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Nitroprusside: Drug information

Nitroprusside: Drug information
2024© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Nitroprusside: Patient drug information" and "Nitroprusside: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Appropriate administration:

Nitropress: After reconstitution, nitroprusside is not suitable for direct injection. The reconstituted solution must be further diluted in dextrose 5% injection before infusion.

Hypotension:

Nitroprusside can cause precipitous decreases in blood pressure. In patients not properly monitored, these decreases can lead to irreversible ischemic injuries or death. Use only when available equipment and personnel allow blood pressure to be continuously monitored.

Cyanide toxicity:

Except when used briefly or at low (less than 2 mcg/kg/min) infusion rates, nitroprusside injection gives rise to important quantities of cyanide ion, which can reach toxic, potentially lethal levels. The usual dose rate is 0.5 to 10 mcg/kg/min, but infusion at the maximum dose rates should never last more than 10 minutes. If blood pressure has not been adequately controlled after 10 minutes of infusion at the maximum rate, terminate administration immediately. Although acid-base balance and venous oxygen concentration should be monitored and may indicate cyanide toxicity, these laboratory tests provide imperfect guidance.

Brand Names: US
  • Nipride RTU;
  • Nitropress [DSC]
Brand Names: Canada
  • Nipride
Pharmacologic Category
  • Antihypertensive;
  • Vasodilator
Dosing: Adult

Note: Safety: Use may be limited due to risk for cyanide and thiocyanate toxicity, which is increased with higher doses (eg, >2 mcg/kg/minute) and/or prolonged duration of use, especially in patients with kidney or hepatic impairment. Invasive blood pressure monitoring, preferably via arterial line in a critical care unit, is recommended for appropriate dose titration.

Acute aortic syndromes/acute aortic dissection

Acute aortic syndromes/acute aortic dissection (adjunctive agent) (off-label use):

Note: Manage patients on an emergency basis (including operative assessment) by first controlling pain with IV opioids and heart rate (target 60 to 80 beats per minute) with a parenteral beta blocker (eg, esmolol) while targeting systolic BP of <120 mm Hg (or lowest tolerated pressure without compromising perfusion). If systolic BP remains elevated after heart rate is controlled at 60 to 80 beats per minute with beta-blockade, may consider adding a vasodilator (eg, nitroprusside) (Ref).

Continuous infusion: IV: Initial: 0.25 to 0.5 mcg/kg/minute; titrate as needed by 0.5 mcg/kg/minute every 5 minutes to achieve desired hemodynamic effect; maximum dose: 10 mcg/kg/minute. Higher doses (eg, 8 to 10 mcg/kg/minute) should only be used for a maximum of 10 minutes; use for the shortest duration possible to avoid toxicity (Ref).

Acute decompensated heart failure

Acute decompensated heart failure (adjunctive agent):

Note: May consider in patients with volume overload in the absence of symptomatic hypotension to help relieve congestion and dyspnea as an adjunct to IV diuretics (Ref).

Continuous infusion: IV: Initial: 0.1 to 0.3 mcg/kg/minute; titrate as needed every 5 to 15 minutes to achieve desired hemodynamic effect; usual dosage range: 1 to 3 mcg/kg/minute; maximum dose: 5 mcg/kg/minute for an 80 kg patient (Ref).

Acute ischemic stroke, BP management with reperfusion therapy

Acute ischemic stroke, BP management with reperfusion therapy (off-label use):

Note: During and 24 hours after reperfusion therapy, maintain a target BP of ≤180/105 mm Hg; reserve nitroprusside for hypertension that is refractory to first-line agents or diastolic BP >140 mm Hg (Ref).

Continuous infusion: IV: Initial: 0.25 to 0.5 mcg/kg/minute; titrate by 0.5 mcg/kg/minute every 5 minutes. Maximum dose: 10 mcg/kg/minute (for a maximum of 10 minutes); consider a maximum dose of 2 mcg/kg/minute to avoid toxicity (Ref).

