Cisatracurium Besylate

Cisatracurium besylate is the (1R,1'R,2R,2'R)-diastereoisomer of atracurium besylate. Commercial atracurium preparations contain a mixture of 10 stereoisomers, with cisatracurium comprising about 15%. It is approximately 3 times more potent than the mixture of atracurium isomers as a neuromuscular blocking agent. Used as a muscle relaxant for endotracheal intubation, controlled ventilation, and general anaesthesia, it functions as a muscle relaxant and nicotinic antagonist. It is a quaternary ammonium salt, an atracurium besylate, and an organosulfonate salt, containing cisatracurium.