Drug Notebook

FDA Alerts

Thoroughly review the package insert before administration.

    Dilution
  • After reconstitution, sodium nitroprusside is notsuitable for direct injection; must be diluted further with 5% dextrose injection before infusion.
  • Acid-base balance and venous oxygen concentrations should be monitored and may indicate cyanide toxicity; these tests alone should not be relied upon to guide therapy.

    Hypotension
  • Can produce precipitous decreases in blood pressure; profound hypotension can lead to irreversible ischemic injury or death.
  • Administer in a setting with equipment and personnel available to continuously monitor blood pressure.

    Cyanide Intoxication
  • Administration (except when used for short periods of time or at low infusion rates [e.g., ≤2 mcg/kg per minute or slower]) can result in the production of clinically important levels of cyanide ion, which can reach toxic or potentially lethal concentrations.
  • Infusions at the maximum recommended rate of 10 mcg/kg per minute should never last longer than 10 minutes; if after 10 minutes the blood pressure has not been adequately controlled, the infusion should be immediately discontinued.

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nitroprusside
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(nye troe PRUS ide)

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 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 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.

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.

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