Skip to main content

Prescription medicine

Cisatracurium First approved as Nimbex

Cisatracurium (Nimbex) is a prescription medicine with an FDA approval on record since 1995. FDA's NDC Directory lists it from 15 generic labelers.

  • Generic listed
  • A presentation discontinued

Check it at the source: the cisatracurium FDA label on DailyMed (effective April 4, 2025, Gland Pharma Limited); the NDA 20551 record on Drugs@FDA; every cisatracurium label on DailyMed.

Highlights of the record

FDA label of April 4, 2025; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026

Used for

From the label: indications and usage

Cisatracurium besylate injection is indicated:

as an adjunct to general anesthesia to facilitate tracheal intubation in adults and in pediatric patients 1 month to 12 years of age

to provide skeletal muscle relaxation in adults during surgical procedures or during mechanical ventilation in the ICU

to provide skeletal muscle relaxation during surgical procedures via infusion in pediatric patients 2 years and old

Forms and strengths

  • 2 mg/ml
  • 10 mg/ml
  • 10 mg/5ml
  • 20 mg/10ml
  • 200 mg/20ml

Injection; injection (solution).

On the market

Earliest approval on file
December 15, 1995 Nimbex Preservative Free, Abbvie; Drugs@FDA’s file, where older or withdrawn approvals can be missing
Generic approvals
27 first February 3, 2012; 19 with a marketed status in Drugs@FDA
Labelers listed (NDC)
15 of which 15 under generic applications, 0 under brand applications, repackagers included

Supply and safety

Pharmacy cost (NADAC)
Not in the survey
Shortage (FDA)
None current 3 past records
Recalls by its makers (FDA)
5 since 2016 1 Class I among all firms' recalls; latest November 26, 2025
FAERS reports
2,195 through July 30, 2026

What is cisatracurium used for?

From the label: indications and usage

Cisatracurium besylate injection is indicated:

as an adjunct to general anesthesia to facilitate tracheal intubation in adults and in pediatric patients 1 month to 12 years of age

to provide skeletal muscle relaxation in adults during surgical procedures or during mechanical ventilation in the ICU

to provide skeletal muscle relaxation during surgical procedures via infusion in pediatric patients 2 years and older Limitations of Use Cisatracurium besylate injection is not recommended for rapid sequence endotracheal intubation due to the time required for its onset of action. […]

FDA pharmacologic class: Nondepolarizing Neuromuscular Blocker.

Source: FDA drug label (Cisatracurium besylate), Gland Pharma Limited, effective April 4, 2025 (SPL set 0bacc37a-5e7f-4f05-9206-56fc8041c1ad), via openFDA; the full label on DailyMed

Is there a generic for cisatracurium (Nimbex)?

The FDA approved the first generic cisatracurium on February 3, 2012. 27 generic applications are approved; 19 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.

FDA's NDC Directory lists cisatracurium from 15 labelers under a generic (ANDA) application. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.

  • 1995 earliest approval on file
  • 2012 first generic approved
  • red ticks recalls

Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)

Is cisatracurium in shortage?

No cisatracurium presentation is listed as in shortage in the FDA Drug Shortage Database (read October 8, 2026); its 3 records are all marked to be discontinued, the latest updated September 11, 2026. ASHP keeps a separate shortage list, which can differ.

PresentationCompanyStatusUpdated
Cisatracurium Besylate, Injection, 10 mg/5ml (2 mg/mL) Single Dose Vial (NDC 0409-1098-02)Hospira, Inc., a Pfizer CompanyTo Be DiscontinuedSeptember 11, 2026
Cisatracurium Besylate, Injection, 20 mg/10 mL (2 mg/mL) Multidose Vial (NDC 0409-1208-01)Hospira, Inc., a Pfizer CompanyTo Be DiscontinuedMay 6, 2026
Cisatracurium Besylate, Injection, 200 mg/20ml (10 mg/mL) Single Dose Vial (NDC 0409-1103-01)Hospira, Inc., a Pfizer CompanyTo Be DiscontinuedMay 6, 2026

Every cisatracurium presentation in the FDA shortage database

Source: FDA Drug Shortage Database via openFDA, updated October 8, 2026

Has cisatracurium been recalled?

