Norepinephrine (Noradrenaline)
- Atc Codes:C01CA03
- CAS Codes:69815-49-2#51-40-1#51-41-2
- PHARMGKB ID:69815-49-2#51-40-1#51-41-2
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
Brand Names
Europe
Belgium: Levophed; Czech Republic: Noradrenalin; France: Noradrenaline; Germany: Arterenol; Greece: Levophed, Noradren, Noradrenaline; Ireland: Noradrenaline; Italy: Noradr Con; Luxembourg: Levophed; Malta: Noradrenaline; Netherlands: Norepinefrine; Poland: Levonor; Portugal: Noradrenalina; Romania: Noradrenaline; Slovakia: Noradrenalin; Sweden: Noradrenalin; Spain: Noradrenalina, Norages; UK: Noradrenaline.
North America
Canada: Levophed, Norepinephrine; USA: Levophed, Norepinephrine.
Latin America
Argentina: Fioritina, Noradrenalina, Norepinefrina; Brazil: Levophed; Mexico: Pridam.
Asia
Japan: Nor-Adrenalin.
Drug combinations
Norepinephrine and Lidocaine
Chemistry
Norepinephrine Bitartrate: C~8~H~11~NO~3~ C~4~H~6~O~6~ H~2~O. Mw: 337.28. (1) 1,2-Benzenediol, 4-(2-amino-1-hydroxyethyl)-, (R)-[R-(R*,R*)]-2,3-dihydroxybutanedioate (1:1), monohydrate; (2)(-)-α-(Aminomethyl)-3,4-dihydroxybenzyl alcohol tartrate (1:1) monohydrate. CAS-69815-49-2; CAS-51-40-1 (anhydrous); CAS-51-41-2 (norepinephrine)(1980).
Pharmacologic Category
Sympathomimetic (Adrenergic) Agents; α- and β-Adrenergic Agonists. (ATC-Code: C01CA03).
Mechanism of action
Stimulates β~1~-adrenergic receptors and α-adrenergic receptors, causing increased contractility and heart rate as well as vasoconstriction, thereby increasing systemic blood pressure and coronary blood flow. Clinically α-effects (vasoconstriction) are greater than β-effects (inotropic and chronotropic effects).
Therapeutic use
Treatment of shock which persists after adequate fluid volume replacement.
Pregnancy and lactiation implications
Use with caution in pregnant and nursing women.
Unlabeled use
Contraindications
Hypersensitivity to norepinephrine, bisulfites (contains metabisulfite), or any component of the formulation. Hypotension from hypovolemia except as emergency measure to maintain coronary and cerebral perfusion until volume can be replaced. Mesenteric or peripheral vascular thrombosis unless a lifesaving procedure. During anesthesia with cyclopropane or halothane anesthesia (risk of ventricular arrhythmias).
Warnings and precautions
Use with extreme caution in patients taking MAOIs (prolonged hypertension may result). Product may contain sodium metasulfite. Avoid hypertension. Avoid extravasation.