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Nitroprusside Dosage

Medically reviewed on December 15, 2017.

Applies to the following strengths: 50 mg; 25 mg/mL; 50 mg/100 mL-NaCl 0.9%; 10 mg/50 mL-NaCl 0.9%

Usual Adult Dose for Hypertensive Emergency

Initial dose: 0.3 mcg/kg/min IBW administered by continuous IV infusion.
Maintenance dose: The dose may be titrated upward to a maximum of 10 mcg/kg/min IBW.

Usual Adult Dose for Congestive Heart Failure

Initial dose: 10 to 15 mcg/min administered by continuous IV infusion.
Maintenance dose: The dose may be titrated to 10 to 200 mcg/min.
Maximum dose: 280 mcg/min (4 mcg/kg/min).

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

The dose may be increased in increments of 0.1 to 0.3 mcg/kg/min IBW every 3 to 5 minutes.

Precautions

US BOXED WARNINGS:
-ADMINISTRATION: Nitropress(R) is not suitable for direct injection. The solution must be further diluted in sterile 5% dextrose injection before infusion.
-CYANIDE TOXICITY: Metabolism of this drug produces dose-related cyanide, which can be lethal. Limit infusion at the maximum rate (10 mcg/kg/min) to as short a duration as possible. Infusion at the maximum dose rate should never last more than 10 minutes.
-EXCESSIVE HYPOTENSION: This drug can cause precipitous decreases in blood pressure which can lead to irreversible ischemic injuries or death. Use only with continuous blood pressure monitoring.

The risk of cyanide toxicity increases significantly when > 500 mcg/kg is administered faster than 2 mcg/kg/min IBW.

Cardiac surgery requiring cardiopulmonary bypass is associated with an increased risk of cyanide toxicity.

In pediatric patients, doses greater than 1.8 mcg/kg/min are associated with increased cyanide concentrations.

Dialysis

Data not available

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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