Hypertensive emergency

Hypertensive emergency:

Note: Consider for use when preferred agents with less toxicity are unavailable. In general, reduce mean arterial blood pressure gradually by ~10% to 20% over the first hour, then by an additional 5% to 15% over the next 23 hours, unless there is a compelling indication for more rapid blood pressure and heart rate control (eg, acute aortic dissection) (Ref).

Continuous infusion: IV: Initial: 0.25 to 0.5 mcg/kg/minute; titrate as needed by 0.5 mcg/kg/minute every 5 minutes to achieve the target blood pressure; to avoid toxicity, limit dose to ≤2 mcg/kg/minute if possible; maximum dose: 10 mcg/kg/minute. Higher doses (eg, 8 to 10 mcg/kg/minute) should only be used for a maximum of 10 minutes; use for the shortest duration possible to avoid toxicity (Ref).

Dosing: Kidney Impairment: Adult

Use in patients with kidney impairment may lead to the accumulation of thiocyanate and subsequent toxicity; limit use.

eGFR <30 mL/minute/1.73 m2: Limit mean infusion rate to <3 mcg/kg/minute.

Anuric patients: Limit mean infusion rate to 1 mcg/kg/minute.

Dosing: Hepatic Impairment: Adult

No dosage adjustment provided in manufacturer's labeling; due to the risk of cyanide toxicity, use with caution.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Nitroprusside: Pediatric drug information")

Note: Increased infusion rates and prolonged use have been associated with increased cyanide concentrations and cyanide toxicity; monitor cyanide levels with prolonged use (eg, >72 hours); coadministration with sodium thiosulfate is recommended (Ref):

Hypertension, acute including hypertensive crisis

Hypertension, acute including hypertensive crisis: Infants, Children, and Adolescents: Continuous IV infusion: Initial: 0.3 to 0.5 mcg/kg/minute; titrate every 5 minutes to desired effect; usual dose: 3 mcg/kg/minute; maximum dose: 10 mcg/kg/minute (Ref).

Cardiac output maintenance/stabilization, postresuscitation

Cardiac output maintenance/stabilization, postresuscitation: Limited data available:

Infants, Children, and Adolescents: Continuous IV infusion: Initial: 0.3 to 1 mcg/kg/minute; titrate to desired effect; maximum dose: 8 mcg/kg/minute (Ref).

Dosing: Kidney Impairment: Pediatric

Infants, Children, and Adolescents: Use in patients with renal impairment may lead to the accumulation of thiocyanate and subsequent toxicity; limit use and monitor thiocyanate blood concentrations:

eGFR <30 mL/minute/1.73 m2: Limit mean infusion rate to <3 mcg/kg/minute.

Anuric patients: Limit mean infusion rate to 1 mcg/kg/minute.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; due to the risk of cyanide toxicity, use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.

Cardiovascular: Bradycardia, ECG changes, flushing, palpitations, severe hypotension, substernal pain, tachycardia

Central nervous system: Apprehension, dizziness, headache, increased intracranial pressure, restlessness

Dermatologic: Diaphoresis, localized erythematous streaking, skin rash

Endocrine & metabolic: Hypothyroidism

Gastrointestinal: Abdominal pain, intestinal obstruction, nausea, retching

Hematologic & oncologic: Decreased platelet aggregation, methemoglobinemia

Local: Irritation at injection site

Neuromuscular & skeletal: Muscle twitching

Contraindications

Treatment of compensatory hypertension (aortic coarctation, arteriovenous shunting); to produce controlled hypotension during surgery in patients with known inadequate cerebral circulation or in moribund patients (A.S.A. Class 5E) requiring emergency surgery; acute heart failure associated with reduced systemic vascular resistance (eg, septic shock); congenital (Leber's) optic atrophy or tobacco amblyopia; concomitant use with avanafil, sildenafil, tadalafil, vardenafil, or riociguat

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Canadian labeling: Additional contraindication (not in US labeling): Hypersensitivity to nitroprusside or any component of the formulation; uncorrected anemia or hypovolemia; hepatic disease; severe kidney disease; disease states associated with vitamin B12 deficiency

Warnings/Precautions

Concerns related to adverse effects:

