NITROPRESS ® (Sodium Nitroprusside Injection) is not suitable for direct injection. The solution must be further diluted in sterile 5% dextrose injection before infusion.
NITROPRESS can cause precipitous decreases in blood pressure (see DOSAGE AND ADMINISTRATION). In patients not properly monitored, these decreases can lead to irreversible ischemic injuries or death. Sodium nitroprusside should be used only when available equipment and personnel allow blood pressure to be continuously monitored.
Except when used briefly or at low (< 2 mcg/kg/min) infusion rates, sodium nitroprusside gives rise to important quantities of cyanide ion, which can reach toxic, potentially lethal levels (see WARNINGS). The usual dose rate is 0.5-10 mcg/kg/min, but infusion at the maximum dose rate should never last more than 10 minutes. If blood pressure has not been adequately controlled after 10 minutes of infusion at the maximum rate, administration of sodium nitroprusside should be terminated immediately.
Although acid-base balance and venous oxygen concentration should be monitored and may indicate cyanide toxicity, these laboratory tests provide imperfect guidance.
This package insert should be thoroughly reviewed before administration of NITROPRESS.
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NEWS HIGHLIGHTSMedia Articles Related to Nitropress (Nitroprusside Anion)
Orthostatic Hypotension
Source: MedicineNet Addison Disease Specialty [2009.06.11]
Title: Orthostatic Hypotension
Category: Diseases and Conditions
Created: 6/11/2009 12:00:00 AM
Last Editorial Review: 6/11/2009 12:00:00 AM
Low Blood Pressure (Hypotension) Pictures Slideshow
Source: MedicineNet Tilt-table Test Specialty [2008.07.30]
Title: Low Blood Pressure (Hypotension) Pictures Slideshow
Category: Slideshows
Created: 7/29/2008 12:00:00 AM
Last Editorial Review: 7/30/2008 12:00:00 AM
Published Studies Related to Nitropress (Nitroprusside Anion)
Efficacy and safety of oral propranolol premedication to reduce reflex tachycardia during hypotensive anesthesia with sodium nitroprusside in orthognathic surgery: a double-blind randomized clinical trial. [2010.01]
PURPOSE: The present study sought to determine whether premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside could reduce reflex tachycardia, the amount of sodium nitroprusside used, and blood loss during hypotensive anesthesia for orthognathic surgery... CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside is safe and effective to reduce reflex tachycardia and the amount of sodium nitroprusside used.
Efficacy and safety of oral propranolol premedication to reduce reflex
tachycardia during hypotensive anesthesia with sodium nitroprusside in
orthognathic surgery: a double-blind randomized clinical trial. [2010]
loss during hypotensive anesthesia for orthognathic surgery... CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive
Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction. [2009.11.20]
BACKGROUND: No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI... CONCLUSION: Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis.
Blood loss and endocrine responses in hypotensive anaesthesia with sodium nitroprusside and nitroglycerin for mandibular osteotomy. [2009.11]
The purpose of this study was to determine the differences in endocrine responses, blood loss and arterial blood gas profiles between patients subjected to hypotensive anaesthesia or normotensive anaesthesia and those between patients given sodium nitroprusside (SNP) or nitroglycerin (NTG) as the hypotensive agent...
Randomized evaluation of intracoronary nitroprusside vs. adenosine after thrombus aspiration during primary percutaneous coronary intervention for the prevention of no-reflow in acute myocardial infarction: the REOPEN-AMI study protocol. [2009.07]
CONCLUSIONS: REOPEN-AMI will provide important data on the efficacy and safety of intracoronary nitroprusside and adenosine as an adjunctive treatment to percutaneous coronary intervention after thrombus aspiration for patients with acute myocardial infarction.
Clinical Trials Related to Nitropress (Nitroprusside Anion)
Safety Study of Nebulized Sodium Nitroprusside in Adult Acute Lung Injury [Recruiting]
Acute lung injury (ALI) is caused by a wide variety of conditions, but always characterized
by hypoxia and non-cardiogenic pulmonary edema. Current treatment of ALI is supportive and
treatment of the underlying cause. New therapies to treat severe ALI have not been shown to
improve survival, and are limited by financial and logistical resources.
The investigators propose to investigate the role of inhaled sodium nitroprusside (iSNP) in
ALI. Sodium nitroprusside (SNP) is a vasodilator. When inhaled, SNP may travel to areas of
the lung participating in gas exchange, and cause the blood vessels surrounding these areas
to enlarge. This may result in an increase of blood vessels to these areas of the lung, and
improve oxygenation. Currently, iSNP has not been studied in the adult population.
Therefore, this study is intended to find the safety profile of varying doses of iSNP.
Sodium Nitroprusside for Blood Pressure Reduction in the ICU [Recruiting]
Nitroprusside is used commonly in the Intensive Care Unit for long periods of time in order
to reduce blood pressure. It is not known if the body compensates over time to the blood
pressure lowering, and if when the nitroprusside is stopped the blood pressure goes up at a
faster rate and is higher than it was at the start of the treatment. This study will answer
these questions.
Clinical Study Investigating the Effect of Sodium Nitroprusside Infusion on Thyroidal Function [Recruiting]
Whether use of SNP during cardiac surgery has any effect on thyroid function has not yet
been investigated in humans. The aim of this study was to investigate the effects of SNP
administration during the rewarming period of cardiac operations on circulating levels of
thyroid hormones.
Study Evaluating the Use of Vasodilators to Reduce Infarct Size and Microvascular Obstruction in ST-elevation MI [Recruiting]
The purpose of this study is to determine whether intra-coronary adenosine or sodium
nitroprusside (SNP) delivered selectively via a thrombus aspiration catheter (or if
unsuccessful via a coronary microcatheter) following thrombus aspiration in Primary
Percutaneous Coronary Intervention (P-PCI) reduces microvascular obstruction (MVO)
parameters and infarct size as measured with cardiac MRI, compared with standard treatment
following thrombus aspiration in patients presenting with ST-elevation myocardial infarction
(STEMI).
Dose-Response Study of Sodium Nitroprusside in Children Requiring Controlled Hypotension in the Operating Room [Recruiting]
Sodium nitroprusside (SNP) has been approved for control of blood pressure in adults, yet
there are no controlled studies in children. The purpose of this study is to determine the
efficacy and safety of sodium nitroprusside in children who will be having surgery, and who
require blood pressure lowering in order to decrease the amount of blood loss during their
surgery.
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