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Nesiritide

    Brands

    DEA Class; Rx

    Common Brand Names; Natrecor

    • Natriuretic Peptides
    Parenteral recombinant preparation of human B-type natriuretic peptide (hBNP)
    Indicated only for acute decompensated heart failure
    Augments the normal physiologic response in heart failure; improves PCWP and CHF symptoms
    Indicated for the treatment of acutely decompensated congestive heart failure in patients who have dyspnea at rest or with minimal activity.

    Atrial/ventricular arrhythmias, constrictive pericarditis, restrictive or obstructive cardiomyopathy, pericardial tamponade, significant valvular stenosis, suspected low cardiac filling pressures

    Hypersensitivity

    Primary treatment for patients with cardiogenic shock

    Persistent systolic BP <100 mm Hg

    • Hypotension (4-35% )
    • Serum creatinine raised (17-28%)
    • Nausea (4-13% )
    • Ventricular tachycardia (3-10% )
    • Headache (7-9% )
    • Dizziness (3-6% )
    • Insomnia (2- 6% )
    • Back pain (4%)
    • Ventricular premature beats (3-4% )
    • Anxiety (3%)
    • Angina (2%)
    • Atrial fibrillation (1% or greater )
    • Atrioventricular node (1% or greater )
    • Bradycardia (1%)
    • Somnolence (1%)
    • Tremor (1%)
    • Hypersensitivity reaction
    • Extravasation

    Hypotenstion effects may be additive when using other agents that cause hypotension

    Potential for nephrotoxicity

    Use only in hospital setting

    Caution in patients with renal impairment

    There are no data to assess a drug associated risk of major birth defects, miscarriage, or adverse maternal fetal outcomes with therapy use in pregnant women

    There are no data on the presence of nesiritide in human or animal breast milk, or regarding the effect on the breastfed child, or on milk production

    Adults

    0.03 mcg/kg/min IV continuous infusion, with cautious hemodynamic monitoring.

    Elderly

    0.03 mcg/kg/min IV continuous infusion, with cautious hemodynamic monitoring.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Nesiritide

    injectable solution

    • 1.5mg/vial