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ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION

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About the medicine

How to use ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the Patient

Atracurium Besylate Kalceks 10 mg/ml Solution for Injection and Infusion EFG

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or nurse.
  • If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack

  1. What is Atracurium Besylate Kalceks and what is it used for
  2. What you need to know before you are given Atracurium Besylate Kalceks
  3. How Atracurium Besylate Kalceks is used
  4. Possible side effects
  5. Storage of Atracurium Besylate Kalceks
  6. Contents of the pack and other information

1. What is Atracurium Besylate Kalceks and what is it used for

Atracurium Besylate belongs to a group of medicines called muscle relaxants.

Atracurium Besylate is used during surgical operations to relax muscles and to help with the insertion of a breathing tube and with artificial breathing. It is also used to assist with artificial breathing in patients admitted to the intensive care unit.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you are given Atracurium Besylate Kalceks

Atracurium Besylate Kalceks must not be given:

  • if you are allergic to atracurium besylate or any of the other ingredients of this medicine (listed in section 6).

Tell your doctor before you are given atracurium besylate if this applies to you.

Warnings and precautions

Tell your doctor or nurse before you are given atracurium besylate:

  • if you have an allergy or bronchial asthma;
  • if you have ever had an allergic reaction to other medicines similar to atracurium besylate, which block the transmission of impulses between the nerve and the muscle;
  • if you have muscle weakness, tiredness or difficulty coordinating your movements (myasthenia gravis);
  • if you have a neuromuscular disease;
  • if you have a heart disease or are sensitive to drops in blood pressure;
  • if you have a significant electrolyte imbalance (unusual levels of ions such as sodium, potassium or chloride in the blood);
  • if you have recently had severe burns that required medical attention.

If you think any of the above applies to you, talk to your doctor.

Children

This medicine is not intended for use in children under 1 month of age.

Other medicines and Atracurium Besylate Kalceks

Tell your doctor if you are taking, have recently taken or might take any other medicines, including those obtained without a prescription.

Some medicines may affect the effects of atracurium besylate. Tell your doctor if you are taking any of the following medicines:

  • anaesthetics (used to reduce consciousness and pain during surgical procedures), such as halothane, isoflurane, enflurane or ketamine;
  • antibiotics (used to treat infections), such as aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin and clindamycin;
  • anti-arrhythmics (used to treat heart rhythm disorders), such as propranolol, oxprenolol, calcium channel blockers, lidocaine, procainamide and quinidine;
  • diuretics, such as furosemide, mannitol, thiazides and acetazolamide;
  • magnesium salts (used to prevent low magnesium levels in the body);
  • medicines used to treat mental disorders, such as lithium or chlorpromazine;
  • medicines used to treat high blood pressure (hypertension), such as trimethaphan and hexamethonium;
  • medicines used to treat joint inflammation (anti-rheumatic drugs), such as chloroquine and penicillamine;
  • medicines used to treat Alzheimer's disease, such as donepezil;
  • corticosteroids (used to treat inflammation or asthma), such as prednisolone;
  • medicines for seizures (epilepsy), such as phenytoin.

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 for advice before taking this medicine. Your doctor will consider the benefit of your treatment with Atracurium Besylate Kalceks to your baby.

This medicine may be used to maintain muscle relaxation during a caesarean section.

Driving and using machines

Atracurium besylate may affect your ability to drive and use machines. Ask your doctor for advice on when it is safe to drive and use machines.

Do not drive or use machines if you do not feel well.

3. How Atracurium Besylate Kalceks is used

Atracurium besylate is used during procedures that require you to be anaesthetized (unconscious) or heavily sedated. It will always be given under the supervision of an experienced doctor.

How much is given

Your doctor will decide the correct dose of atracurium besylate based on:

  • your body weight;
  • the degree and duration of muscle relaxation required;
  • your expected response (reaction) to the administration of the medicine.

How Atracurium Besylate Kalceks is given

This medicine will be given to you by a single injection into a vein or as a continuous infusion (usually using an infusion pump) into a vein. In this case, the medicine is given slowly over a certain period of time.

Instructions for opening the ampoule:

  1. Hold the ampoule with the colored dot facing upwards. If any solution remains in the top part of the ampoule, gently tap it with your finger to make the solution flow down to the bottom part of the ampoule.
  2. Use both hands to open it and while holding the bottom part of the ampoule with one hand, use the other hand to break the top part of the ampoule in the opposite direction of the colored dot (see the images below).

