ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)-

Prescription medicine
Given by a clinician
Identity checked
Sources last checked 2026-09-04

This page shows what was measured, who it was measured in, and what that does not settle.

Atracurium besylate injection is indicated, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

From the FDA-approved label: Atracurium besylate is a nondepolarizing skeletal muscle relaxant. Nondepolarizing agents antagonize the neurotransmitter action of acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate. This antagonism is inhibited, and neuromuscular block reversed, by acetylcholinesterase inhibitors such as neostigmine, edrophonium, and pyridostigmine. Atracurium can be used most advantageously if muscle twitch response to peripheral nerve stimulation is monitored to assess degree of muscle relaxation.

Why people take it. Atracurium besylate injection is indicated, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

What happened in people

RNAWiki has not yet published a reviewed conclusion for this use.

A fixed RNAWiki sentence

Where this came from

Wording RNAWiki always uses, not a finding about this substance.

No reviewed claim names a result for any goal on this record.

No source is stored against this line.

The limit that matters most

Not recorded.

Where it acts: Not recorded.
Kind of result: No result is published, so no kind of result applies yet
Supervision: Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.

What the registries record it as

Its recorded molecular formula is C65H82N2O18S2, weighing 1243.49.
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-30

Where each sentence above came from

The use the label states, quoted from it. No plain-language version of this sentence has been written.

The use the label states, quoted from it. It is written for a clinician, not for a reader without medical training.

No statement of the main limit is recorded.

The four opening statements run to 133 words.

Words this page uses

Four words worth knowing first

Chosen from what this page shows, with each one explained before the word it depends on.

Biomarker

A biomarker is a number from a test that stands in for something about health.

A picture of it, and where the picture fails

A biomarker is like a fuel gauge.

Where that stops being true. A gauge is wired to the tank. Many biomarkers are only loosely tied to health.

What people get wrong. A better number is read as a better life. Several medicines improved a number and helped nobody.

A measurable indicator used as a substitute for a clinical outcome of interest.

Placebo

A placebo is a dummy treatment given so the real one can be compared with it.

A picture of it, and where the picture fails

A placebo is like a blank control in an experiment.

Where that stops being true. A blank does nothing. People given a placebo often do get better.

What people get wrong. A placebo effect is read as imaginary. The improvement is measured and real.

An inactive intervention matched in appearance to the test intervention, used to control for non-specific effects.

Comparator

A comparator is whatever the treatment was measured against.

A picture of it, and where the picture fails

It is like the other runner in a race.

Where that stops being true. A race has one winner. A study can show both arms improved.

What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.

The control condition against which the experimental intervention is assessed.

What happened in peopleRead from sources, not yet reviewed

What happened in people

Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.

Incidence of postoperative delirium

The study did not show it

Who was studied: NCT01661907
How many people: 1800
Study design: Not applicable
Compared against: Not recorded for this study
Kind of result: A number that stands in for health
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

mortality

The study did not show it

Who was studied: NCT03318133
How many people: 1086
Study design: Not applicable
Compared against: Not recorded for this study
Kind of result: Living longer, or avoiding a major event
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

the incidence of myocardial Injury after non-cardiac surgery

The study did not show it

Who was studied: NCT07028593
How many people: 1058
Study design: Phase 4
Compared against: Not recorded for this study
Kind of result: A number that stands in for health
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

Perioperative adverse cardiac events

The study did not show it

Who was studied: NCT04553536
How many people: 1000
Study design: Not applicable
Compared against: Not recorded for this study
Kind of result: A number that stands in for health
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

Time of first flatus

The study did not show it

Who was studied: NCT02504749
How many people: 450
Study design: Phase 4
Compared against: Not recorded for this study
Kind of result: A number that stands in for health
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

The overall complication rate

The study did not show it

Who was studied: NCT04087668
How many people: 405
Study design: Not applicable
Compared against: Not recorded for this study
Kind of result: A number that stands in for health
What was found: Result not recorded on this page
Repeated elsewhere: Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Injection

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

openFDA Drugs@FDA · a recorded source, not a stored snapshot
openFDA NDC Directory · a recorded source, not a stored snapshot
openFDA SPL label · a recorded source, not a stored snapshot
PubChem PUG-REST · a recorded source, not a stored snapshot

What we know: RNAWiki holds 6 written-up human studies for this substance, each with the question it asked.
How we know it: Each card names the study, the number of people and what the study set out to measure.
What this does not prove: These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters: A study that failed is as informative as one that worked, and both are here.
What we still do not know: No reviewed claim exists, so no exact population, effect size or interval is published yet.

