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Levophed (Norepinephrine Bitartrate) - Summary



Norepinephrine (sometimes referred to as l-arterenol/Levarterenol or l-norepinephrine ) is a sympathomimetic amine which differs from epinephrine by the absence of a methyl group on the nitrogen atom.

LEVOPHED (NOREPINEPHRINE) is indicated for the following:

For blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions).

As an adjunct in the treatment of cardiac arrest and profound hypotension.

See all Levophed indications & dosage >>


Media Articles Related to Levophed (Norepinephrine)

Low Blood Pressure (Hypotension) Symptoms and Treatments
Source: MedicineNet Abdominal Aortic Aneurysm Specialty [2017.09.28]
Title: Low Blood Pressure (Hypotension) Symptoms and Treatments
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 9/28/2017 12:00:00 AM

Low Blood Pressure (Hypotension)
Source: MedicineNet Cholera Specialty [2017.05.05]
Title: Low Blood Pressure (Hypotension)
Category: Symptoms and Signs
Created: 4/29/2014 12:00:00 AM
Last Editorial Review: 5/5/2017 12:00:00 AM

Orthostatic Hypotension
Source: MedicineNet Addison Disease Specialty [2017.01.13]
Title: Orthostatic Hypotension
Category: Diseases and Conditions
Created: 6/11/2009 12:00:00 AM
Last Editorial Review: 1/13/2017 12:00:00 AM

Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
Source: MedicineNet Tilt-table Test Specialty [2016.07.28]
Title: Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
Category: Slideshows
Created: 7/29/2008 12:00:00 AM
Last Editorial Review: 7/28/2016 12:00:00 AM

more news >>

Published Studies Related to Levophed (Norepinephrine)

Restrictive deferred hydration combined with preemptive norepinephrine infusion during radical cystectomy reduces postoperative complications and hospitalization time: a randomized clinical trial. [2014]
approach could result in reduced postoperative complication rate... CONCLUSION: A restrictive-deferred hydration combined with preemptive

Vasopressin compared with norepinephrine augments the decline of plasma cytokine levels in septic shock. [2013]
shock... CONCLUSIONS: Survivors of septic shock had greater decreases of cytokines,

Association of common variations in the norepinephrine transporter gene with response to olanzapine-fluoxetine combination versus continued-fluoxetine treatment in patients with treatment-resistant depression: a candidate gene analysis. [2012]
CONCLUSIONS: Our findings further support the hypothesis that the synergistic

The norepinephrine transporter inhibitor reboxetine reduces stimulant effects of MDMA ("ecstasy") in humans. [2011.08]
This study assessed the pharmacodynamic and pharmacokinetic effects of the interaction between the selective norepinephrine (NE) transporter inhibitor reboxetine and 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") in 16 healthy subjects...

Remission of major depressive disorder without adverse events: a comparison of escitalopram versus serotonin norepinephrine reuptake inhibitors. [2011.06]
OBJECTIVE: An antidepressant's tolerability, generally captured as the frequency and severity of adverse events (AEs), is often as important as its efficacy in determining treatment success. This study used a composite outcome - remission of major depressive disorder (MDD) without AEs - to compare the benefit-risk profiles of escitalopram versus the norepinephrine reuptake inhibitors (SNRIs) duloxetine and venlafaxine extended release (XR)... CONCLUSION: Treatment of adult MDD patients with escitalopram was significantly more likely to result in remission without concurrent AEs compared to treatment with current SNRIs. Study limitations include focus on only the initial 8 weeks of treatment and exclusion of trials for which individual patient data were not obtained.

more studies >>

Clinical Trials Related to Levophed (Norepinephrine)

Weaning of Norepinephrine Guided by the Dynamic Arterial Compliance in Cardiac Surgery Post Operative. [Recruiting]
After cardiac surgery, vasoplegic syndrome is a hemodynamic state characterized by profound hypotension associated with a decrease in systemic vascular resistance. The care of this disease is based on the intravenous administration of a vasopressor, usually norepinephrine. During the recovery phase, weaning of norepinephrine, is an important step in which any lack of preload (blood volume) initial or secondary can be, and increase tissue malperfusion.

A Pilot Trial of Phenylephrine Versus Norepinephrine for Septic Shock in Critically Ill Patients [Recruiting]
Septic shock is a condition that is marked by severe infection causing hypotension requiring vasopressors to maintain adequate perfusion to vital organs. The Surviving Sepsis campaign, an international organization formed for the purpose of guiding the management of sepsis and septic shock, currently recommends norepinephrine as the first-choice vasopressor for septic shock. Phenylephrine, a vasopressor FDA-approved for use in septic shock, is recommended as an alternative vasopressor when septic shock is complicated by tachyarrhythmia to mitigate cardiac complications. This recommendation is based solely on experience with no scientific evidence to support this recommendation. The investigators will conduct an open-label randomized controlled trial (RCT) directly comparing phenylephrine and norepinephrine, two FDA-approved vasopressors that are both used in clinical practice for the management of septic shock. The investigators will perform this study with a population of patients that have septic shock to complete the following aims: Aim 1: Determine the incidence of tachyarrhythmias. Aim 2: Determine which vasopressor, phenylephrine or norepinephrine, is associated with a lower heart rate. Aim 3: Determine which vasopressor, phenylephrine or norepinephrine, is associated with a higher incidence of new tachyarrhythmias. Aim 4: Determine which vasopressor, phenylephrine or norepinephrine, is associated with less time in tachyarrhythmia. Aim 5: Determine which vasopressor, phenylephrine or norepinephrine, is associated with fewer complications, including cardiac complications. The investigators hypothesize that in this setting, phenylephrine will improve the management of septic shock when used as a "first choice" vasopressor by: 1. Decreasing the mean heart rate 2. Decreasing the incidence of new tachyarrhythmias 3. Decreasing the amount of time spent in tachyarrhythmia for patients who develop new onset and recurrent tachyarrhythmias 4. Decreasing the number of cardiac complications

NOrepinephrine and VasoprEssin Versus Norepinephrine aLone in Critically Ill Patients With Septic Shock [Not yet recruiting]
Sepsis, a systemic host response to the invasion of a pathogenic microorganism, may progress to severe sepsis, wherein the patient experiences acute dysfunction in at least one organ system, and further develop into septic shock if the patient cannot regain adequate systemic blood pressure and perfusion after adequate and appropriate fluid resuscitation. Further prospective study of the potential mortality benefit with combination norepinephrine and vasopressin in critically ill patients with septic shock needs to be performed. Our research will resolve this essential question and improve the scientific knowledge surrounding vasoactive medications in patients with septic shock.

Exploratory Study of Topical Norepinephrine in Breast Cancer Patients Receiving Radiotherapy [Withdrawn]
This study, a nonrandomized open-label safety and exploratory study, will evaluate the safety of topical norepinephrine in post-surgical breast cancer patients who are undergoing radiation therapy. The study will also provide information about whether topical norepinephrine can prevent or decrease the severity of the radiation dermatitis experienced by these patients.

Early Use of Norepinephrine in Septic Shock Resuscitation [Recruiting]
Current septic shock guideline recommends fluid resuscitation as the first treatment. Vasopressors, including norepinephrine is recommended to start after achieve adequate fluid therapy. This can cause a certain duration of systemic hypotension before vasopressor is commenced. Initiation of norepinephrine together with fluid therapy soon after diagnosis of septic shock may increase blood pressure quicker than start treatment with intravenous fluid alone. The rapid restoration of perfusion pressure may improve septic shock outcome.

more trials >>

Page last updated: 2017-09-28

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