Hand holding a glass ampoule with dotted lines indicating the break point and preparation for use

Use in children

Children under 1 month of age must not be given this medicine.

If you are given too much Atracurium Besylate Kalceks

This medicine should only be used by doctors who are properly trained in its administration. Since this medicine will be given to you while you are in the hospital, it is unlikely that you will be given too much or too little, however, tell your doctor or a healthcare professional immediately if you have any doubts. If you are given too much, the appropriate measures will be taken immediately.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

If any of the following happen, tell your doctor immediately:

  • Severe allergic reaction – sudden rash with itching (urticaria), swelling of hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing), and you may feel like you are going to faint;
  • shock;
  • heart failure;
  • cardiac arrest.

The above are very rare, serious side effects. You may need urgent medical attention.

Tell your doctor as soon as possible if you notice any of the following:

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

  • low blood pressure (hypotension), usually mild and temporary;
  • redness of the skin.

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

  • difficulty breathing and wheezing (bronchospasm).

Frequency not known(cannot be estimated from the available data):

  • seizures;
  • muscle disorders (myopathy), muscle weakness.

Reporting of side effects

If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Spanish Medicines Surveillance System for Human Use: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Atracurium Besylate Kalceks

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

Do not use this medicine after the expiry date which is stated on the label and carton, after EXP. The expiry date is the last day of the month stated.

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

Store in the original packaging to protect from light.

For single use only. Once opened, the product should be used immediately.

The solution should be inspected visually before use. It should only be used if the solution is clear and free of particles.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

Composition of Atracurium Besylate Kalceks

  • The active substance is atracurium besylate.

1 ml of solution contains 10 mg of atracurium besylate.

Each ampoule (2.5 ml) contains 25 mg of atracurium besylate.

Each ampoule (5 ml) contains 50 mg of atracurium besylate.

  • The other ingredients are benzene sulfonic acid (for pH adjustment), water for injections.

Appearance of Atracurium Besylate Kalceks and pack contents

Clear, colorless or yellowish solution for injection and infusion, without visible particles.

Solution of 2.5 ml or 5.0 ml filled in type I glass ampoules of 5.0 ml.

The ampoules are placed in a PVC tray. The tray is packaged in a cardboard box.

Pack sizes: 1 or 5 ampoules.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

AS KALCEKS

Krustpils iela 71E,

Riga, LV‑1057,

Latvia

Tel.: +371 67083320

E‑mail: [email protected]

Manufacturer

Akciju sabiedriba “Kalceks”

Krustpils iela 71E,

Riga, LV‑1057,

Latvia

You can obtain further information on this medicine from the representative of the Marketing Authorisation Holder

EVER Pharma Therapeutics Spain SL

C/ Toledo 170

28005 Madrid

Spain

This medicine is authorised in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Bulgaria Atracurium Kalceks 10 mg/ml ???????????/?????????? ???????

Belgium Atracurium Kalceks 10 mg/ml solution injectable/pour perfusion

Atracurium Kalceks 10 mg/ml oplossing voor injectie/infusie

Atracurium Kalceks 10 mg/ml Injektions-/Infusionslösung

Czech Republic Atracurium Kalceks

Estonia Atracurium besilate Kalceks

France ATRACURIUM KALCEKS 10 mg/ml, solution injectable/pour perfusion

Hungary Atracurium besilate Kalceks 10 mg/ml oldatos injekció/infúzió

Ireland Atracurium besilate 10 mg/ml solution for injection/infusion

Latvia Atracurium besilate Kalceks 10 mg/ml škidums injekcijam/infuzijam

Lithuania Atracurium besilate Kalceks 10 mg/ml injekcinis ar infuzinis tirpalas

Malta Atracurium Kalceks 10 mg/ml solution for injection/infusion

Netherlands Atracurium Kalceks 10 mg/ml oplossing voor injectie/infusie

Poland Atracurium Kalceks

Romania Atracurium Kalceks 10 mg/ml solu?ie injectabila/perfuzabila

Slovakia Atracurium Kalceks 10 mg/ml injekcný/infúzny roztok

Spain Atracurium Besylate Kalceks 10 mg/ml solution for injection and infusion EFG

Sweden Atracurium Kalceks 10 mg/ml injektions-/infusionsvätska, lösning

United Kingdom (Northern Ireland) Atracurium besilate 10 mg/ml solution for injection/infusion

Date of last revision of this leaflet: August 2022

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This information is intended only for healthcare professionals:

For single use only. Once opened, the product should be used immediately.

