Bulletin
Mivacurium Injection
09 June 2006
Products Affected - Description
Mivacron injection 2 mg/mL, Abbott
50 mL MDV NDC 00074-4375-50
20 mL MDV NDC 00074-4375-20
10 mL SDV NDC 00074-4365-10
5 mL SDV NDC 00074-4365-05
Reason for the Shortage
Abbott has discontinued Mivacron because of the timeframe for manufacture and the competitive environment.1,2 There is no alternative supplier of mivacurium injection.1
Estimated Resupply Dates
Abbott has no plans to resume marketing of Mivacron.1,2
Implications for Patient Care
Mivacurium is a short-acting neuromuscular blocking agent (NMBA) used to facilitate intubation and relax skeletal muscles as an adjunct to general anesthesia.3,4
Safety
Ensure clinicians are familiar with the use of an alternative NMBA.
Alternative Agents & Management
Alternative NMBAs vary in onset time and duration of action; see the table below. Most non-depolarizing neuromuscular blocking agents, with the exception of mivacurium, may be reversed with neostigmine or edrophonium.3,4
Characteristics of NMBAs3,4
|
NMBA
|
Onset of Action (min)
|
Clinical Duration (min)
|
|
Atracurium
|
3-5
|
60
|
|
Cisatracurium
|
1.5-2
|
55-61
|
|
Doxacurium*
|
5
|
100
|
|
Mivacurium*
|
3
|
15-20
|
|
Pancuronium
|
2-4
|
65
|
|
Rocuronium
|
1
|
20-60
|
|
Succinylcholine
|
0.5-1
|
4-6
|
|
Tubocurarine**
|
2-5
|
25-90
|
|
Vecuronium
|
2.5-3
|
25-30
|
*Doxacurium has been discontinued for business reasons.5 Mivacurium has been discontinued for business reasons.1,2**Tubocurarine has been discontinued because of a raw material shortage.5-7
Related Shortages
References
- Abbott. Customer Service (personal communication). June 8 and 9, 2006.
- Abbott. (written communication). May 15, 2006.
- Muscle Relaxants: Adjuncts to Anesthesia. In: Wickersham RM, Novack KK, eds. Drug Facts and Comparisons. Updated Monthly. St. Louis, MO: Facts and Comparisons; 2005:1044-1067.
- Skeletal Muscle Relaxants. In: McEvoy GK, Litvak K, Welsh OH, Ford ME, Kester L, eds. AHFS 2005 Drug Information. Bethesda, MD: American Society of Health-System Pharmacists; 2005:1332-1352.
- Abbott Laboratories, Pharmaceutical Products Division. Customer Service (personal communication). September 1 and 28, 2004.
- Geneva Pharmaceuticals, Customer Service (personal communication). August 16, 2001.
- Eli Lilly, Customer Service (personal communication). August 16, 2001.
Updated
Updated June 9, 2006 by Erin R. Fox, PharmD, Drug Information Specialist. Created by Jane Chandramouli, PharmD, Drug Information Specialist, and Erin R. Fox, PharmD, Drug Information Specialist, April 11, 2002. Copyright 2006, Drug Information Service, University of Utah, Salt Lake City, UT.
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