational
Alclometasone	Mivacurium may increase the adverse neuromuscular activities of Alclometasone.	Approved
Aldosterone	Mivacurium may increase the adverse neuromuscular activities of Aldosterone.	Experimental
Ambenonium	Ambenonium may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Amcinonide	Mivacurium may increase the adverse neuromuscular activities of Amcinonide.	Approved
Amikacin	Amikacin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
Amlodipine	Amlodipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Amrinone	Amrinone may increase the neuromuscular blocking activities of Mivacurium.	Approved
Amrubicin	Amrubicin may increase the respiratory depressant activities of Mivacurium.	Approved, Investigational
Androstenedione	Mivacurium may increase the adverse neuromuscular activities of 4-Androstenedione.	Experimental, Illicit
Anecortave	Mivacurium may increase the adverse neuromuscular activities of Anecortave.	Investigational
Apramycin	Apramycin may increase the respiratory depressant activities of Mivacurium.	Experimental, Vet Approved
Arbekacin	Arbekacin may increase the respiratory depressant activities of Mivacurium.	Approved
Azelnidipine	Azelnidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Azimilide	Azimilide may increase the neuromuscular blocking activities of Mivacurium.	Investigational
Barnidipine	Barnidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Beclomethasone dipropionate	Mivacurium may increase the adverse neuromuscular activities of Beclomethasone dipropionate.	Approved, Investigational
Benidipine	Benidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Bepridil	Bepridil may increase the neuromuscular blocking activities of Mivacurium.	Approved, Withdrawn
Betamethasone	Mivacurium may increase the adverse neuromuscular activities of Betamethasone.	Approved, Vet Approved
Botulinum Toxin Type A	Botulinum Toxin Type A may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Botulinum Toxin Type B	Mivacurium may increase the neuromuscular blocking activities of Botulinum Toxin Type B.	Approved
Budesonide	Mivacurium may increase the adverse neuromuscular activities of Budesonide.	Approved
Bumetanide	Bumetanide may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Capreomycin	Capreomycin may increase the neuromuscular blocking activities of Mivacurium.	Approved
Carboxyamidotriazole	Cai may increase the neuromuscular blocking activities of Mivacurium.	Investigational
Chlortetracycline	Chlortetracycline may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Ciclesonide	Mivacurium may increase the adverse neuromuscular activities of Ciclesonide.	Approved, Investigational
Cilnidipine	Cilnidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Cinnarizine	Cinnarizine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Clevidipine	Clevidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Clindamycin	Clindamycin may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Clobetasol	Mivacurium may increase the adverse neuromuscular activities of Clobetasol.	Investigational
Clobetasol propionate	Mivacurium may increase the adverse neuromuscular activities of Clobetasol propionate.	Approved
Clocortolone	Mivacurium may increase the adverse neuromuscular activities of Clocortolone.	Approved
Colistimethate	Colistimethate may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Cortisone acetate	Mivacurium may increase the adverse neuromuscular activities of Cortisone acetate.	Approved
Cyclosporine	Cyclosporine may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational, Vet Approved
Darodipine	Darodipine may increase the neuromuscular blocking activities of Mivacurium.	Experimental
Daunorubicin	Daunorubicin may increase the respiratory depressant activities of Mivacurium.	Approved
Decamethonium	Decamethonium may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Demecarium	Demecarium may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Demeclocycline	Demeclocycline may increase the neuromuscular blocking activities of Mivacurium.	Approved
Desflurane	Desflurane may increase the neuromuscular blocking activities of Mivacurium.	Approved
Deslanoside	Mivacurium may increase the arrhythmogenic activities of Deslanoside.	Approved
Desoximetasone	Mivacurium may increase the adverse neuromuscular activities of Desoximetasone.	Approved
Desoxycorticosterone Pivalate	Mivacurium may increase the adverse neuromuscular activities of Desoxycorticosterone Pivalate.	Experimental, Vet Approved
Dexamethasone	Mivacurium may increase the adverse neuromuscular activities of Dexamethasone.	Approved, Investigational, Vet Approved
Diflorasone	Mivacurium may increase the adverse neuromuscular activities of Diflorasone.	Approved
