Tramus 2.5ml injection

18 TO 65 YEARS OLD
Use in Adults:
Administered by intravenous injection
The recommended dose: 0.3-0.6 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 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.

Administered by intravenous infusion
After an initial bolus dose of 0.3-0.6 mg/kg, atracurium can be used to maintain neuromuscular block during long surgical procedures by administration as a continuous infusion at rates of 0.3 to 0.6 mg/kg/hour.

Atracurium can be administered by infusion during cardiopulmonary bypass surgery at the recommended infusion rates. Induced hypothermia to a body temperature of 25°C 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.

0 TO 18 YEARS OLD
The dosage in children over the age of one month is similar to that in Adults on a bodyweight basis.

65 YEARS OLD AND ABOVE
Atracurium may be used at standard dosage.
It is recommended, however, that the initial dose be at the lower end of the range and that it be administered slowly

PATIENTS WITH REDUCED RENAL FUNCTION
Atracurium may be used at standard dosage at all levels of renal function, including end stage failure.

PATIENTS WITH REDUCED HEPATIC FUNCTION
Atracurium may be used at standard dosage at all levels of hepatic function, including end stage failure.

PATIENTS WITH CARDIOVASCULAR DISEASE
In patients with clinically significant cardiovascular disease, the initial dose of atracurium should be administered over a period of 60 seconds.

PATIENTS IN INTENSIVE CARE
After an optional initial bolus dose of atracurium of 0.3 to 0.6 mg/kg, atracurium can be used to maintain neuromuscular block by administering a continuous infusion at rates of between 11 and 13 microgram/kg/min (0.65 to 0.78 mg/kg/hr). There may be wide interpatient 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 in ICU patients is independent of the duration of administration.

As an adjunct to general anesthesia to enable tracheal intubation to be performed and to relax skeletal muscles during surgery or controlled ventilation, and to facilitate mechanical ventilation in Intensive Care Unit (ICU) patients.