This leaflet contains important information about Nimbex, please read it carefully. If you want to know more about your illness or your medicine, please ask your doctor.

Nimbex is supplied as ampoules and vials. The active ingredient is cisatracurium besylate. Each ampoule of Nimbex injection contains either 5mg or 20mg of cisatracurium. Each vial of Nimbex Forte injection contains 150mg of cisatracurium. The injection is a sterile solution which also contains benzenesulphonic acid and water. Nimbex injection comes in boxes of 5 x 2.5ml or 10ml ampoules and Nimbex Forte injection as 1 x 30ml vial. The Wellcome Foundation Limited, London, NW1 2BP makes Nimbex and is licensed to sell it in the UK.

Nimbex belongs to a group of drugs called muscle relaxants. It is used to relax muscles during a wide range of surgical operations and in intensive care.

This medicine suits most people, but there are a few people who, in some cases it may not be suitable for Ask yourself these questions to check whether it is right for you;

• have you ever had an allergy (rash, itching, shortness of breath) or bad reaction to Nimbex cisatracurium besylate, any other muscle relaxant or to benzenesulphonic acid.
• have you ever reacted badly to an anaesthetic.

If the answer to any of these questions is 'YES', please tell your doctor before you are given Nimbex.

• muscle weakness, tiredness or difficulty in co-ordinating your movements (myasthenia gravis).
• a muscle wasting disease, paralysis, motor neurone disease or cerebral palsy.
• any long-standing illness which has left you weak.
• a burn injury requiring medical treatment within the last two or three months.

Please also tell your doctor if:

• you are pregnant, trying to become pregnant or breast feeding.

Nimbex may interact with other medicines. It is important to let your doctor know if you are taking any of the following drugs before you are given your injection (please check with your doctor if you are not sure):

• antibiotics.
• drugs used to treat disturbances in heart beat rhythm.
• drugs used to treat high blood pressure (hypertension).
• drugs to help you lose body fluids (diuretics).

• drugs for arthritis (or myasthenia gravis)
• steroids.
• drugs for epilepsy.
• drugs used in psychiatry.
• monoamine oxidase inhibitors.
• chlorpromazine.
• lithium.
• medicines containing magnesium (such as those used to treat indigestion and heart burn, etc).

Nimbex is usually given by injection over 5-10 seconds into a vein at a dose of 0.1 to O.4 mg for every kilogram of your bodyweight. Further doses of 0.03 mg per kg of your bodyweight may be used during the operation. The size of the dose controls the duration of muscle relaxation. Nimbex can be infused slowly into a vein, diluted with, for example glucose or saline solution, at a rate of 0.06 to 018 mg per kilogram of your bodyweight per hour. This dose may be changed depending on Nimbex's effect on you.

Nimbex is usually given by injection over 5-10 seconds into a vein at a dose of 0.1 mg for every kilogram of your body weight. When given by infusion the rate is 0.06 to 0.18 mg per kilogram of your bodyweight per hour Further doses of 0.02 mg per kg of your bodyweight may be used during the operation. This dose may be changed depending on Nimbex's effect on you. Nimbex should not be used in children under two years of age.

The effects of Nimbex are monitored carefully throughout your operation and appropriate action can be taken promptly if you receive too much.

Side effects which may happen occasionally during or after the operation:

• a rash or redness of the skin

Tell your doctor if you notice any side effects from your medicine, even if they are not mentioned here.

Leaflet last revised: September 1995.

The product licence number for Nimbex injection is 3/0364.

The product licence number for Nimbex Forte injection is 3/0365.

Nimbex is a Trade mark of

the GlaxoWellcome Group of Companies.

A/5882 95.09