Levofed 2 mg/2 ml (IV Infusion)

Indications

• Control of blood pressure in acute hypotensive states
• Adjunct in treatment of cardiac arrest and profound hypotension

Pharmacology

• Direct-acting sympathomimetic
• Stimulates β1- and α-adrenergic receptors
• Causes vasoconstriction to raise blood pressure with reflex slowing of heart rate

Dosage & Administration

• Infusion should be given into a large vein
• Diluted in 5 percent dextrose injection or 5 percent dextrose and sodium chloride injections
• Average dosage is 4 mcg/ml in 5 percent dextrose solution
• High dosage may be necessary based on patient response

Interaction

• Increased cardiac irritability with cyclopropane and halothane anesthesia
• Caution with monoamine oxidase inhibitors or tricyclic antidepressants

Contraindications

• Hypotension from blood volume deficits
• Mesenteric or peripheral vascular thrombosis
• Use with cyclopropane and halothane anesthesia
• Avoid in patients with profound hypoxia or hypercarbia

Side Effects

• Ischemic injury
• Bradycardia
• Arrhythmias
• Anxiety
• Headache
• Respiratory difficulty
• Extravasation necrosis at injection site
• Plasma volume depletion
• Gangrene of extremities

Pregnancy & Lactation

• Pregnancy Category C
• Caution in nursing women

Precautions & Warnings

• Avoid hypertension
• Monitor blood pressure during administration
• Prevent extravasation necrosis
• Use large veins for infusion
• Antidote for extravasation ischemia

Use in Special Populations

• Safety and effectiveness in pediatric patients not established
• Caution in geriatric patients
• No studies on carcinogenesis, mutagenesis, or impairment of fertility

Overdose Effects

• Headache
• Severe hypertension
• Reflex bradycardia
• Increased peripheral resistance
• Decreased cardiac output

Therapeutic Class

• Alpha and Beta-adrenergic agonist

Reconstitution

• Dilute with 5% glucose injection with or without sodium chloride

Storage Conditions

• Store at a temperature not exceeding 30°C
• Protect from light

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