Difluocortolone	Mivacurium may increase the adverse neuromuscular activities of Difluocortolone.	Approved
Difluprednate	Mivacurium may increase the adverse neuromuscular activities of Difluprednate.	Approved
Digitoxin	Mivacurium may increase the arrhythmogenic activities of Digitoxin.	Approved
Digoxin	Mivacurium may increase the arrhythmogenic activities of Digoxin.	Approved
Diltiazem	Diltiazem may increase the neuromuscular blocking activities of Mivacurium.	Approved
Donepezil	Donepezil may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Doxorubicin	Doxorubicin may increase the respiratory depressant activities of Mivacurium.	Approved, Investigational
Doxycycline	Doxycycline may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational, Vet Approved
Echothiophate	Echothiophate may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Edrophonium	Edrophonium may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Efonidipine	Efonidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Enflurane	Enflurane may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Eperisone	Eperisone may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Epirubicin	Epirubicin may increase the respiratory depressant activities of Mivacurium.	Approved
Equilenin	Mivacurium may increase the adverse neuromuscular activities of Equilenin.	Experimental
Equilin	Mivacurium may increase the adverse neuromuscular activities of Equilin.	Approved
Estrone	Mivacurium may increase the adverse neuromuscular activities of Estrone.	Approved
Estrone sulfate	Mivacurium may increase the adverse neuromuscular activities of Estrone sulfate.	Approved
Etacrynic acid	Etacrynic acid may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Felodipine	Felodipine may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Fendiline	Fendiline may increase the neuromuscular blocking activities of Mivacurium.	Withdrawn
Fludrocortisone	Mivacurium may increase the adverse neuromuscular activities of Fludrocortisone.	Approved
Flumethasone	Mivacurium may increase the adverse neuromuscular activities of Flumethasone.	Approved, Vet Approved
Flunarizine	Flunarizine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Flunisolide	Mivacurium may increase the adverse neuromuscular activities of Flunisolide.	Approved, Investigational
Fluocinolone Acetonide	Mivacurium may increase the adverse neuromuscular activities of Fluocinolone Acetonide.	Approved, Investigational, Vet Approved
Fluocinonide	Mivacurium may increase the adverse neuromuscular activities of Fluocinonide.	Approved, Investigational
Fluocortolone	Mivacurium may increase the adverse neuromuscular activities of Fluocortolone.	Approved, Withdrawn
Fluorometholone	Mivacurium may increase the adverse neuromuscular activities of Fluorometholone.	Approved
Fluprednidene	Mivacurium may increase the adverse neuromuscular activities of Fluprednidene.	Approved, Withdrawn
Flurandrenolide	Mivacurium may increase the adverse neuromuscular activities of Flurandrenolide.	Approved
Fluticasone furoate	Mivacurium may increase the adverse neuromuscular activities of Fluticasone furoate.	Approved
Fluticasone propionate	Mivacurium may increase the adverse neuromuscular activities of Fluticasone Propionate.	Approved
Formestane	Mivacurium may increase the adverse neuromuscular activities of Formestane.	Approved, Investigational, Withdrawn
Fosphenytoin	Fosphenytoin may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Framycetin	Framycetin may increase the respiratory depressant activities of Mivacurium.	Approved
Furosemide	Furosemide may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Gabapentin	Gabapentin may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Galantamine	Galantamine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Gallamine Triethiodide	Gallamine Triethiodide may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Gallopamil	Gallopamil may increase the neuromuscular blocking activities of Mivacurium.	Investigational
Geneticin	Geneticin may increase the respiratory depressant activities of Mivacurium.	Experimental
Gentamicin	Gentamicin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
GENTAMICIN C1A	GENTAMICIN C1A may increase the respiratory depressant activities of Mivacurium.	Experimental
Ginkgo biloba	Ginkgo biloba may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Nutraceutical
Halothane	Halothane may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
HE3286	Mivacurium may increase the adverse neuromuscular activities of HE3286.	Investigational
Huperzine A	Huperzine A may decrease the neuromuscular blocking activities of Mivacurium.	Investigational
