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 are the possible side effects of nitroprusside?

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.

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.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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