# Atracurium: veterinary dose and monograph

> Atracurium is a veterinary drug. A non-depolarising NEUROMUSCULAR BLOCKING AGENT (muscle paralytic) used during general anaesthesia to provide skeletal-muscle relaxation for delicate surgery (intra-ocular, intra-thoracic, fracture reduction) and to facilitate mechanical… Indications include skeletal-muscle relaxation during general anaesthesia (intra-ocular, intra-thoracic, abdominal, orthopaedic surgery); facilitation of mechanical ventilation / controlled ventilation; patients with hepatic or renal impairment needing a neuromuscular blocker (organ-independent elimination). This monograph lists 5 reference doses for dogs, cats, horses and rabbits, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/atracurium · Last reviewed: 2026-10-01

## At a glance

- **Drug class:** Veterinary drug
- **Also known as:** Tracrium, Atracurium besylate
- **Species with doses:** Dogs, Cats, Horses and Rabbits
- **General dose range:** 0.2–0.5 mg/kg IV bolus then CRI/top-ups (to effect) — check the species tables for the indication
- **Routes:** IV
- **Last reviewed:** 1 October 2026

## Indications

- Skeletal-muscle relaxation during general anaesthesia (intra-ocular, intra-thoracic, abdominal, orthopaedic surgery)
- Facilitation of mechanical ventilation / controlled ventilation
- Patients with hepatic or renal impairment needing a neuromuscular blocker (organ-independent elimination)

## Atracurium dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

### Dogs

*Atracurium doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Neuromuscular blockade (intra-op) | 0.2–0.5 mg/kg | IV | bolus then top-ups/CRI to TOF monitoring | — |
| Neuromuscular blockade — CRI | 3–9 µg/kg/min | IV | CRI after 0.2–0.5 mg/kg IV load | — |

- Neuromuscular blockade (intra-op): Papich 5e: 0.2 mg/kg IV initially, then 0.15 mg/kg q30min. Plumb’s p.125: 0.2 mg/kg IV then 0.1 mg/kg no more often than every 20–30 min without a nerve stimulator (Spelts); 0.25 mg/kg to facilitate intubation (Crowe); ventilated patients 0.2–0.5 mg/kg load (Dhupa). Deep anaesthesia and positive-pressure ventilation are mandatory; reverse with neostigmine or edrophonium plus an anticholinergic.
- Neuromuscular blockade — CRI: Papich 5e: 0.3–0.5 mg/kg IV load then 4–9 µg/kg/min. Plumb’s p.125 (Dhupa 2005): 0.2–0.5 mg/kg load, then 3–9 µg/kg/min starting 5 min later, in D5W or saline; do not mix with other drugs. Ventilate and monitor.

### Cats

*Atracurium doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Neuromuscular blockade (intra-op) | 0.2–0.5 mg/kg | IV | bolus then to effect | — |

- Neuromuscular blockade (intra-op): Papich 5e (dogs and cats): 0.2 mg/kg IV then 0.15 mg/kg q30min; CRI 0.3–0.5 mg/kg load then 4–9 µg/kg/min. Plumb’s p.125: induction 0.22 mg/kg IV with a 1/10–1/6 priming dose given 4–6 min earlier; intra-operative 0.11 mg/kg IV (Mandsager); 0.2 mg/kg then 0.1 mg/kg (Spelts). Ventilation and neuromuscular monitoring are mandatory.

### Horses

*Atracurium doses for horses*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Neuromuscular blockade (specialist) | 0.05–0.07 mg/kg | IV | to effect | — |

- Neuromuscular blockade (specialist): Papich 5e: 0.05–0.07 mg/kg IV. Plumb’s p.125 (Mandsager 1988): 0.055 mg/kg IV intra-operatively. Full ventilatory support and monitoring required. ARCI Class 2.

### Rabbits

*Atracurium doses for rabbits*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Paralysis for peri-ophthalmic surgery | 0.1 mg/kg | IV | single dose | — |

- Paralysis for peri-ophthalmic surgery: Plumb’s p.125 (Ivey & Morrisey 2000): rabbits 0.1 mg/kg. Requires ventilation.

## Contraindications

Use without the ability to mechanically ventilate and monitor neuromuscular function. Inadequate anaesthesia (awareness/paralysis is catastrophic — it has no anaesthetic/analgesic effect). Myasthenia gravis (profound, prolonged block). Known hypersensitivity (histamine release). Without trained anaesthesia personnel/equipment.