Hydrocortisone	Mivacurium may increase the adverse neuromuscular activities of Hydrocortisone.	Approved, Vet Approved
Idarubicin	Idarubicin may increase the respiratory depressant activities of Mivacurium.	Approved
Isoflurane	Isoflurane may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Isoflurophate	Isoflurophate may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Withdrawn
Isradipine	Isradipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Kanamycin	Kanamycin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
Ketorolac	The risk or severity of adverse effects can be increased when Ketorolac is combined with Mivacurium.	Approved
Lacidipine	Lacidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Lamotrigine	Lamotrigine may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Lercanidipine	Lercanidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Lithium	Lithium may increase the neuromuscular blocking activities of Mivacurium.	Approved
Magnesium Hydroxide	Magnesium hydroxide may increase the neuromuscular blocking activities of Mivacurium.	Approved
Magnesium oxide	Magnesium oxide may increase the neuromuscular blocking activities of Mivacurium.	Approved
Magnesium salicylate	Magnesium salicylate may increase the neuromuscular blocking activities of Mivacurium.	Approved
Magnesium Sulfate	Magnesium Sulfate may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Malathion	Malathion may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Manidipine	Manidipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
ME-609	Mivacurium may increase the adverse neuromuscular activities of ME-609.	Investigational
Medrysone	Mivacurium may increase the adverse neuromuscular activities of Medrysone.	Approved
Mefloquine	Mefloquine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Memantine	Memantine may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Methanesulfonyl Fluoride	Methanesulfonyl Fluoride may decrease the neuromuscular blocking activities of Mivacurium.	Investigational
Methoxyflurane	Methoxyflurane may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Methylprednisolone	Mivacurium may increase the adverse neuromuscular activities of Methylprednisolone.	Approved, Vet Approved
Metrizamide	Metrizamide may increase the respiratory depressant activities of Mivacurium.	Approved
Mibefradil	Mibefradil may increase the neuromuscular blocking activities of Mivacurium.	Withdrawn
Minaprine	Minaprine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Minocycline	Minocycline may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Mometasone	Mivacurium may increase the adverse neuromuscular activities of Mometasone.	Approved, Vet Approved
Naftopidil	Naftopidil may increase the neuromuscular blocking activities of Mivacurium.	Investigational
NCX 1022	Mivacurium may increase the adverse neuromuscular activities of NCX 1022.	Investigational
Neamine	Neamine may increase the respiratory depressant activities of Mivacurium.	Experimental
Neomycin	Neomycin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
Neostigmine	Neostigmine may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Netilmicin	Netilmicin may increase the respiratory depressant activities of Mivacurium.	Approved
Nicardipine	Nicardipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Nifedipine	Nifedipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Niguldipine	Niguldipine may increase the neuromuscular blocking activities of Mivacurium.	Experimental
Niludipine	Niludipine may increase the neuromuscular blocking activities of Mivacurium.	Experimental
Nilvadipine	Nilvadipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Nimesulide	Nimesulide may increase the neuromuscular blocking activities of Mivacurium.	Approved, Withdrawn
Nimodipine	Nimodipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Nisoldipine	Nisoldipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Nitrendipine	Nitrendipine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Nitrous oxide	Nitrous oxide may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Oleandrin	Mivacurium may increase the arrhythmogenic activities of Anvirzel.	Experimental
Oleoyl-estrone	Mivacurium may increase the adverse neuromuscular activities of Oleoyl estrone.	Investigational
Ouabain	Mivacurium may increase the arrhythmogenic activities of Ouabain.	Approved
Oxytetracycline	Oxytetracycline may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Paramethasone	Mivacurium may increase the adverse neuromuscular activities of Paramethasone.	Approved
Paromomycin	Paromomycin may increase the respiratory depressant activities of Mivacurium.	Approved, Investigational
Perhexiline	Perhexiline may increase the neuromuscular blocking activities of Mivacurium.	Approved