From a microbiological point of view, unless the method of dilution prevents the risk of microbial contamination, the product should be used immediately. If not used immediately, the in-use storage times and conditions are the responsibility of the user.

Atracurium besylate is inactivated at high pH, so it should not be mixed in the same syringe with thiopental solutions or other alkaline solutions.

After injecting atracurium besylate into a small vein, it should be flushed through the vein with physiological solution. When other medicines are administered through the same needle or permanent cannula as atracurium besylate, it should be rinsed with a sufficient volume of physiological solution after administration of each medicine.

Atracurium Besylate Kalceks is a hypotonic solution and should not be administered in the same venous access as a blood transfusion.

Atracurium besylate is compatible with the following infusion solutions.

Infusion solution

Stability period

Sodium chloride solution (9 mg/ml) for intravenous infusion

24 hours

Glucose solution (50 mg/ml) for intravenous infusion

8 hours

Ringer's solution for intravenous infusion

8 hours

Sodium chloride solution (1.8 mg/ml) and glucose solution (40 mg/ml) for intravenous infusion

8 hours

Ringer lactate solution for intravenous infusion

4 hours

When diluted in these solutions to obtain atracurium besylate concentrations of 0.5 mg/ml and above, the resulting solutions will be stable in daylight for the indicated periods at temperatures up to 25°C.

Online doctors for ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION

Discuss questions about ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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Doctor

Sergey Ilyasov

Psychiatry 7 years exp.

Dr Sergey Ilyasov is an experienced neurologist and qualified psychiatrist who provides online consultations for adults and adolescents. Combining deep neurological expertise with a modern psychiatric approach, he ensures comprehensive diagnostics and effective treatment for a wide range of conditions affecting both physical and mental health.

Dr. Ilyasov helps patients in the following cases:

  • Chronic headaches (migraine, tension-type headache), back pain, neuropathic pain, dizziness, numbness in limbs, coordination disorders.
  • Anxiety disorders (panic attacks, generalized anxiety disorder), depression (including atypical and treatment-resistant forms), sleep disturbances (insomnia, hypersomnia, nightmares), stress, burnout.
  • Chronic pain syndromes and psychosomatic symptoms (e.g., irritable bowel syndrome related to stress, vegetative-vascular dystonia).
  • Behavioral disorders and concentration difficulties in adolescents (including ADHD, autism spectrum disorders), nervous tics.
  • Memory impairments, phobias, obsessive-compulsive disorder (OCD), emotional swings, and support for post-traumatic stress disorder (PTSD).

Thanks to his dual specialization in neurology and psychiatry, Dr Sergey Ilyasov offers integrated and evidence-based care for complex conditions requiring a multidisciplinary approach. His consultations focus on accurate diagnosis, development of an individualized treatment plan (including pharmacotherapy and psychotherapeutic methods), and long-term support adapted to each patient's unique needs.

Book an online consultation with Dr. Sergey Ilyasov to receive qualified assistance and improve your well-being today.

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Doctor

Alexander Nazarchuk

Allergology 7 years exp.

Dr. Alexander Nazarchuk is a physician specialising in allergology and internal medicine. He provides online consultations for adults, following the principles of evidence-based medicine — no outdated treatments or unnecessary tests, with clear explanations and a personalised approach. He helps patients with a wide range of allergic and therapeutic conditions, from common day-to-day complaints to complex cases involving allergies, gastrointestinal issues, cardiovascular concerns, respiratory symptoms, and more.

You can consult Dr. Nazarchuk for:

  • Test interpretation and guidance on diagnostic plans.
  • Allergic rhinitis, hay fever, bronchial asthma (including severe cases).
  • Food and drug allergies, skin rashes, angioedema.
  • Atopic dermatitis, urticaria, contact allergies.
  • Allergen-specific immunotherapy (AIT) – initiation and ongoing management.
  • Abdominal pain, bloating, changes in bowel habits, nausea, heartburn.
  • High blood pressure and adjustment of baseline antihypertensive therapy.
  • Hyperlipidaemia and elevated cholesterol.
  • Cough, nasal congestion, fever, sore throat.
  • Anaemia, including iron deficiency and related conditions.
  • Other issues related to allergology and internal medicine.

During consultations, Dr. Nazarchuk takes a thorough, structured approach — analysing symptoms, identifying potential causes, and helping patients make informed decisions. Whether treatment, further investigation, or monitoring is needed, he explains each step clearly so you understand your health and how best to manage it.

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Andrei Popov

General medicine 7 years exp.

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

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Doctor

Bulat Garipov

General medicine 15 years exp.

Dr. Bulat Garipov is a radiologist with more than 15 years of experience, specializing in magnetic resonance imaging (MRI). Throughout his professional career, he has worked in leading diagnostic imaging centers, both in on-site practice and teleradiology, which has allowed him to develop a broad and versatile approach to radiology.

Over the years, he has gained solid experience in interpreting MRI studies in various areas, including:

  •  Neuroimaging
  •  Musculoskeletal system (MSK)
  •  Angiography
  •  Abdomen and pelvis
  •  Soft tissues

Additionally, Dr. Garipov is open to new collaboration opportunities in radiology and teleradiology projects. He offers his expertise in MRI, providing both first and second readings of studies, as well as advanced image interpretation, ensuring accurate and high-quality diagnostics.

You could consult Dr. Bulat Garipov in cases where accurate interpretation of MRI studies or a second expert opinion is required. His expertise is especially valuable in cases of suspected neurological conditions, back and joint pain, vascular disorders, as well as in the diagnosis of abdominal and pelvic diseases. The doctor also provides support in complex or unclear clinical situations, including the review of previously performed studies, which helps improve diagnostic accuracy and determine the optimal treatment strategy. A teleradiology format is available, allowing you to receive a professional opinion remotely.

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0.0 (0)
Doctor

Sviatoslav Chekhun

Oncology 13 years exp.

Dr. Sviatoslav Chekhun is a medical oncologist with international clinical and research experience, specializing in modern medical oncology and a personalized approach to cancer treatment.

Currently (since 2025), he works as a Medical Oncologist at Institut Català d’Oncologia (Girona, Spain). Previously, he completed his residency in Medical Oncology and was involved in clinical research at Hospital Universitari Germans Trias i Pujol.

Dr. Chekhun has a strong academic and scientific background. He served as a lecturer in Internal Medicine at O.O. Bohomolets National Medical University and conducted research in experimental oncology at the R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology.

Earlier in his career, he worked as a medical oncologist at the Kyiv City Clinical Oncological Center and contributed to regulatory evaluation of medicinal products at the State Expert Center of the Ministry of Health of Ukraine.

When to consult Dr. Chekhun:

  •  for diagnosis or clarification of a cancer diagnosis
  •  to obtain a second opinion on an existing treatment plan 
  •  when you need a personalized treatment strategy 
  •  for interpretation of test results, CT, MRI, PET-CT, and biopsies 
  •  when choosing between treatment options (chemotherapy, targeted therapy, immunotherapy) 
  •  in case of doubts about treatment strategy or disease progression 

Consultation format

Dr. Chekhun provides online consultations, where you can receive:

  •  expert second opinion 
  •  detailed case review 
  •  recommendations based on current international treatment guidelines 
  •  personalized treatment and follow-up plan 

Important:
Prescription and monitoring of medications must be carried out by your treating physician in an in-person (offline) setting. An online consultation does not replace a face-to-face visit but helps you make more informed decisions about your treatment.

Dr. Sviatoslav Chekhun combines clinical practice, research, and international experience, enabling him to provide patients with modern, evidence-based approaches in oncology.

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€280

Frequently Asked Questions

Is a prescription required for ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION?
ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION?
The active ingredient in ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION is atracurium. This information helps identify medicines with the same composition but different brand names.
Who manufactures ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION?
ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION is manufactured by Kalceks As. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to ATRACURIUM BESILATE KALCEKS 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION?
Other medicines with the same active substance (atracurium) include ATRACURIUM BESILATE HAMELN 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION, TRACRIUM 10 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION, CISATRACURIO ACCORDPHARMA 2 mg/ml INJECTABLE SOLUTION AND PERFUSION SOLUTION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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