Nesiritide Side Effects

Some side effects of nesiritide may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to nesiritide: intravenous powder for solution

Along with its needed effects, nesiritide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking nesiritide:

More common
  • Low blood pressure
Less common
  • Bluish lips or skin
  • chest pain, tightness, or discomfort
  • cool, clammy skin
  • difficulty in breathing or shortness of breath
  • dizziness
  • fainting
  • lightheadedness
  • fast, slow, or irregular heartbeat
  • unusual tiredness or weakness

Some side effects of nesiritide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Headache
Less common
  • Abdominal or stomach pain
  • anxiety
  • back pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings on the skin
  • change in vision
  • confusion
  • coughing or spitting up blood
  • fever
  • increased cough
  • itching skin
  • leg cramps
  • nausea
  • pain or irritation at the injection site
  • pale skin, unusual bleeding or bruising
  • rash
  • sleepiness or unusual drowsiness
  • sleeplessness
  • sweating
  • trembling or shakiness
  • vomiting

For Healthcare Professionals

Applies to nesiritide: intravenous powder for injection

Cardiovascular

Cardiovascular side effects have included hypotension (11% to 35%), ventricular tachycardia (3% to 10%), ventricular extrasystoles (3% to 4%), angina pectoris (2% to 6%), and bradycardia (1% to 5%). Other side effects occurring in at least 1% of patients have included tachycardia, atrial fibrillation, and AV node conduction abnormalities.

The mean duration of symptomatic hypotension was 2.2 hours with nesiritide, compared to 0.7 hours with nitroglycerin.

Nesiritide was associated with a lower incidence of severe ventricular arrhythmias than dobutamine: sustained ventricular tachycardia (1% vs 7%), nonsustained ventricular tachycardia (11% vs 17%), cardiac arrest (0 vs 5%).

Nervous system

Nervous system side effects have included headache (up to 4.2%), insomnia (2% to 6%), dizziness (3% to 6%), and anxiety (2% to 3%). Other side effects occurring in at least 1% of patients have included confusion, paresthesia, somnolence, tremor, and fever.

Gastrointestinal

Gastrointestinal side effects have included dry mouth (up to 20.1%), constipation (up to 9.6%), upper abdominal pain (up to 1.5%), constipation (up to 1.4%), dyspepsia (up to 1.2%), and flatulence (up to 1.2%).

Local

Local reactions reported in at least 1% of patients have included catheter pain and injection site reactions.

Respiratory

Respiratory side effects reported in at least 1% of patients have included increased cough and apnea.

Renal

Renal side effects reported have included increases in serum creatinine of greater than 0.5 mg/dL above baseline (17% in patients receiving 0.015 mcg/kg/min, 19% in patients receiving 0.03 mcg/kg/min, 28% in patients receiving a 2 mcg/kg bolus followed by 0.020 mcg/kg/min).

Other

Other side effects have included anticholinergic central nervous system (CNS) effects including dizziness, confusion, hallucinations and somnolence. Patients should be monitored for signs of anticholinergic CNS effects, particularly after beginning treatment or increasing the dose. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered.

Ocular

Ocular side effects have included amblyopia (up to 1%) and dry eyes (up to 1.2%).

Dermatologic

Dermatologic side effects have included pruritus and rash in at least 1% of patients. Angioedema of the face, lips, tongue, and/or larynx has been reported postmarketing.

Endocrine

Endocrine side effects have included sweating in at least 1% of patients.

Musculoskeletal

Musculoskeletal side effects have included back pain (1% to 4%) and leg cramps (at least 1%).

Hematologic

Hematologic side effects have included anemia in at least 1% of patients.

Metabolic

Metabolic side effects have included hypokalemia (3%) and hypomagnesemia (1% to 3%) in a trial with 103 CHF patients.

Hypersensitivity

Hypersensitivity side effects including postmarketing reports of hypersensitivity reactions have been reported.

Genitourinary

Genitourinary side effects have included urinary retention (up to 1.2%).

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