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Norepinephrine Side Effects

For the Consumer

Applies to norepinephrine: parenteral injection

Warning

    Extravasation Risk
  • Phentolamine is the local antidote for peripheral ischemia resulting from extravasation of norepinephrine.101

  • Phentolamine should be given as soon as possible after extravasation is noted.101

  • Infiltrate the affected area (using a syringe with a fine hypodermic needle) liberally throughout as soon as possible with 10–15 mL of 0.9% sodium chloride injection containing 5–10 mg of phentolamine mesylate (an α-adrenergic blocking agent) to prevent sloughing and necrosis in ischemic areas.101

  • Sympathetic blockade with phentolamine causes immediate and conspicuous local hyperemic changes if the area is infiltrated within 12 hours.101

Side effects include:

May cause headache, anxiety, arrhythmias, bradycardia, respiratory difficulty, ischemic injury, or extravasation at the infusion site.

For Healthcare Professionals

Applies to norepinephrine: injectable solution, intravenous solution

General

If plasma volumes are not corrected, hypotension may recur when this drug is discontinued, or blood pressure may be maintained at the risk of severe peripheral and visceral vasoconstriction (e.g., decreased renal perfusion) with diminution in blood flow and tissue perfusion with subsequent tissue hypoxia and lactic acidosis and possible ischemic injury. Overdoses or conventional doses in hypersensitive patients (e.g., hyperthyroid patients) can cause severe hypertension with violent headache, photophobia, stabbing retrosternal pain, pallor, intense sweating, and vomiting.[Ref]

Local

Frequency not reported: Extravasation necrosis[Ref]

Cardiovascular

Frequency not reported: Ischemic injury, bradycardia, arrhythmia, blood pressure increased, hypertension, pallor, stabbing retrosternal pain[Ref]

Nervous system

Frequency not reported: Headache

Dermatologic

Frequency not reported: Sweating[Ref]

Gastrointestinal

Frequency not reported: Vomiting[Ref]

Ocular

Frequency not reported: Photophobia[Ref]

Metabolic

Frequency not reported: Plasma volume depletion[Ref]

Psychiatric

Frequency not reported: Anxiety[Ref]

Respiratory

Frequency not reported: Respiratory difficulty, dyspnea

Other

Frequency not reported: Gangrene[Ref]

References

1. "Product Information. Levophed (norepinephrine)." Hospira Inc, Lake Forest, IL.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. Cerner Multum, Inc. "Australian Product Information." O 0

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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