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Short-acting non-depolarising neuromuscular blocker

Mivacurium

Brand names: Mivacron

Mivacurium is a short-acting non-depolarising (benzylisoquinolinium) neuromuscular blocking agent used to provide muscle relaxation during anaesthesia.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It competitively antagonises acetylcholine at nicotinic receptors of the neuromuscular junction; it is uniquely metabolised by plasma cholinesterase (pseudocholinesterase), which accounts for its short duration of action.

Prescribing in practice

  • Action is markedly prolonged in patients with reduced or atypical plasma cholinesterase activity, which can cause unexpectedly long paralysis.
  • Rapid administration can provoke histamine release with flushing, hypotension, and bronchospasm, so it should be given slowly.
  • Neuromuscular function should be monitored and a patent airway with ventilatory support maintained until full recovery.

Monitoring

Monitor depth of block with a peripheral nerve stimulator (train-of-four) and confirm adequate recovery before extubation.

Counselling the patient

  • You will be fully anaesthetised and breathing will be supported while this medicine is working.
  • Inform the anaesthetic team of any family history of prolonged paralysis after anaesthesia.

Evidence & guidelines

Use reflects established anaesthetic practice; consult current prescribing references and the SPC.

Reference: AAGBI; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators