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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.

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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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Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

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Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

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Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

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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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