• Cyanide toxicity: [US Boxed Warning]: Except when used briefly or at low (<2 mcg/kg/minute) infusion rates, nitroprusside gives rise to large cyanide quantities. Do not use the maximum dose for more than 10 minutes; if blood pressure is not controlled by the maximum rate (ie, 10 mcg/kg/minute) after 10 minutes, discontinue infusion. Monitor for cyanide toxicity via acid-base balance and venous oxygen concentration; however, clinicians should note that these indicators may not always reliably indicate cyanide toxicity. Patients at risk of cyanide toxicity include those who are malnourished, have hepatic impairment, or those undergoing cardiopulmonary bypass, or therapeutic hypothermia (Rindone 1992). Discontinue use of nitroprusside if signs and/or symptoms of cyanide toxicity (eg, metabolic acidosis, decreased oxygen saturation, bradycardia, confusion, convulsions) occur. Although not routinely done, sodium thiosulfate has been co-administered with nitroprusside using a 10:1 ratio of sodium thiosulfate to nitroprusside when higher doses of nitroprusside are used (eg, 4 to 10 mcg/kg/minute) for extended periods of time in order to prevent cyanide toxicity (Shulz 2010; Varon 2008); thiocyanate toxicity may still occur with this approach (Rindone 1992). The use of other agents (eg, clevidipine, labetalol, nicardipine) should be considered if blood pressure is not controlled with nitroprusside.

• Hypotension: [US Boxed Warning]: Excessive hypotension resulting in compromised perfusion of vital organs may occur; continuous blood pressure monitoring by experienced personnel is required.

• Increased intracranial pressure: Use may elevate intracranial pressure; in patients whose intracranial pressure is already elevated, use only with extreme caution.

Methemoglobinemia: Nitroprusside can cause a dose-dependent conversion of hemoglobin to methemoglobin. Methemoglobinemia should be suspected in any patient receiving >10 mg/kg of nitroprusside and exhibiting signs of impaired oxygen delivery despite adequate cardiac output and arterial pO2. Symptomatic patients, regardless of methemoglobin level should be treated with methylene blue (first-line). Treatment is suggested if level is ≥30% even if asymptomatic unless patient has a preexisting condition (eg, coronary artery disease) and are incapable of tolerating reductions in oxygen carrying capacity then treatment is suggested if level reaches 10% (Cortazzo 2013).

• Thiocyanate toxicity: Can occur in patients with kidney impairment or those on prolonged infusions (ie, >3 mcg/kg/minute for >72 hours).

Disease-related concerns:

• Anemia: When nitroprusside is used for controlled hypotension during surgery, correct pre-existing anemia prior to use when possible.

• Hepatic impairment: Use with extreme caution in patients with hepatic impairment.

• Hypovolemia: When nitroprusside is used for controlled hypotension during surgery, correct pre-existing hypovolemia prior to use when possible.

• Kidney impairment: Use with extreme caution in patients with kidney impairment; use the lowest end of the dosage range; monitor thiocyanate concentrations closely.

• Myocardial infarction: Use caution in patients with acute myocardial infarction because of hemodynamic effects and possible coronary steal.

Other warnings/precautions:

• Appropriate administration: Nitropress: [US Boxed Warning]: Solution must be further diluted with 5% dextrose in water. Do not administer by direct injection.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Intravenous, as sodium:

Nipride RTU: 20 mg/100 mL in NaCl 0.9% (100 mL)

Nitropress: 25 mg/mL (2 mL [DSC])

Generic: 25 mg/mL (2 mL); 50 mg/2 mL (2 mL)

Solution, Intravenous, as sodium [preservative free]:

Nipride RTU: 50 mg/100 mL in NaCl 0.9% (100 mL)

Generic: 25 mg/mL (2 mL); 20 mg/100 mL in NaCl 0.9% (100 mL); 50 mg/100 mL in NaCl 0.9% (100 mL)

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Nipride RTU Intravenous)

20 mg/100 mL 0.9% (per mL): $0.54

50 mg/100 mL 0.9% (per mL): $0.66

Solution (Nitroprusside Sodium Intravenous)

25 mg/mL (per mL): $9.75 - $161.82

Solution (Nitroprusside Sodium-NaCl Intravenous)

20 mg/100 mL 0.9% (per mL): $0.43

50 mg/100 mL 0.9% (per mL): $0.53

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous, as sodium:

Nipride: 25 mg/mL (2 mL)

Generic: 25 mg/mL (2 mL)

Administration: Adult

IV: IV infusion only; infusion pump required. Due to potential for excessive hypotension, continuously monitor patient’s blood pressure during therapy. Product should always be protected from light, even during administration.

