Norepinephrine

4 mg/4 ml ampoules (IV)

Executive Summary

(July 2, 2023)


Norepinephrine (NE) is used for hemodynamic support frequently as a first-line vasopressor with the exception of anaphylaxis (epinephrine) and post cardiac arrest care (epinephrine). Consider using noradrenaline in combination with inodilator drugs in cardiogenic shock


Adult dose for shock:
0.01-0.3 μg/kg/min IV.

Mechanism of Action and Usage

NE is an endogenous sympathomimetic catecholamine (acts as a hormone and neurotransmitter). It has alpha-1 and beta-1 adrenergic activity, causing arterial vasoconstriction (alpha-1), increased  heart rate (beta-1) and contractility (beta1), thereby increasing systemic blood pressure and coronary blood flow. Clinically alpha effects are greater than beta effects. In short, it has  inoconstrictor effects, and it also mobilizes unstressed venous blood volume.

 

The following clinical scenarios include NE for hemodynamic support:

Indications

Adult dose and Preparation

Adult dose for shock

0.01-3 μg/kg/min IV.

 

Preparation:

Pediatric dose

Pediatric dose for shock

0.05-2 ug/kg/min IV

Renal, Hepatic, and other adjustments

No adjustments needed. 

Dosage Forms and Brand Names

Cautions


Central venous access is preferred for infusion, but peripheral use is reasonably safe when taken  appropriate precautions (1, 2). Consider large veins particularly antecubital vein, and using peripheral catheters of at least 20G in caliber.

Emergency Treatment of Extravasation (7)

Pregnancy and Lactation

Pharmacology

References

® 2023 EMDrugs. All rights reserved.

contact@emdrugs.com

DISCLAIMER

This website provides general information and discussion about medications, health, and related subjects. The words and other con­tent pro­vided in this website, and in any linked mate­ri­als, are not intended and should not be con­strued as med­ical advice. If the reader or any other per­son has a med­ical con­cern, he or she should con­sult with an appropriately-licensed physi­cian or other legally accredited health care worker in the country that resides or is visiting. 

 

Please do not delay your medical concerns and potential health emergencies by searching information in this website, instead look out for medical opinion in the services that exist with that specific purpose and work under the respective local health-care regulations. 

 

The views expressed on this blog and web­site have no rela­tion to those of any academic, hospital, practice or other insti­tu­tion with which the authors are  affiliated. 

 

For other instances, the authors of this website do not have any conflict of interest with any institution or pharmaceutical company in particular, and do not receive any compensation about any licenced drug mentioned in the website. In the same matter, the website is not intended to recommend any specific patented medication.


EMDrugs Team