Nitroprusside

Generic Name: nitroprusside (nye troe PRUS ide)Brand Names: Nitropress

What is nitroprusside?

Nitroprusside is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries.

Nitroprusside is used to treat congestive heart failure and life-threatening high blood pressure (hypertension). Nitroprusside is also used to keep blood pressure low during a surgery.

Nitroprusside may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about nitroprusside?

You should not receive this medication if you are allergic to nitroprusside, or if you have hereditary vision loss (Leber's disease), vision problems caused by smoking, or a history of blood clot in your brain.

Before receiving nitroprusside, tell your doctor if you have high blood pressure (hypertension), liver disease, anemia (a lack of red blood cells), a seizure disorder, or a history of head injury or brain tumor.

Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a nitroprusside overdose may include nausea, vomiting, stomach pain, sweating, severe dizziness, headache, muscle twitching, fast or pounding heartbeat, restless feeling, and chest or back pain.

Tell your caregivers right away about any serious side effects such as breathing problems, tremors or chills, numbness or cold feeling in your hands or feet, easy bruising, unusual bleeding, muscle pain or weakness, confusion, feeling extremely light-headed, or fainting.

What should I discuss with my health care provider before receiving nitroprusside?

You should not receive this medication if you are allergic to nitroprusside, or if you have:
  • hereditary vision loss (Leber's disease);

  • vision problems caused by smoking; or

  • a history of blood clot in your brain.

Before receiving nitroprusside, tell your doctor if you are allergic to any drugs, or if you have:

  • high blood pressure (hypertension);

  • liver disease;

  • anemia (a lack of red blood cells);

  • epilepsy or other seizure disorder; or

  • a history of head injury or brain tumor.

If you have any of these conditions, you may not be able to receive nitroprusside, or you may need dosage adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Nitroprusside may pass into breast milk and could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How should I take nitroprusside?

Nitroprusside is given as an injection through a needle placed into a vein. An infusion pump is used to inject nitroprusside, to assure that you do not receive the medicine too quickly.

You will receive this injection in a clinic or hospital setting. Nitroprusside is usually given for as long as needed until your body responds to the medication.

To be sure nitroprusside is not causing harmful effects, your blood pressure will need to be checked during the entire time you are receiving this medication.

See also: Nitroprusside dosage in more detail

What happens if I miss a dose?

Since nitroprusside is usually given as needed in a hospital setting, it is not likely that you will miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a nitroprusside overdose may include nausea, vomiting, stomach pain, sweating, severe dizziness, headache, muscle twitching, fast or pounding heartbeat, restless feeling, and chest or back pain.

What should I avoid while receiving nitroprusside?

Follow your doctor's instructions about any restrictions in food, beverages, activities, or other medications after treatment with nitroprusside.

Nitroprusside side effects

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 any of these serious side effects:
  • feeling extremely light-headed, even while lying down;

  • confusion, ringing in your ears;

  • fainting, breathing that stops;

  • gasping or struggling to breathe;

  • dizziness with nausea and vomiting, confusion, rapid breathing, and seizure;

  • tremors, chills, bowel or bladder urgency;

  • fast, slow, or uneven heart rate;

  • easy bruising or bleeding; or

  • muscle pain or weakness, numb or cold feeling in your arms and legs.

Less serious side effects may be more likely to occur, such as:

  • skin rash;

  • warmth, redness, or tingly feeling under your skin;

  • darkening or deeper color of veins through your skin; or

  • pain or irritation where the needle is placed.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Nitroprusside Dosing Information

Usual Adult Dose for Hypertensive Emergency:

Initial dose: 0.3 mcg/kg/min IBW administered by continuous IV infusion.Maintenance dose: The dose may be titrated upward to a maximum of 10 mcg/kg/min IBW.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 10 to 15 mcg/min administered by continuous IV infusion.Maintenance dose: The dose may be titrated to 10 to 200 mcg/min. Maximum dose: 280 mcg/min (4 mcg/kg/min).

What other drugs will affect nitroprusside?

Before receiving nitroprusside, tell your doctor if you take any blood pressure medications. You may not be able to receive nitroprusside, or you may need dosage adjustments or special tests during treatment.

There may be other drugs that can affect nitroprusside. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist has information about nitroprusside written for health professionals that you may read.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.03. Revision Date: 4/12/2009 4:36:05 PM.
  • Nitropress Prescribing Information (FDA)