Administration: Pediatric

Parenteral: Administer as a continuous IV infusion via infusion pump. Solution should be protected from light, but not necessary to wrap administration set or IV tubing.

Concentrated solution (25 mg/mL): Not for direct injection; must dilute prior to administration.

Premixed solutions (200 mcg/mL, 500 mcg/mL): No further dilution required.

Usual Infusion Concentrations: Adult

IV infusion: 50 mg in 250 mL (concentration: 200 mcg/mL) or 100 mg in 250 mL (concentration: 400 mcg/mL) of D5W

Usual Infusion Concentrations: Pediatric

Note: Premixed solutions available.

IV infusion: 100 mcg/mL or 200 mcg/mL.

Use: Labeled Indications

Acute decompensated heart failure: Management of acute decompensated heart failure.

Hypertensive emergency: Management of hypertensive crises; used for controlled hypotension to reduce bleeding during surgery.

Use: Off-Label: Adult

Acute aortic syndromes/acute aortic dissection; Acute ischemic stroke, BP management with reperfusion therapy

Medication Safety Issues
Sound-alike/look-alike issues:

Nitroprusside may be confused with nitroglycerin

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Blood Pressure Lowering Agents: May enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Dapsone (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Iloperidone: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Isocarboxazid: May enhance the antihypertensive effect of Antihypertensive Agents. Risk X: Avoid combination

Local Anesthetics: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitric Oxide: May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Nitroprusside. Risk X: Avoid combination

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prilocaine: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor for signs of methemoglobinemia when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid use of these agents with prilocaine/lidocaine cream in infants less than 12 months of age. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Riociguat: May enhance the hypotensive effect of Nitroprusside. Risk X: Avoid combination

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Nitrite: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Pregnancy Considerations

Animal studies have shown that nitroprusside may cross the placental barrier and result in fetal cyanide levels that are dose-related to maternal nitroprusside levels. However, information related to use in pregnancy is limited.

Breastfeeding Considerations

It is not known if nitroprusside is present in breast milk. Due to the potential for serious adverse reactions in the breastfed infant, a decision should be made whether to discontinue breastfeeding or to discontinue the drug, taking into account the importance of treatment to the mother.

Monitoring Parameters

Blood pressure via arterial line and heart rate (cardiac monitor and blood pressure monitor required) (Friedrich 1995); monitor for cyanide and thiocyanate toxicity; monitor venous oxygen saturation; monitor acid-base status as acidosis can be the earliest sign of cyanide toxicity; monitor thiocyanate levels if requiring prolonged infusion (>3 days) or dose >3 mcg/kg/minute or patient has kidney dysfunction; monitor cyanide blood levels (if available with appropriate turnaround time) in patients with decreased hepatic function

Consult individual institutional policies and procedures.

Reference Range

Serum thiocyanate levels are not helpful in detecting toxicity. A level may be confirmatory if a patient is exhibiting signs and symptoms of thiocyanate toxicity. Initial signs of toxicity (eg, tinnitus) may be observed at levels >35 mcg/mL (SI: >602 micromole/L) (manufacturer suggests 60 mcg/mL [SI: 1,032 micromole/L]), but serious toxicity typically may not occur with levels <100 mcg/mL (SI: <1,720 micromole/L).

Mechanism of Action

Causes peripheral vasodilation by direct action on venous and arteriolar smooth muscle, thus reducing peripheral resistance; will increase cardiac output by decreasing afterload; reduces aortal and left ventricular impedance

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Hypotensive effect: <2 minutes

Duration: Hypotensive effect: 1-10 minutes

Metabolism: Nitroprusside combines with hemoglobin to produce cyanide and cyanmethemoglobin. Cyanide detoxification occurs via rhodanase-mediated conversion of cyanide to thiocyanate; rhodanase couples cyanide molecules to sulfane sulfur groups from a sulfur donor (eg, thiosulfate, cystine, cysteine). This process has limited capacity and may become overwhelmed with large exposures once sulfur donor supplies are exhausted resulting in toxicity.