What is missing or unclearRead from sources, not yet reviewed

Were people like you studied?

RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.

Who was studied

People similar to this profile were included.

ANDUSAGE Atracurium Besylate Injection, USP is indicated, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Who is missing from the studies

Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What the label states about particular groups

On pediatric, the label states: “Safety and effectiveness in pediatric patients below the age of 1 month have not been established.”
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-30
On people who are pregnant, the label states: “Teratogenic Effects: Pregnancy Category C Atracurium besylate has been shown to be potentially teratogenic in rabbits when given in doses up to approximately one-half the human dose.”
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-30
On people who are breastfeeding, the label states: “It is not known whether this drug is excreted in human milk.”
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-30

Where the result stopped carrying

This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.

RNAWiki cannot tell whether a study fits you. It can show who was in it.

What it would be like to takeRead from sources, not yet reviewed

Why it might seem to do nothing

A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.

It was studied in different people

The people in the studies were not much like the reader.

On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

The evidence may simply be wrong

Small early studies often do not hold up.

On this record: RNAWiki has not yet published a reviewed conclusion for this use.

Other reasons RNAWiki checked and found nothing for (11)

It was studied for a different goal: The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied: The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct: Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too: In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel: A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it: Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet: The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied: Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time: Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says: Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason: RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.

None of these is a reason to take more. Taking more is not a step this page ever suggests.

What it would be like to takeRead from sources, not yet reviewed

What taking it involves

The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.

How it is supplied

Given by a clinician

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Read from the recorded approval status.

No source is stored against this line.

Form and route

Injection

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form and route recorded on this substance.

No source is stored against this line.

Who oversees it

Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Suppression classes recorded: S7.

No source is stored against this line.

What is in the pack

Sold as injectable, injection, solution, given by the injection, intravenous route.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on how this is sold and what that means for what is in the pack.

No source is stored against this line.

Where it is registered

Regulatory records are listed in the technical disclosure at the foot of this page.

Counted from records

Where this came from

A count of rows RNAWiki holds. It describes our records, not your body.

No source is stored against this line.

Why people stop

Not recorded.

Nothing recorded

Where this came from

RNAWiki holds nothing here and says so rather than guessing.

No record of why people stopped taking it is stored for this substance.

No source is stored against this line.

What it would be like to takeNothing found in the sources checked

What can go wrong

Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.

Nothing found in the sources checked

No harm is recorded against this substance in the sources RNAWiki checked. Finding nothing is not the same as showing there is nothing.

The sources listed were searched and held nothing. That is not the same as nothing existing.

Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.

Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What is missing or unclearRead from sources, not yet reviewed

Does the exact form matter?

Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.

The form that was studied

Injection

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form used in the studies cited on this page.

No source is stored against this line.

What is sold

Not recorded.

Nothing recorded

Where this came from

RNAWiki holds nothing here and says so rather than guessing.

Nothing further is recorded about which forms are sold.

No source is stored against this line.

What is recorded as being sold

8 products list this as an active ingredient in the United States drug directory. 8 of them contain it and nothing else.
FDA National Drug Code directory · 71288-701 · read 2026-08-29
They are sold as injection, solution and powder, taken intravenous.
FDA National Drug Code directory · 71288-701 · read 2026-08-29
The regulator's established pharmacologic class for it is neuromuscular nondepolarizing blockade [pe] and nondepolarizing neuromuscular blocker [epc].
FDA National Drug Code directory · 71288-701 · read 2026-08-29
4 published labels name it as an active ingredient. 4 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-29
Atracurium Besylate is intravenous at HOW SUPPLIED Atracurium Besylate Injection, USP is supplied as follows: NDC Atracurium Besylate Injection, USP (10 mg per mL) Package Factor 71288- 701 -05 50 mg per 5 mL Single-Dose Vial 10 vials per carton NDC Atracur…, recorded as fda label in effect 2024-12-04 in the United States.
US prescribing information · efe90ee2-fe9e-421f-9e54-2961085d3b12 · read 2026-08-30

Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.

What it would be like to takeRead from sources, not yet reviewed

What you could measure

This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.

Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.

Questions worth asking

Which of the trials of ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)- studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?

Tracking can show whether something changed for you. It cannot show what caused it.

RNAWiki records evidence. It does not say whether this substance is right for you.

What is missing or unclearRead from sources, not yet reviewed

What nobody knows yet

Open questions, each with why it is open and what would close it.

How much did people take in the studies?

The sources RNAWiki checked hold nothing for this field.

Why it matters. A result belongs to an amount. Without the amount the result floats free.

What would answer it

A stored source that records it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing populations

Which groups were under-represented in the studies has not been recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing long-term data

No completed tested study window is recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

No reviewed conclusion

RNAWiki has not yet published a reviewed conclusion for this use.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing interaction studies

No interaction was found in the registers checked. Not finding one is not the same as showing there is none.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Formulation uncertainty

Several salts, forms or products of ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)- are recorded. Results from one form may not transfer to another.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Mechanism not reviewed

No reviewed mechanism story exists for this substance.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

What happened in peopleNothing found in the sources checked

Check any of this yourself

Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.

Nothing found in the sources checked

No traced study record is stored for this substance.

The sources listed were searched and held nothing. That is not the same as nothing existing.

Checks this page had to pass

Passed
Identity resolved
no open identity hold
Passed
No unresolved merge across substance families
no quarantine open
Passed
Every public sentence names a source
The opening statement carries the origin: Quoted from a stored source.
Not passed
Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
Passed
No internal keys in reader text
enforced by the copy-contract test over the rendered page
Passed
Safety mode resolved
Suppression classes recorded: S7.
Passed
Canonical metadata present
slug and display name present

What is missing or unclearRead from sources, not yet reviewed

How this medicine reached us

Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.

What the approval register records

23 approved applications cover products containing this substance. The earliest was NDA018831, approved 19831123 to HOSPIRA.
Drugs@FDA application register · NDA018831 · read 2026-08-29
Marketing status on the register: discontinued and prescription.
Drugs@FDA application register · NDA018831 · read 2026-08-29
The earliest marketing start date recorded for a listed product is 19961218.
FDA National Drug Code directory · 71288-701 · read 2026-08-29

What is missing or unclearRead from sources, not yet reviewed

What to learn next

Ordered by what would most change how you read this page, starting with what is easiest to misunderstand.

Which studies of this failed, and what did they measure?Surface a meaningful outcome
Were people like me actually studied?Reveal a population mismatch
How close is this evidence to something I would notice?Reveal the evidence boundary
What does nobody know about this yet?Reveal an important unknown
What is a biomarker?Support deeper learning

This order is fixed in code and does not count clicks or time on the page.

What is not here

9 questions this page could not answer

These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.

What was measured, goal by goal — found nothing in the sources checked.
How close this is to real life — found nothing in the sources checked.
The path through the body — found nothing in the sources checked.
Felt, measured, or meaningful — found nothing in the sources checked.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
Claims that go past the evidence — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.

The record as stored

The full record, for auditing

Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.

Recorded evidence blocks (6)

On the ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)- label: indicated for what?

"Atracurium besylate injection is indicated, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.": indications and usage on ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)-'s label. DailyMed label · efe90ee2-fe9e-421f-9e54-2961085d3b12 · 2024-12-04

15 registered trials of ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)- — at which phases?

Registered studies posting no result: 13 of 15

15 registered studies of ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)-: 9 na, 3 phase4, 1 early phase1, 1 phase2, 1 phase3. CLINICALTRIALS_SNAPSHOT · 2026-09-01

670 with a PubMed record

Show the evidence

na
9
phase4
3
early phase1
1
phase2
1
phase3
1
completed
9

2 more recorded rows

unknown
5
withdrawn
1

recorded 2026-09-01 · last checked 2026-09-04

Why did ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)-'s trial NCT03005860 stop?

1 recorded trial of ATRACURIUM, (1R,2R,1'R,2'S)-(+/-)- stopped. CLINICALTRIALS_SNAPSHOT · 2026-09-01

"Funding could not be arranged, so the study was prematurely terminated"; 1 of 15 registered studies

Show the evidence

Trial NCT03005860
withdrawn; "Funding could not be arranged, so the study was prematurely terminated"

recorded 2026-09-01 · last checked 2026-09-04