Phenytoin	Phenytoin may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Physostigmine	Physostigmine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Pinaverium	Pinaverium may increase the neuromuscular blocking activities of Mivacurium.	Approved
Pirarubicin	Pirarubicin may increase the respiratory depressant activities of Mivacurium.	Investigational
Piretanide	Piretanide may decrease the neuromuscular blocking activities of Mivacurium.	Experimental
Plicamycin	Plicamycin may increase the respiratory depressant activities of Mivacurium.	Approved, Withdrawn
Polymyxin B Sulfate	Polymyxin B Sulfate may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Prasterone	Mivacurium may increase the adverse neuromuscular activities of Prasterone.	Approved, Nutraceutical
Prasterone sulfate	Mivacurium may increase the adverse neuromuscular activities of dehydroepiandrosterone sulfate.	Investigational
Prednicarbate	Mivacurium may increase the adverse neuromuscular activities of Prednicarbate.	Approved
Prednisolone	Mivacurium may increase the adverse neuromuscular activities of Prednisolone.	Approved, Vet Approved
Prednisone	Mivacurium may increase the adverse neuromuscular activities of Prednisone.	Approved, Vet Approved
Pregabalin	Pregabalin may increase the neuromuscular blocking activities of Mivacurium.	Approved, Illicit, Investigational
Pregnenolone	Mivacurium may increase the adverse neuromuscular activities of Pregnenolone.	Experimental
Prenylamine	Prenylamine may increase the neuromuscular blocking activities of Mivacurium.	Withdrawn
Procainamide	Procainamide may increase the neuromuscular blocking activities of Mivacurium.	Approved
Puromycin	Puromycin may increase the respiratory depressant activities of Mivacurium.	Experimental
Pyridostigmine	Pyridostigmine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Quinidine	Quinidine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Quinine	Quinine may increase the neuromuscular blocking activities of Mivacurium.	Approved
Ribostamycin	Ribostamycin may increase the respiratory depressant activities of Mivacurium.	Approved
Rimexolone	Mivacurium may increase the adverse neuromuscular activities of Rimexolone.	Approved
Risedronate	Risedronate may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Rivastigmine	Rivastigmine may decrease the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Sevoflurane	Sevoflurane may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Sisomicin	Sisomicin may increase the respiratory depressant activities of Mivacurium.	Investigational
SP1049C	SP1049C may increase the respiratory depressant activities of Mivacurium.	Investigational
Spectinomycin	Spectinomycin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
Spironolactone	Spironolactone may increase the neuromuscular blocking activities of Mivacurium.	Approved
Streptomycin	Streptomycin may increase the respiratory depressant activities of Mivacurium.	Approved, Vet Approved
Streptozocin	Streptozocin may increase the respiratory depressant activities of Mivacurium.	Approved
Tacrine	Tacrine may decrease the neuromuscular blocking activities of Mivacurium.	Withdrawn
Tetracycline	Tetracycline may increase the neuromuscular blocking activities of Mivacurium.	Approved, Vet Approved
Tixocortol	Mivacurium may increase the adverse neuromuscular activities of Tixocortol.	Approved
Tobramycin	Tobramycin may increase the respiratory depressant activities of Mivacurium.	Approved, Investigational
Tolfenamic Acid	Tolfenamic Acid may increase the neuromuscular blocking activities of Mivacurium.	Approved
Torasemide	Torasemide may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Tranilast	Tranilast may increase the neuromuscular blocking activities of Mivacurium.	Approved, Investigational
Triamcinolone	Mivacurium may increase the adverse neuromuscular activities of Triamcinolone.	Approved, Vet Approved
Tubocurarine	Tubocurarine may decrease the neuromuscular blocking activities of Mivacurium.	Approved
Valrubicin	Valrubicin may increase the respiratory depressant activities of Mivacurium.	Approved
Vancomycin	Vancomycin may increase the neuromuscular blocking activities of Mivacurium.	Approved
Verapamil	Verapamil may increase the neuromuscular blocking activities of Mivacurium.	Approved
Vinpocetine	Vinpocetine may increase the neuromuscular blocking activities of Mivacurium.	Investigational
Xylometazoline	Xylometazoline may increase the neuromuscular blocking activities of Mivacurium.	Approved
Ziconotide	Ziconotide may increase the neuromuscular blocking activities of Mivacurium.	Approved
Zorubicin	Zorubicin may increase the respiratory depressant activities of Mivacurium.	Experimental