Half-life elimination: Nitroprusside, circulatory: ~2 minutes; Thiocyanate, elimination: ~3 days (may be doubled or tripled in renal failure)

Excretion: Urine (as thiocyanate)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Nitropress;
  • (AR) Argentina: Niprusodio | Nitroprusiato de sodio gemepe;
  • (BR) Brazil: Nitrop;
  • (CH) Switzerland: Nipruss;
  • (CL) Chile: Nitropress;
  • (CO) Colombia: Nitroprusiato de sodio | Prusiat;
  • (CZ) Czech Republic: Nipride;
  • (EC) Ecuador: Nitroprusiato de sodio;
  • (GB) United Kingdom: Nitropress;
  • (HK) Hong Kong: Nitropress;
  • (HU) Hungary: Nipride;
  • (JP) Japan: Nitopro;
  • (KR) Korea, Republic of: Nipride;
  • (LT) Lithuania: Nipride;
  • (LU) Luxembourg: Nipruss;
  • (LV) Latvia: Nipride;
  • (MX) Mexico: Cordibux | Dorespin | Nitroprusiato de sodio;
  • (MY) Malaysia: Nipride | Sodium nitroprusside;
  • (NO) Norway: Nitropress | Nitroprusside sagent;
  • (NZ) New Zealand: Sodium nitroprusside;
  • (PE) Peru: Clenil | Nitropress;
  • (PR) Puerto Rico: Nipride rtu | Nitropress | Sodium nitroprusside;
  • (QA) Qatar: Nitropress;
  • (RU) Russian Federation: Nanipruss;
  • (SG) Singapore: DBL sodium nitroprusside;
  • (SI) Slovenia: Nipruss | Nitropress;
  • (TR) Turkey: Nipride | Nipruss;
  • (UY) Uruguay: Niprusodio fada;
  • (VE) Venezuela, Bolivarian Republic of: Nitroprusiato
  1. American Society of Health-System Pharmacists (ASHP). Pediatric continuous infusion standards. https://www.ashp.org/-/media/assets/pharmacy-practice/s4s/docs/Pediatric-Infusion-Standards.ashx. Updated January 2021. Accessed January 7, 2022.
  2. Benitz WE, Malachowski N, Cohen RS, et al. Use of Sodium Nitroprusside in Neonates: Efficacy and Safety. J Pediatr. 1985;106(1):102-110. [PubMed 3917495]
  3. Cachat F, Guignard JP. Reply to the letter from C. von Schnakenburg and M. Krüger. Pediatr Nephrol. 2004;19:1308-1309.
  4. Coons JC, McGraw M, Murali S. Pharmacotherapy for acute heart failure syndromes. Am J Health Syst Pharm. 2011;68(1):21-35. doi:10.2146/ajhp100202 [PubMed 21164062]
  5. Cortazzo JA, Lichtman AD. Methemoglobinemia: a review and recommendations for management. J Cardiothorac Vasc Anesth. 2014;28(4):1043-1047. doi:10.1053/j.jvca.2013.02.005 [PubMed 23953868]
  6. Chandar J, Zilleruelo G. Hypertensive crisis in children. Pediatr Nephrol. 2012;27(5):741-751. [PubMed 21773822]
  7. Der-Nigoghossian C, Levasseur-Franklin K, Makii J. Acute blood pressure management in neurocritically ill patients. Pharmacotherapy. 2019;39(3):335-345. doi:10.1002/phar.2233 [PubMed 30734342]
  8. Elkayam U, Janmohamed M, Habib M, Hatamizadeh P. Vasodilators in the management of acute heart failure. Crit Care Med. 2008;36(1)(suppl):S95-S105. doi:10.1097/01.CCM.0000297161.41559.93 [PubMed 18158484]
  9. Elliot WJ, Varon J. Drugs used for the treatment of hypertensive emergencies. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 23, 2022b.
  10. Elliot WJ, Varon J. Evaluation and treatment of hypertensive emergencies in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 8, 2022a.
  11. Erstad BL, Barletta JF. Treatment of Hypertension in the Perioperative Patient. Ann Pharmacother. 2000;34(1):66-79. [PubMed 10669188]
  12. Flynn JT. Neonatal hypertension: diagnosis and management. Pediatr Nephrol. 2000;14(4):332-341. [PubMed 10775081]
