Nesiritide
- Atc Codes:C01DX19
- CAS Codes:124584-08-3#189032-40-4
- PHARMGKB ID:124584-08-3#189032-40-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
North America
Canada: Natrecor; USA: Natrecor.
Latin America
Argentina: Natrecor.
Drug combinations
Chemistry
Nesiritide: C~143~H~244~N~50~O~42~S~4~. Mw: 3464. (1) Natriuretic factor-32 (human brain clone λhBNP57); (2) L-Seryl-L-prolyl-L-lysyl-L-methionyl-L-valyl-L-glutaminylglycyl-L-serylglycyl-L-cysteinyl-L-phenylalanylglycyl-L-arginyl-L-lysyl-L-methionyl-L-aspartyl-L-arginyl-L-isoleucyl-L-seryl-L-seryl-L-seryl-L-serylglycyl-L-leucylglycyl-L-cysteinyl-L-lysyl-L-valyl-L-leucyl-L-arginyl-L-arginyl-L-histidine cyclic (10→26)-disulfide. CAS-124584-08-3 (1998).
Nesiritide Citrate: C~143~H~244~N~50~O~42~S~4~ xC~6~H~8~O~7~. Natriuretic factor-32 (human brain clone λhBNP57), 2-hydroxy-1,2,3-propanetricarboxylate. CAS-189032-40-4 (1998).
Pharmacologic Category
Vasodilating Agents, Miscellaneous; Human B-type Natriuretic Peptide. (ATC-Code: C01DX19).
Mechanism of action
Binds to guanylate cyclase receptor on vascular smooth muscle and endothelial cells, increasing intracellular cyclic GMP, resulting in smooth muscle cell relaxation. Has been shown to produce dose-dependent reductions in pulmonary capillary wedge pressure and systemic arterial pressure.
Therapeutic use
Treatment of acutely decompensated congestive heart failure in dyspnea at rest or with minimal activity.
Pregnancy and lactiation implications
Use with caution in pregnant and nursing women.
Unlabeled use
Contraindications
Hypersensitivity to natriuretic peptide or any component of the formulation. Cardiogenic shock (when used as primary therapy). Hypotension (systolic blood pressure <90 mm Hg).
Warnings and precautions
Prepared through recombinant technology using E. coli (allergic or anaphylactic reactions might occur). May cause hypotension (use caution in systolic blood pressure <100 mm Hg (contraindicated if <90 mm Hg)); effects may be additive with other agents capable of causing hypotension. May be associated with development of azotemia (use caution in renal impairment or where renal perfusion dependent on renin-angiotensin-aldosterone system (e.g. severe heart failure)). Should not be used in low cardiac filling pressures, or in conditions which depend on venous return including significant valvular stenosis, restrictive or obstructive cardiomyopathy, constrictive pericarditis, and pericardial tamponade. Use with caution in renal impairment. Use caution with prolonged infusions.