Food Interactions

Not Available

References

Synthesis Reference

Maurizio Francesco Velati, Andrea Busca, Cristina Manfrotto, Marco Nicolini, Claudio Gianluca Pozzoli, "Process for the preparation of mivacurium chloride." U.S. Patent US20070293534, issued December 20, 2007.

US20070293534

General References

Not Available

External Links

Resource	Link
Human Metabolome Database (HMDB)	HMDB15357
KEGG Compound	C07550
PubChem Compound	5281042
PubChem Substance	46505071
ChemSpider	4444509
ChEBI	6958
ChEMBL	CHEMBL1182833
Therapeutic Targets Database	DAP000716
PharmGKB	PA450528
Drug Product Database	11976
RxList	http://www.rxlist.com/cgi/generic3/mivacur.htm
Wikipedia	Mivacurium

ATC Codes

M03AC10 — Mivacurium chloride

AHFS Codes

12:20.00

PDB Entries

Not Available

FDA label

Download (1.5 MB)

MSDS

Download (25.3 KB)

Clinical Trials

Phase	Status	Purpose	Conditions	Count
1	Completed	Treatment	Muscle Relaxation / Sex	1
2	Recruiting	Treatment	Liver Dysfunction	1
4	Completed	Prevention	Prostate Hypertrophy / Renal Diseases	1
4	Completed	Treatment	Efficacy and Safety of Mivacurium Chloride for Pediatric Patients	1
4	Completed	Treatment	Intubations / Newborns / Preterms	1
Not Available	Completed	Treatment	Intubating Conditions / Performance With Respiratory Exercise Device / Postoperative Myalgia	1
Not Available	Enrolling by Invitation	Not Available	Neuromuscular Blockade	1

Pharmacoeconomics

Manufacturers

Not Available

Packagers

Not Available

Dosage forms

Form	Route	Strength
Liquid	Intravenous	2 mg
Solution	Intravenous	2 mg/mL

Prices

Not Available

Patents

Not Available

Properties

State

Liquid

Experimental Properties

Not Available

Predicted Properties

Property	Value	Source
Water Solubility	3.26e-05 mg/mL	ALOGPS
logP	3.8	ALOGPS
logP	-0.76	ChemAxon
logS	-7.5	ALOGPS
pKa (Strongest Acidic)	18.59	ChemAxon
pKa (Strongest Basic)	-4.1	ChemAxon
Physiological Charge	2	ChemAxon
Hydrogen Acceptor Count	12	ChemAxon
Hydrogen Donor Count	0	ChemAxon
Polar Surface Area	144.9 Å²	ChemAxon
Rotatable Bond Count	30	ChemAxon
Refractivity	308.74 m³·mol^-1	ChemAxon
Polarizability	116.68 Å³	ChemAxon
Number of Rings	6	ChemAxon
Bioavailability	0	ChemAxon
Rule of Five	No	ChemAxon
Ghose Filter	No	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	Yes	ChemAxon

Predicted ADMET features

Property	Value	Probability
Human Intestinal Absorption	-	0.9832
Blood Brain Barrier	+	0.9465
Caco-2 permeable	+	0.629
P-glycoprotein substrate	Substrate	0.8476
P-glycoprotein inhibitor I	Non-inhibitor	0.5119
P-glycoprotein inhibitor II	Inhibitor	0.7645
Renal organic cation transporter	Non-inhibitor	0.5515
CYP450 2C9 substrate	Non-substrate	0.8376
CYP450 2D6 substrate	Non-substrate	0.7529
CYP450 3A4 substrate	Substrate	0.6975
CYP450 1A2 substrate	Non-inhibitor	0.8986
CYP450 2C9 inhibitor	Non-inhibitor	0.9583
CYP450 2D6 inhibitor	Non-inhibitor	0.8914
CYP450 2C19 inhibitor	Non-inhibitor	0.9348
CYP450 3A4 inhibitor	Non-inhibitor	0.8426
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.919
Ames test	Non AMES toxic	0.7046
Carcinogenicity	Non-carcinogens	0.9137
Biodegradation	Not ready biodegradable	0.876
Rat acute toxicity	2.6607 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.8134
hERG inhibition (predictor II)	Non-inhibitor	0.6401

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )

Spectra

Mass Spec (NIST)

Not Available

Spectra

Not Available

Taxonomy

Description

This compound belongs to the class of chemical entities known as benzylisoquinolines. These are organic compounds containing an isoquinoline to which a benzyl group is attached.

