Nitroprusside Side Effects
Medically reviewed by Drugs.com. Last updated on Apr 21, 2025.
Applies to nitroprusside: intravenous solution.
Important warnings
This medicine can cause some serious health issues
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.
Serious side effects of nitroprusside
Along with its needed effects, nitroprusside 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 side effects
- chest pain or discomfort
- fast, pounding, or irregular heartbeat or pulse
- lightheadedness, dizziness, or fainting
- slow heartbeat
- trouble breathing
- unusual tiredness
Incidence not known
Other side effects of nitroprusside
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 side effects
- 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 adverse events
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
Hematologic
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]
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References
1. "Product Information. Nipride RTU (sodium nitroprusside)." Roche Laboratories
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Further information
Nitroprusside side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.