Mivacron - Mivacurium chloride

Mivacurium chloride (Mivacron) is a newer agent that is chemically related to atracurium. The primary mechanism of inactivation is hydrolysis by plasma cholinesterase. Although it is useful for patients with renal or hepatic disease, some caution is warranted, since these individuals may have reduced plasma cholinesterase as a result of the disease. Mivacurium has an onset of action (1.8 minutes) and duration of effect (20 minutes) only twice that of succinylcholine, and in this respect, it is the most similar to succinylcholine of all of the nondepolarizing agents. 

Short-acting ester-containing neuromuscular drugs, such as succinylcholine (Anec-tine, 2) (Fig. 15.3) and mivacurium chloride (Mivacron) (61) designed to undergo hydrolysis by human plasma cholinesterase, also exploit similar principles, to ensure fast and spontaneous recovery upon cessation of administration. Hence, their durations of action are only 6-8 and 12-18 min, respectively,and the corresponding elimination routes remain functional even in renal failure. 

I. Mivacurium chloride (Mivacron) 0.5 mg/mL and 2 mg/mL in 5- and 10-mL single-use vials. The suggested minimum stocking level to treat a 70-kg adult for the first 24 hours is four 10-mL vials or equivalent. 

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