Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Mivacurium

Generic name
Mivacurium
Brand name
ATC Code
M03AC10

Pharmacokinetics in children

No information

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

No information is present at this moment.

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Dosages

Neuromuscular blockade during endotracheal intubation
  • Intravenous
    • 2 months up to 7 months
      • 0.15 mg/kg/dose single IV push.
    • 12 years up to 18 years
      • 0.2 mg/kg/dose single IV push.
        • Alternative: 0.25 mg/kg in 2 divided doses: 0.15 mg/kg, followed after 30 seconds by 0.1 mg/kg
        .
    • 2 months up to 7 months
      [2]
      • 0.15 mg/kg/dose single IV push.
    • 7 months up to 12 years
      • 0.2 mg/kg/dose single IV push.
    • 12 years up to 18 years
      [2]
      • 0.2 mg/kg/dose single IV push.
        • Alternative: 0.25 mg/kg in 2 divided doses: 0.15 mg/kg, followed after 30 seconds by 0.1 mg/kg
        .
Neuromuscular blockade
  • Intravenous
    • 7 months up to 2 years
      • Initial dose: 0.1 - 0.2 mg/kg/dose single IV push.
      • Maintenance dose: 0.1 mg/kg/dose, bolus.
        • Repeat if indicated based on Train of Four (ToF) test
        • ALTERNATIVE :0.2-1.6 mg/kg/hour continuous infusion
        .
    • 2 years up to 12 years
      • Initial dose: 0.1 - 0.2 mg/kg/dose single IV push.
      • Maintenance dose: 0.1 mg/kg/dose, bolus.
        • Repeat if indicated based on Train of Four (ToF) test
        • ALTERNATIVE: 0.3-1.9 mg/kg/hour continuous infusion
        .

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

The safety profile in children is comparable to that of adults.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Monitor neuromuscular function. The duration of action for muscle relaxants is so variable that relaxation measurement should be considered before extubation and to antagonize if necessary.

Cross hypersensitivity - including from other groups - is possible. This may be based on the excipients but also on the active ingredient. Advice is to consult a pediatric allergist in case of a suspected allergic reaction to a muscle relaxant and with the request to also test for safety of alternative muscle relaxants.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Choline derivatives
M03AB01
Other quaternary ammonium compounds
M03AC04
M03AC11
M03AC01
M03AC09
M03AC03
Other muscle relaxants, peripherally acting agents
M03AX01

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References

  1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
  2. GlaxoSmithKline BV, SPC Mivacron (RVG 16146), www.cbg-meb.nl, Geraadpleegd 16 april 2013, http://db.cbg-meb.nl/IB-teksten/h16146.pdf

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Changes

Changes