Nitroprusside

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

• feeling like you might pass out, even while lying down;
• gasping, struggling to breathe, or shallow breathing;
• confusion, ringing in your ears;
• dizziness with nausea and vomiting, rapid breathing, seizure (convulsions);
• fast, slow, or uneven heart rate;
• numb or cold feeling in your arms and legs; or
• chills, sweating, tremors, twitching, overactive reflexes.

Less serious side effects may include:

• mild skin rash;
• mild stomach pain or nausea;
• warmth, redness, or tingly feeling under your skin;
• darkening or deeper color of veins through your skin; or
• irritation around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Nitroprusside is a prescription medication used to treat high blood pressure (hypertention) and congestive heart failure.

Nitroprusside belongs to a group of drugs called antihypertensives. These work by relaxing smooth muscle of blood vessels which causes dilation of arteries and veins. This dilation leads to lower blood pressure.

This medication is available in an injectable form to be given directly into a vein by a healthcare professional.

Common side effects of nitroprusside include excessively low blood pressure (hypotension), cyanide toxicity, and injection site irritation.

Since nitroprusside is given as needed by a healthcare professional, you are not likely to miss a dose.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

• feeling like you might pass out, even while lying down;

• gasping, struggling to breathe, or shallow breathing;

• confusion, ringing in your ears;

• dizziness with nausea and vomiting, rapid breathing, seizure (convulsions);

• fast, slow, or uneven heart rate;

• numb or cold feeling in your arms and legs; or

• chills, sweating, tremors, twitching, overactive reflexes.

Less serious side effects may include:

• mild skin rash;

• mild stomach pain or nausea;

• warmth, redness, or tingly feeling under your skin;

• darkening or deeper color of veins through your skin; or

• irritation around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
• Have your blood pressure checked often. Talk with your doctor.
• If you are 65 or older, use nitroprusside with care. You could have more side effects.
• This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this medicine, call your doctor right away.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Acute hypertension: Initial: 0.3 to 0.5 mcg/kg/minute; may be titrated by 0.5 mcg/kg/minute every few minutes to achieve desired hemodynamic effect (Rhoney 2009); maximum dose: 10 mcg/kg/minute (for a maximum of 10 minutes). To avoid toxicity, some recommend a maximum dose of 2 mcg/kg/minute (Marik 2007).

Acute decompensated heart failure: IV: Initial: 5 to 10 mcg/minute; may be titrated rapidly (eg, up to every 5 minutes) to achieve desired hemodynamic effect; usual dosage range: 5 to 300 mcg/minute. Doses >400 mcg/minute are not recommended due to minimal added benefit and increased risk for thiocyanate toxicity (HFSA 2010).

IV infusion only; infusion pump required. Due to potential for excessive hypotension, continuously monitor patient’s blood pressure during therapy. Product should always be protected from light, even during administration.

Animal studies have shown that nitroprusside may cross the placental barrier and result in fetal cyanide levels that are dose-related to maternal nitroprusside levels. However, information related to use in pregnancy is limited.

Initial dose: 0.3 mcg/kg/min IBW administered by continuous IV infusion.
Maintenance dose: The dose may be titrated upward to a maximum of 10 mcg/kg/min IBW.

Initial dose: 10 to 15 mcg/min administered by continuous IV infusion.
Maintenance dose: The dose may be titrated to 10 to 200 mcg/min.
Maximum dose: 280 mcg/min (4 mcg/kg/min).