Sisacure contains a medicine called cisatracurium. This belongs to a group of medicines called muscle relaxants.

Sisacure is used:

• To relax muscles during operations on adults and children over 1 month of age, including heart surgery
• To help insert a tube into the windpipe (tracheal intubation), if a person needs help to breathe
• To relax the muscles of adults in intensive care.

Ask your doctor if you would like more explanation about this medicine.

You should not be given Sisacure

• If you are allergic to cisatracurium, any other muscle relaxant or any of the other ingredients in Sisacure (listed in section 6)
• You have reacted badly to an anaesthetic before.

Do not have Sisacure if any of the above apply to you. If you are not sure, talk to your doctor, nurse or pharmacist before you have Sisacure.

Warnings and precautions

Talk to your doctor, nurse or pharmacist before having this medicine:

• If you have muscle weakness, tiredness or difficulty in co-ordinating your movements (myasthenia gravis)
• You have a neuromuscular disease, such as a muscle wasting disease, paralysis, motor neurone disease or cerebral palsy
• If you have a burn which requires medical treatment
• You have ever had an allergic reaction to any muscle relaxant which was given as part of an operation.

If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before you are given Sisacure.

Other medicines and Sisacure

Tell your doctor if you are taking or have recently taken any other medicines. This includes any herbal products or medicines bought without a prescription.

In particular tell your doctor if you are taking any of the following:

• Anaesthetics (used to reduce sensation and pain during surgical procedures)
• Antibiotics (used to treat infections)
• Medicines for uneven heart beats (anti-arrhythmics)
• Medicines for high blood pressure
• Water tablets (diuretics), such as furosemide
• Medicines for inflammation of the joints, such as chloroquine or d-penicillamine
• Steroids
• Medicines for fits (epilepsy), such as phenytoin or carbamazepine
• Medicines for mental illness, such as lithium or chlorpromazine (which can also be used for sickness)
• Medicines containing magnesium
• Drugs for Alzheimer’s disease (anticholinesterases e.g. donepezil).

Pregnancy and breast-feeding

Do not breast feed for at least 3 hours after your last dose when the effects of cisatracurium have worn off.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Driving and using machines

If you are only staying in hospital for the day, your doctor will tell you how long to wait before leaving the hospital or driving a car. It can be dangerous to drive too soon after having an operation.

How your injection is given

You will never be expected to give yourself this medicine. It will always be given to you by a person who is qualified to do so.

Sisacure can be given:

• As a single injection into your vein (intravenous bolus injection)
• As a continuous infusion into your vein. This is where the drug is slowly given to you over a long period of time.

Your doctor will decide the way you are given the drug and the dose you will receive. It will depend on:

• Your body weight.
• The amount and duration of muscle relaxation required.
• Your expected response to the medicine.

Children less than 1 month old should not have this medicine.

If you receive more Sisacure than you should

Sisacure will always be given under carefully controlled conditions. However, if you think that you have been given more than you should tell your doctor or nurse immediately.

If you have any further questions on the use of this medicine, ask your doctor.

Like all medicines, cisatracurium can cause side effects, although not everybody gets them. If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet.

Allergic reactions (affects less than 1 in 10,000 people)

If you have an allergic reaction, tell your doctor or nurse straight away. The signs may include:

• Sudden wheeziness, chest pain or chest tightness.
• Swelling of your eyelids, face, lips, mouth or tongue.
• A lumpy skin rash or ‘hives’ anywhere on your body.
• A collapse and shock.

Talk to your doctor, nurse or pharmacist if you notice any of the following:

Common (affects less than 1 in 10 people)

• Decrease in heart rate
• Decrease in blood pressure.

Uncommon (affects less than 1 in 100 people)

• A rash or redness of your skin
• Wheezing or coughing.

Very rare (affects less than 1 in 10,000 people)

• Weak or aching muscles.

Keep this medicine out of the sight and reach of children.

Store in a refrigerator (2-8°C). Do not freeze.

Store in the original package in order to protect from light.

If diluted, store the infusion solution between 2-8°C or 25°C and use within 24 hours. Any unused infusion solution should be discarded 24 hours after it was prepared.

Do not use this medicine after the expiry date which is stated on the package “EXP”. The expiry date refers to the last day of that month.

Do not use this medicine if you notice any visible signs of deterioration.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.