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Nitropress Side Effects

Generic Name: nitroprusside

Note: This document contains side effect information about nitroprusside. Some of the dosage forms listed on this page may not apply to the brand name Nitropress.

For the Consumer

Applies to nitroprusside: intravenous solution

Warning

Intravenous route (Solution)

Sodium nitroprusside may cause precipitous decreases in blood pressure and may lead to irreversible ischemic injuries or death. Continuous blood pressure monitoring is required. Sodium nitroprusside metabolism produces dose-related cyanide and may be lethal. Limit infusions at the maximum rate (10 mcg/kg/min) to the shortest duration possible as patient's ability to buffer cyanide will be exceeded in less than 1 hour at this rate.

Intravenous route (Solution)

Sodium nitroprusside is not suitable for direct injection; the reconstituted solution must be further diluted in sterile 5% dextrose injection before infusion. Sodium nitroprusside can cause precipitous decreases in blood pressure; monitor blood pressure continuously while patient is on therapy. Nitroprusside can cause cyanide toxicity which can be lethal. Infusion at the maximum dose rate (10 mcg/kg/min) should never last more than 10 minutes. Monitor acid-base balance and venous oxygen concentration while on therapy; these tests may indicate cyanide toxicity.

Along with its needed effects, nitroprusside (the active ingredient contained in Nitropress) 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 or nurse immediately if any of the following side effects occur while taking nitroprusside:

Less Common

Incidence Not Known

  • Bluish-colored lips, fingernails, or palms
  • blurred vision
  • confusion
  • dark urine
  • difficulty with breathing
  • fever
  • headache
  • pale skin
  • rapid heart rate
  • sore throat
  • sweating
  • unusual bleeding or bruising

Some side effects of nitroprusside 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:

Less Common

  • Abdominal or stomach pain
  • constipation
  • depressed mood
  • dizziness
  • dry skin and hair
  • feeling cold or warmth
  • hair loss
  • headache
  • hoarseness or husky voice
  • increased sweating
  • irritation at the infusion site
  • muscle cramps, stiffness, or twitching
  • nausea
  • rash
  • redness of the face, neck, arms, and occasionally, upper chest
  • weight gain

For Healthcare Professionals

Applies to nitroprusside: intravenous powder for injection, intravenous solution

General

The most important adverse reactions are excessive hypotension and cyanide toxicity.[Ref]

Cardiovascular

Frequency not reported: Hypotension, excessive hypotension, palpitations, bradycardia, electrocardiographic changes, tachycardia, flushing, venous streaking, retrosternal discomfort[Ref]

Gastrointestinal

Frequency not reported: Abdominal pain, nausea, retching, ileus[Ref]

Hematologic

Frequency not reported: Methemoglobinemia, platelet aggregation decreased, anemia[Ref]

Metabolic

Frequency not reported: Cyanide toxicity, thiocyanate toxicity, hypovolemia[Ref]

Nervous system

Frequency not reported: Dizziness, headache, intracranial pressure increased[Ref]

Dermatologic

Frequency not reported: Diaphoresis, rash[Ref]

Psychiatric

Frequency not reported: Apprehension, restlessness[Ref]

Endocrine

Frequency not reported: Hypothyroidism[Ref]

Local

Frequency not reported: Infusion site irritation[Ref]

Musculoskeletal

Frequency not reported: Muscle twitching[Ref]

References

1. "Product Information. Nipride (nitroprusside)." Roche Laboratories, Nutley, NJ.

Further information

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

Some side effects may not be reported. You may report them to the FDA.

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