Norepinephrine Bitartrate
Generic Details
Generic Name
Norepinephrine Bitartrate
Other Names
- Levophed
Drug Class
- Vasopressor
- Sympathomimetic
Chemical Formula
C8H11NO3.C4H6O6
Molecular Weight
337.27 g/mol
Mechanism of Action
- Norepinephrine Bitartrate is a direct-acting alpha and beta adrenergic agonist that stimulates alpha and beta receptors in the sympathetic nervous system, leading to vasoconstriction and increased heart rate.
Indications
- Treatment of hypotension and shock
Common Dosage Forms
- Injection
Typical Dosage
- Initial dose: 0.5 to 1 mcg/min, titrated to response (usual range: 2 to 4 mcg/min)
Pediatric Dosage
- Dosage must be individualized based on patient weight and condition
Geriatric Dosage
- Start at the lower end of the dosing range
Side Effects
- Hypertension
- Bradycardia
- Necrosis at injection site
- Tissue Ischemia
- Arrhythmias
Contraindications
- Hypersensitivity to norepinephrine
- Shock caused by hypovolemia
Pregnancy Category
- C
Lactation Safety
- Compatible, caution advised
Drug Interactions
- MAO Inhibitors
- Tricyclic antidepressants
- Ergot alkaloids
Overdose Symptoms
- Severe hypertension
- Bradycardia
- Cerebrovascular hemorrhage
Antidote for Overdose
- Alpha-adrenergic blockers such as phentolamine
Storage Conditions
- Store at room temperature away from light and moisture
Pharmacokinetics
- Absorption: Rapidly metabolized
- Distribution: Quickly distributed in the body
- Metabolism: Primarily hepatic
- Excretion: Primarily renal
Precautions
- Monitor blood pressure and ECG continuously during infusion
- Avoid extravasation during administration
Warnings
- Use with caution in patients with hypertension, hyperthyroidism, or cardiovascular disease