NORADRENALINE (NOREPINEPHRINE)

33 ml/min). 6 mg/hour noradrenaline tartrate). 4 mg/hour noradrenaline tartrate). 1 μg/kg/min of noradrenaline base according to the pressor effect observed. There is great individual variation in the dose required to attain and maintain normotension.

The aim should be to establish a low normal systolic blood pressure (100 - 120 mm Hg) or to achieve an adequate mean arterial blood pressure (greater than 65 - 80 mm Hg – depending on the patient’s condition). 4 135 Some clinicians may prefer to dilute to other concentrations.

If dilutions other than 40 mg/l are used, check the infusion rate calculation carefully before starting treatment.

Renal or hepatic impairment:

There is no experience in treatment of renally or hepatically impaired patients Elderly: As for adults but see section

System Organ Class Undesirable effect Psychiatric disorders Anxiety Nervous system disorders Headache Cardiac disorders Arrhythmias (when used in conjunction with cardiac sensitising agents), bradycardia, stress cardiomyopathy Vascular disorders Hypertension, peripheral ischaemia including gangrene of the extremities, plasma volume depletion with prolonged use Respiratory, thoracic and mediastinal disorders Dyspnoea General disorders and administration site conditions Extravasation necrosis at injection site Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

4. Paediatric population Not recommended.

Duration of Treatment and Monitoring:

Noradrenaline should be continued for as long as vasoactive drug support is indicated. The patient should be monitored carefully for the duration of therapy. Blood pressure should be carefully monitored for the duration of therapy.

Withdrawal of Therapy:

The noradrenaline infusion should be gradually decreased since abrupt withdrawal can result in acute hypotension.

Route of Administration:

For intravenous use.

Method of administration:

Administer as a diluted solution via a central venous catheter. The infusion should be at a controlled rate using either a syringe pump or an infusion pump or a drip counter. 6. 1. 4 Special warnings and precautions for use Noradrenaline should only be administered by healthcare professionals who are familiar with its use.

Elderly patients may be especially sensitive to the effects of noradrenaline. Particular caution should be observed in patients with coronary, mesenteric or peripheral vascular thrombosis because noradrenaline may increase the ischemia and extend the area of infarction.

Similar caution should be observed in patients with hypotension following myocardial infarction, in patients with Prinzmetal’s variant angina and in patients with diabetes, hypertension or hyperthyroidism. Noradrenaline should be used with caution in patients who exhibit profound hypoxia or hypercarbia.

Noradrenaline should be used only in conjunction with appropriate blood volume replacement. When infusing noradrenaline, the blood pressure and rate of flow should be checked frequently to avoid hypertension. Extravasation of the solution may cause local tissue necrosis.

The infusion site should be checked frequently. If extravasation occurs, the infusion should be stopped and the area should be infiltrated with phentolamine without delay. Prolonged administration of any potent vasopressor may result in plasma volume depletion which should be continuously corrected by appropriate fluid and electrolyte replacement therapy.

, decreased renal perfusion) with diminution in blood flow and tissue perfusion with subsequent tissue hypoxia and lactic acidosis and possible ischaemic injury. Excipient with known effects This medicinal product contains less than 1 mmol sodium (23 mg) per ampoule.

Patients on low sodium diets can be informed that this medicinal product is essentially ‘sodium-free’. 6) and this should be considered in relation to the total sodium from all sources that will be administered to the patient.

1.