The FDA's Enforcement Report lists 5 recalls naming cisatracurium since 2016: 1 Class I (the most serious), 1 Class II, 3 Class III; 3 still ongoing. A recall names products and lots, not every product of the medicine.

StartedClassCompanyReason
November 26, 2025Class IIISOMERSET THERAPEUTICS LLCSubpotent product:out of specification assay results observed during long term stability testing.
January 27, 2021Class IMeitheal Pharmaceuticals IncLabeling: Label mix-up: Carton of Cisatracurium Besylate Injection, USP was observed to contain ten vials mislabeled as Phenylephrine Hydrochloride Injection …
April 5, 2016Class IIFresenius Kabi USA, LLCIncorrect/ Undeclared Excipient: Firm is recalling product due to an incorrect statement of Preservative free on the individual carton label. …

Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026

What does the cisatracurium label say about other medicines?

The cisatracurium label names 12 other medicines in its interaction, contraindication or warning sections. The labels of 4 other medicines name cisatracurium. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.

Medicine namedSectionWhat the label says
Bacitracindrug interactions… adjustments need to be made to the dose with subsequent administration. † Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate
Carbamazepinedrug interactionsUse peripheral nerve stimulator and monitor clinical signs of neuromuscular blockade. (5.8, 7.1) Phenytoin and Carbamazepine:
Clindamycindrug interactions… subsequent administration. † Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate
Colistimethatedrug interactions… Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate
Lincomycindrug interactions… the dose with subsequent administration. † Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate
Lithiumdrug interactionsDRUG INTERACTIONS Succinylcholine: May decrease time to onset of maximum neuromuscular blockade. (7.1) I nhalational anesthetics, antibiotics, local anesthetics, magnesium salts, procainamide, lithium, quinidine:
Nitrous oxidedrug interactionsInhalational Anesthetics Administration of inhalational anesthetics with nitrous oxide/oxygen for greater than 30 minutes to achieve
Phenytoindrug interactionsUse peripheral nerve stimulator and monitor clinical signs of neuromuscular blockade. (5.8, 7.1) Phenytoin and Carbamazepine:
Procainamidedrug interactionsDRUG INTERACTIONS Succinylcholine: May decrease time to onset of maximum neuromuscular blockade. (7.1) I nhalational anesthetics, antibiotics, local anesthetics, magnesium salts, procainamide, lithium, quinidine:
Propofoldrug interactionsIn clinical studies, propofol had no effect on the duration of action or dosing requirements for cisatracurium besylate injection.
Quinidinedrug interactionsDRUG INTERACTIONS Succinylcholine: May decrease time to onset of maximum neuromuscular blockade. (7.1) I nhalational anesthetics, antibiotics, local anesthetics, magnesium salts, procainamide, lithium, quinidine:
Succinylcholinedrug interactionsDRUG INTERACTIONS Succinylcholine: May decrease time to onset of maximum neuromuscular blockade. (7.1) I nhalational anesthetics, antibiotics, local anesthetics, magnesium salts, procainamide, lithium, quinidine:

Check cisatracurium against other medicines

Source: FDA drug label (Cisatracurium besylate), Gland Pharma Limited, effective April 4, 2025 (SPL set 0bacc37a-5e7f-4f05-9206-56fc8041c1ad), via openFDA; the full label on DailyMed

What do FAERS reports show for cisatracurium?

The FDA Adverse Event Reporting System holds 2,195 reports that list cisatracurium among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 369 are coded as a death and 901 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.

Reports received each year

The most reported reactions

  • Off Label Use (a use or a product term, not a reaction)161
  • Hypotension (named in the label)150
  • Anaphylactic Shock126
  • Drug Ineffective (a use or a product term, not a reaction)119
  • Anaphylactic Reaction (named in the label)117
  • Drug Interaction (a use or a product term, not a reaction)117
  • Anaesthetic Complication Neurological115
  • Rhabdomyolysis84

Side effects: the label's list and every FAERS reaction

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026

What next?

Other nondepolarizing neuromuscular blockers
the pharmacologic class, with prices and generics
Cisatracurium side effects
the label's list beside FAERS reports
Cisatracurium shortage record
every presentation, company and date
Check an interaction
what two or more labels say about each other