Products
Norepinephrine is commercially available as a solution for injection in many countries. It is also known as norepinephrine.
Structure and properties
Norepinephrine (C8H11NO3, Mr = 169.2 g/mol) is a demethylated epinephrine. It is present in drugs as noradrenaline tartrate, a white crystalline powder that is readily soluble in water.
Effects
Norepinephrine (ATC C01CA03) has sympathomimetic and potent vasoconstrictor properties. It constricts blood vessels, increases blood pressure, and promotes cardiac contractility. The effects are due to binding to alpha and beta adrenoceptors.
Indications
As an emergency medication to increase blood pressure in acute hypotensive states in shock, after cardiac arrest, and for resuscitation.
Dosage
According to the SmPC. The drug is administered as an infusion.
Contraindications
- Norepinephrine should not be combined with cyclopropane or halogenated hydrocarbon anesthetics because cardiac arrhythmias may occur.
For complete precautions, see the drug label.
Interactions
Norepinephrine is biotransformed by catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO). Drug interactions have been described with beta-blockers, anesthetics, atropine, antidepressants, antihistamines, ergot alkaloids, methyldopa, guanethidine, furosemide, and diuretics.
Adverse effects
Possible adverse effects include headache, dizziness, tremor, difficulty breathing, lightheadedness, weakness, pallor, chest pain, restlessness, anxiety, and insomnia. Norepinephrine is highly vasoconstrictive and can reduce blood flow to organs and cause ischemia and necrosis. Other possible side effects include palpitations, a low or high pulse, and arrhythmias.