## Adverse effects

- Histamine release (hypotension, flushing, bronchospasm) — dose/rate-related
- Prolonged paralysis if overdosed or with potentiating drugs
- No sedation/analgesia (awareness risk if anaesthesia inadequate)
- Laudanosine metabolite (CNS-stimulant at very high cumulative doses — rarely relevant)

## Drug interactions

- Volatile anaesthetics, aminoglycosides, polymyxins, magnesium: POTENTIATE and prolong the block
- Anticholinesterases (neostigmine, edrophonium): REVERSE the block (give with an anticholinergic)
- Hypothermia/acidosis: slow Hofmann elimination (prolonged block)
- Other neuromuscular blockers: additive

## Pregnancy and lactation

Does not readily cross the placenta (quaternary compound); used in anaesthesia when needed with full support.

## Monitoring

- NEUROMUSCULAR monitoring (train-of-four) — essential to titrate and confirm recovery
- Mechanical ventilation / capnography / SpO2 (the diaphragm is paralysed)
- Depth of anaesthesia (NO awareness — it provides no anaesthesia/analgesia)
- Blood pressure (histamine release); temperature (affects offset)

## Toxicity and overdose

The "toxicity" is its intended, dangerous pharmacology — total skeletal-muscle paralysis including respiratory muscles with NO anaesthesia. Overdose/potentiation causes prolonged paralysis; rapid administration causes histamine-mediated hypotension/bronchospasm. Awareness under paralysis (inadequate anaesthesia) is a catastrophic risk.

Management: Continue mechanical VENTILATION and maintain anaesthesia until the block resolves (Hofmann elimination is reliable). Reverse residual block with neostigmine + glycopyrrolate guided by train-of-four. Treat histamine reactions (fluids, antihistamine, manage bronchospasm). Ensure adequate depth of anaesthesia throughout.

## Clinical pearls

- The neuromuscular blocker for ORGAN-COMPROMISED patients — Hofmann elimination means predictable offset regardless of liver/kidney function
- It PARALYSES but does NOT anaesthetise — the patient must be deeply anaesthetised AND mechanically ventilated, with train-of-four monitoring; awareness under paralysis is a catastrophe
- Reverse residual block with neostigmine + an anticholinergic (glycopyrrolate) once recovery starts
- Refrigerate it (it self-degrades), give slowly to limit histamine release, and remember volatile agents/aminoglycosides/magnesium prolong the block

## Mechanism of action

A non-depolarising (competitive) neuromuscular blocker that competes with acetylcholine for nicotinic receptors at the motor end-plate, preventing depolarisation and causing flaccid skeletal-muscle paralysis without initial fasciculation. Uniquely, it is eliminated by spontaneous, temperature- and pH-dependent Hofmann degradation (and ester hydrolysis), independent of hepatic/renal function — giving predictable offset even in organ failure. Reversal is achieved with an anticholinesterase (neostigmine) once spontaneous recovery begins.

## Formulations and products

- Injection 10 mg/mL
- Tracrium / Atracurium — 10 mg/mL injection, Injection (refrigerate) (human-label)

## Storage

Injection: REFRIGERATE (2–8 °C), protect from light; potency declines at room temperature (Hofmann degradation). Use promptly once warmed.

## Before you use this dose

> **Caution:** Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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## Frequently asked questions

### What is the dose of Atracurium for dogs?

Reference doses for Atracurium in dogs: 0.2–0.5 mg/kg IV bolus then top-ups/CRI to TOF monitoring (Neuromuscular blockade (intra-op)); 3–9 µg/kg/min IV CRI after 0.2–0.5 mg/kg IV load (Neuromuscular blockade — CRI). Confirm against the label and the patient before use.

### What is the dose of Atracurium for cats?

Reference doses for Atracurium in cats: 0.2–0.5 mg/kg IV bolus then to effect (Neuromuscular blockade (intra-op)). Confirm against the label and the patient before use.

### What is the dose of Atracurium for horses?

Reference doses for Atracurium in horses: 0.05–0.07 mg/kg IV to effect (Neuromuscular blockade (specialist)). Confirm against the label and the patient before use.

### When should Atracurium not be used?

Use without the ability to mechanically ventilate and monitor neuromuscular function. Inadequate anaesthesia (awareness/paralysis is catastrophic — it has no anaesthetic/analgesic effect). Myasthenia gravis (profound, prolonged block). Known hypersensitivity (histamine release). Without trained anaesthesia personnel/equipment.

### What are the side effects of Atracurium in animals?

Histamine release (hypotension, flushing, bronchospasm) — dose/rate-related; Prolonged paralysis if overdosed or with potentiating drugs; No sedation/analgesia (awareness risk if anaesthesia inadequate); Laudanosine metabolite (CNS-stimulant at very high cumulative doses — rarely relevant).

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.