Kingdom

Chemical entities

Super Class

Organic compounds

Class

Organoheterocyclic compounds

Sub Class

Isoquinolines and derivatives

Direct Parent

Benzylisoquinolines

Alternative Parents

Tetrahydroisoquinolines / Phenoxy compounds / Anisoles / Methoxybenzenes / Alkyl aryl ethers / Aralkylamines / Fatty acid esters / Dicarboxylic acids and derivatives / Tetraalkylammonium salts / Carboxylic acid esters

Substituents

Benzylisoquinoline / Tetrahydroisoquinoline / Phenoxy compound / Anisole / Phenol ether / Methoxybenzene / Alkyl aryl ether / Fatty acid ester / Aralkylamine / Monocyclic benzene moiety

Molecular Framework

Aromatic heteropolycyclic compounds

External Descriptors

isoquinolines (CHEBI:6958 )

Targets

Details

1. Neuronal acetylcholine receptor subunit alpha-2

Kind: Protein
Organism: Human
Pharmacological action: yes
Actions: antagonist

General Function:: Drug binding
Specific Function:: After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.
Gene Name:: CHRNA2
Uniprot ID:: Q15822
Uniprot Name:: Neuronal acetylcholine receptor subunit alpha-2
Molecular Weight:: 59764.82 Da

References

Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
Ihmsen H, Schmidt J, Schwilden H, Schmitt HJ, Muenster T: Influence of disease progression on the neuromuscular blocking effect of mivacurium in children and adolescents with Duchenne muscular dystrophy. Anesthesiology. 2009 May;110(5):1016-9. doi: 10.1097/ALN.0b013e31819daf31. [PubMed:19352159 ]
Jonsson Fagerlund M, Dabrowski M, Eriksson LI: Pharmacological characteristics of the inhibition of nondepolarizing neuromuscular blocking agents at human adult muscle nicotinic acetylcholine receptor. Anesthesiology. 2009 Jun;110(6):1244-52. doi: 10.1097/ALN.0b013e31819fade3. [PubMed:19417616 ]
Jonsson M, Gurley D, Dabrowski M, Larsson O, Johnson EC, Eriksson LI: Distinct pharmacologic properties of neuromuscular blocking agents on human neuronal nicotinic acetylcholine receptors: a possible explanation for the train-of-four fade. Anesthesiology. 2006 Sep;105(3):521-33. [PubMed:16931985 ]
Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]

Details

2. Muscarinic acetylcholine receptor M2

Kind: Protein
Organism: Human
Pharmacological action: no
Actions: antagonistpartial agonist

General Function:: G-protein coupled acetylcholine receptor activity
Specific Function:: The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Primary transducing effect is adenylate cyclase inhibition. Signaling promotes phospholipase C activity, leading to the release of inositol trisphosphate (IP3); this then trigge...
Gene Name:: CHRM2
Uniprot ID:: P08172
Uniprot Name:: Muscarinic acetylcholine receptor M2
Molecular Weight:: 51714.605 Da

References

Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]

Details

3. Muscarinic acetylcholine receptor M3

Kind: Protein
Organism: Human
Pharmacological action: no
Actions: antagonist

General Function:: Receptor activity
Specific Function:: The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Primary transducing effect is Pi turnover.
Gene Name:: CHRM3
Uniprot ID:: P20309
Uniprot Name:: Muscarinic acetylcholine receptor M3
Molecular Weight:: 66127.445 Da

References

Habre W, Adamicza A, Lele E, Novak T, Sly PD, Petak F: The involvement of histaminic and muscarinic receptors in the bronchoconstriction induced by myorelaxant administration in sensitized rabbits. Anesth Analg. 2008 Dec;107(6):1899-906. doi: 10.1213/ane.0b013e318186587c. [PubMed:19020136 ]

Details

4. Cholinesterase

Kind: Protein
Organism: Human
Pharmacological action: unknown

General Function:: Identical protein binding
Specific Function:: Esterase with broad substrate specificity. Contributes to the inactivation of the neurotransmitter acetylcholine. Can degrade neurotoxic organophosphate esters.
Gene Name:: BCHE
Uniprot ID:: P06276
Uniprot Name:: Cholinesterase
Molecular Weight:: 68417.575 Da

References

Kao YJ, Le ND: The reversal of profound mivacurium-induced neuromuscular blockade. Can J Anaesth. 1996 Nov;43(11):1128-33. [PubMed:8922768 ]

Drug created on June 13, 2005 07:24 / Updated on July 18, 2017 16:57

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Structure for DB01226 (Mivacurium)

Targets

References

References

References

References