Brand and Other Names:Natrecor
- Classes: Cardiovascular, Other
Dosing & Uses
Dosage Forms & Strengths
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Hypotension (4-35% )
Serum creatinine raised (17-28% )
Nausea (4-13% )
Ventricular tachycardia (3-10% )
Headache (7-9% )
Dizziness (3-6% )
Insomnia (2- 6% )
Back pain (4%)
Ventricular premature beats (3-4% )
Atrial fibrillation (1% or greater )
Atrioventricular node (1% or greater )
Death, Increased risk
Risk of azotemia in pts with renal impairment
Atrial/ventricular arrhythmias, constrictive pericarditis, restrictive or obstructive cardiomyopathy, pericardial tamponade, significant valvular stenosis, suspected low cardiac filling pressures
Primary Tx for pts with cardiogenic shock
Systolic BP <90
Potential for nephrotoxicity
Use only in hospital setting
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted into breast milk, use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Half-Life: 18-23 min
Hemodynamic effect: IV bolus: 2-4 hr, IV infusion: 0.5-2 hr
Diuretic effect: IV infusion: 60 min
Hemodynamic effect: initial effect: 15-30 min, max effect: 60 min
Diuretic effect: 30-60 min
Peak Plasma Time: 90-120 min
Vd: 0.19 L/kg
Metabolism: by neutral endopeptidases in proximal tubule brush border in the kidney
Mechanism of Action
Recombinant human B-type natriuretic peptide; incr cGMP in vascular smooth muscle resulting in vasodilation, reduce pulmonary capillary wedge pressure (PCWP)
No effect on cardiac contractility
Reconstitute 1.5 mg vial with 5 mL of diluent removed from a premixed plastic IV bag; mix gently; add contents of vial to a 250 mL IV bag. Allowable diluents include D5W, NS, D5/0.5NS. Makes ~6 mcg/mL
No preservatives - use within 24 hr. May be stored in fridge or room temp for 24 hr
- Must be drawn from prepared infusion bag
- Prime IV tube with 5 mL infusion soln prior to bolus or infusion
- Withdraw bolus amount from infusion bag & administer over 1 min thru IV port
- Immediately following bous, start infusion at 0.01 mcg/kg/min (0.1 mL/kg/hr)
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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