  13. Flynn JT, Kaelber DC, Baker-Smith CM, et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. [PubMed 29192011]
  14. Friederich JA, Butterworth JF 4th. Sodium nitroprusside: twenty years and counting. Anesth Analg. 1995;81(1):152-162. [PubMed 7598246]
  15. Furck AK, Hansen JH, Uebing A, et al. The Impact of Afterload Reduction on the Early Postoperative Course After the Norwood Operation - A 12-year Single-Centre Experience. Eur J Cardiothorac Surg. 2010;37(2):289-295. [PubMed 19800251]
  16. Hegenbarth MA; American Academy of Pediatrics Committee on Drugs. Preparing for pediatric emergencies: drugs to consider. Pediatrics. 2008;121(2):433-443. [PubMed 18245435]
  17. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
  18. Hollenberg SM. Vasodilators in acute heart failure. Heart Fail Rev. 2007;12(2):143-147. doi:10.1007/s10741-007-9017-2 [PubMed 17447137]
  19. Ihlen H, Myhre E, Opstad P. Evaluation of Potential Adverse Effects of Sodium Nitroprusside During Pacing-Induced Myocardial Ischaemia in Man. Eur Heart J. 1984;5(10):834-841. [PubMed 6499856]
  20. Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association/American College of Cardiology joint committee on clinical practice guidelines. Circulation. 2022;146(24):e334-e482. doi:10.1161/CIR.0000000000001106 [PubMed 36322642]
  21. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. [PubMed 24352797]
  22. Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870-947. [PubMed 23370205]
  23. Johanning RJ, Zaske DE, Tschida SJ, et al. A retrospective study of sodium nitroprusside use and assessment of the potential risk of cyanide poisoning. Pharmacotherapy. 1995;15(6):773-777. [PubMed 8602386]
  24. Kiran U, Zuber K, Kakani M. Combination of Low-Dose Phenoxybenzamine and Sodium Nitroprusside in Children Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth. 2006;20(2):291-292. [PubMed 16616682]
  25. Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):S876-S908. [PubMed 20956230]
  26. Marik PE, Varon J. Hypertensive crises: challenges and management. Chest. 2007;131(6):1949-1962. doi:10.1378/chest.06-2490 [PubMed 17565029]
  27. Moffett BS, Price JF. Evaluation of Sodium Nitroprusside Toxicity in Pediatric Cardiac Surgical Patients. Ann Pharmacother. 2008;42(11):1600-1604. [PubMed 18957627]
  28. Motta P, Mossad E, Toscana D, Zestos M, Mee R. Comparison of phenoxybenzamine to sodium nitroprusside in infants undergoing surgery. J Cardiothorac Vasc Anesth. 2005;19(1):54-59. doi:10.1053/j.jvca.2004.11.010 [PubMed 15747270]
  29. Mullens W, Abrahams Z, Francis GS, et al. Sodium nitroprusside for advanced low-output heart failure. J Am Coll Cardiol. 2008;52(3):200-207. doi:10.1016/j.jacc.2008.02.083 [PubMed 18617068]
  30. Murray KL, Wright D, Laxton B, Miller KM, Meyers J, Englebright J. Implementation of standardized pediatric i.v. medication concentrations. Am J Health Syst Pharm. 2014;71(17):1500-1508. [PubMed 25147175]
  31. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(2)(suppl):555-576. [PubMed 15286277]
  32. Nipride RTU (sodium nitroprusside) [prescribing information]. Lenoir, NC: Exela Pharma Sciences LLC; July 2018.
  33. Nipride (sodium nitroprusside) [product monograph]. Kirkland, Quebec, Canada: Pfizer Canada Inc; July 2017.
