noradrenaline acid

CLINICAL USE

Hypotension Cardiac arrest (sympathomimetic)

DOSE IN NORMAL RENAL FUNCTION

(Doses expressed as noradrenaline acid tartrate)Acute hypotension: 80 mcg/mL solution, initially 0.16–0.33 mL/minute; adjust according to responseCardiac arrest: 200 mcg/mL solution, 0.5–0.75 mL

PHARMACOKINETICS

Molecular weight :337.3

%Protein binding :~50

%Excreted unchanged in urine : ~16

Volume of distribution (L/kg) :0.09–0.4

half-life – normal/ESRD (hrs) :1 minute/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAdrenergic neurone blockers: antagonise hypotensive effect

Antidepressants: tricyclics may cause hypertension and arrhythmias; MAOIs and moclobemide may cause hypertensive crisis

Beta-blockers: can cause severe hypertension

Clonidine: possibly increased risk of hypertension

Dopaminergics: effects possibly increased by entacapone; avoid concomitant use with rasagiline

Sympathomimetics: effects possibly enhanced by dopexamine

ADMINISTRATION

Reconstition

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Route

Rate of Administration

According to response

Comments

Preferably give centrally (low pH) Dilute 1–4 mg in 100 mL glucose 5% Can be given undiluted

OTHER INFORMATION

Do not mix with alkaline drugs/solutions The pharmacokinetics of noradrenaline are not significantly affected by renal or hepatic diseasenoradrenaline acid tartrate (norepinephrine bitartrate).

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