Atacure contains a medicine called atracurium besylate. This belongs to a group of medicines called muscle relaxants.

Atacure is used:

• To relax muscles during operations on adults and children over 1 month of age
• 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.

Do not have Atacure if:

• You are allergic to atracurium besylate, any other muscle relaxant or any of the other ingredients in Atacure (listed in section 6)
• You have reacted badly to an anaesthetic before.

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

Warnings and Precautions
Talk to your doctor, pharmacist or nurse 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
• You have a severe electrolyte imbalance
• You have a lower than normal volume of blood (hypovolaemia)
• 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
• You have a history of sensitivity to histamine. In particular, spasm of the airways may occur if you have a history of allergy or asthma.

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

Other medicines and Atacure

Tell your doctor, nurse or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because these medicines can affect how well this medicine works or can cause side effects.

In particular tell your doctor, nurse or pharmacist 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 heart conditions
• Medicines for high blood pressure
• Water tablets (diuretics), such as furosemide
• Medicines for fits (epilepsy), such as phenytoin or carbamazepine
• Medicines containing magnesium, such as those to treat indigestion and heart burn
• Drugs for Alzheimer’s disease (anticholinesterases e.g. donepezil)
• Medicines for mental illness, such as lithium
• Medicines for inflammation of the joints, such as chloroquine or D-penicillamine
• Steroids.

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

Driving and using machines
It can be dangerous to drive or operate machinery too soon after having had an operation. Your doctor will tell you how long to wait before you can drive and use machinery.

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.

This medicine 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 Atacure than you should

This medicine 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

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following effects may happen with this medicine:

Allergic reactions

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

Common side effects (may affect up to 1 in 10 people)

• Decrease in blood pressure
• Reddening of your skin

Uncommon side effects (may affect up to 1 in 100 people)

• Wheezing or coughing

Rare side effects (may affect up to 1 in 1,000 people)

• A lumpy skin rash or ‘hives’ anywhere on your body

Very Rare side effects (may affect up to 1 in 10,000 people)

• Sudden wheeziness, chest pain or chest tightness
• Swelling of your eyelids, face, lips, mouth or tongue
• Decrease in heart rate
• Shock, circulatory failure, cardiac arrest

Very rarely a severe allergic reaction can occur when given one or more anaesthetic agent.

Other side effects (unknown frequency) that you may experience are:

• Seizures
• Muscle disease (myopathy) or muscle weakness

Keep this medicine out of the sight and reach of children

Store in a refrigerator (2-8°C). Avoid freeze.

Protect from light.

Store in the original package.

When this medicine is made up it should be used straight away. Any unused solution should be thrown away.

Do not use this medicine after the expiry date which is stated on the pack after “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.