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(sodium nitroprusside) Injection, Solution, Concentrate
NITROPRESS ® (Sodium Nitroprusside Injection) is not suitable for direct injection. The solution must be further diluted in sterile 5% dextrose injection before infusion.
NITROPRESS (nitroprusside sodium) 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 (nitroprusside sodium) .
Sodium nitroprusside is disodium pentacyanonitrosylferrate(2-) dihydrate, an inorganic hypotensive agent whose structural formula is
whose molecular formula is Na2[Fe(CN)5NO]• 2H2O, and whose molecular weight is 297.95. Dry sodium nitroprusside is a reddish-brown powder, soluble in water. In an aqueous solution infused intravenously, sodium nitroprusside is a rapid-acting vasodilator, active on both arteries and veins.
Sodium nitroprusside solution is rapidly degraded by trace contaminants, often with resulting color changes. (See DOSAGE AND ADMINISTRATION section.) The solution is also sensitive to certain wavelengths of light, and it must be protected from light in clinical use.
NITROPRESS (Sodium Nitroprusside Injection) is available as:
50 mg Fliptop Vial - Each 2 mL vial contains the equivalent of 50 mg sodium nitroprusside dihydrate in sterile water for injection.
What are the possible side effects of nitroprusside (Nitropress)?
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;...
Last reviewed on RxList: 4/7/2009
This monograph has been modified to include the generic and brand name in many instances.
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