  34. Nishimura RA, Otto CM, Bonow RO, et al, 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440-2492. doi:10.1161/CIR.0000000000000029 [PubMed 24589852]
  35. Nitropress (sodium nitroprusside injection) [prescribing information]. McPherson, KS: Hospira Inc; October 2016.
  36. Nitropress injection (nitroprusside) [prescribing information]. Bridgewater, NJ: Valeant Pharmaceuticals North America LLC; February 2015.
  37. Nitroprusside Sodium [prescribing information]. Florham Park, NJ: Xiromed LLC; September 2020.
  38. Palmer RF, Lasseter KC. Drug Therapy: Sodium Nitroprusside. N Engl J Med. 1975;292(6):294-297. [PubMed 1089194]
  39. Park, MK. Park's Pediatric Cardiology for Practitioners. 6th ed. Philadelphia, PA: Elsevier Health Sciences; 2014.
  40. Park, MK. Park's Pediatric Cardiology for Practitioners. 7th ed. Elsevier Health Sciences; 2021:972.
  41. Peixoto AJ. Acute severe hypertension. N Engl J Med. 2019;381(19):1843-1852. doi:10.1056/NEJMcp1901117 [PubMed 31693807]
  42. Phillips MS. Standardizing I.V. Infusion Concentrations: National Survey Results. Am J Health Syst Pharm. 2011;68(22):2176-2182. [PubMed 22058104]
  43. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211 [PubMed 31662037]
  44. Pramar Y, Das Gupta V, Gardner SN, Yau B. Stabilities of dobutamine, dopamine, nitroglycerin and sodium nitroprusside in disposable plastic syringes. J Clin Pharm Ther. 1991;16(3):203-207. [PubMed 1907977]
  45. Refer to the manufacturer's labeling.
  46. Rhoney D, Peacock WF,. Intravenous Therapy for Hypertensive Emergencies, Part 1. Am J Health-Syst Pharm. 2009;66(15):1343-1352. [PubMed 19635770]
  47. Rindone JP, Sloane EP. Cyanide toxicity from sodium nitroprusside: risks and management. Ann Pharmacother. 1992;26:515-519. [PubMed 1533553]
  48. Schwartzenberg S, Redfield MM, From AM, Sorajja P, Nishimura RA, Borlaug BA. Effects of vasodilation in heart failure with preserved or reduced ejection fraction implications of distinct pathophysiologies on response to therapy. J Am Coll Cardiol. 2012;59(5):442-451. doi:10.1016/j.jacc.2011.09.062 [PubMed 22281246]
  49. Shenoi RP, Timm N; Committee on Drugs; Committee on Pediatric Emergency Medicine. Drugs used to treat pediatric emergencies. Pediatrics. 2020;145(1):e20193450. [PubMed 31871244]
  50. Shulz LT, Elder EJ, Jones KJ, et al. Stability of Sodium nitroprusside and sodium thiosulfate 1:10 intravenous admixture. Hosp Pharm. 2010;45(10):779-784. [PubMed 21625332]
  51. Varon J. Treatment of acute severe hypertension. Drugs. 2008;68(3):283-297. [PubMed 18257607]
  52. Vesey CJ, Cole PV. Blood Cyanide and Thiocyanate Concentrations Produced by Long-Term Therapy With Sodium Nitroprusside. Br J Anaesth. 1985;57(2):148-155. [PubMed 3970795]
  53. Wesson DE, Foley R, Sabatini S, et al. Treatment of Acute Cyanide Intoxication With Hemodialysis. Am J Nephrol. 1985;5(2):121-126. [PubMed 3993700]
  54. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065 [PubMed 29133356]
  55. Williams RS, Mickell JJ, Young ES, et al. Methemoglobin Levels During Prolonged Combined Nitroglycerin and Sodium Nitroprusside Infusions in Infants After Cardiac Surgery. J Cardiothorac Vasc Anesth. 1994;8(6):658-662. doi:10.1016/1053-0770(94)90198-8 [PubMed 7880995]
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