Norepinephrine 0.1% (Norepinephrine Tartrate Hydrate)

Adult administration

1. Acute hypotension or shock: Dilute 8mg of norepinephrine tartrate hydrate (equivalent to 4mg of norepinephrine) in 1,000mL of 5% glucose injection or 5% glucose saline injection and administer via intravenous infusion at a rate of 2-3mL per minute, adjusting appropriately while monitoring reactions. The maintenance dose is 0.5-1.0mL per minute. 2. Cardiac arrest: Intravenous infusion after establishing effective cardiac rhythm and ventilation by other methods, similar to the case of acute hypotension or shock.

This drug raises blood pressure and causes vasoconstriction. Therefore, it should not be administered until blood volume is restored in hypotensive patients with low blood volume. Caution is necessary when administered to hypertensive patients as it may cause a rapid rise in blood pressure. In patients with hyperthyroidism, administration may lead to severe headaches or blurriness accompanied by significantly elevated blood pressure. It should be avoided in patients with specific neuroendocrine tumors, severe renal dysfunction, cor pulmonale, or severe arrhythmias. Use is also contraindicated in patients with numbness in their fingers, toes, nose, or penis, as well as in pregnant women or those who may become pregnant. In cases of cocaine addiction, ventricular tachycardia, arteriosclerosis, heart diseases, bradycardia, vascular thrombosis, hypotension due to myocardial infarction, certain angina patients, or in the elderly, it should only be administered with caution if absolutely necessary. Side effects may include a rapid or slow heartbeat, chest pain, abnormal blood pressure elevation, cardiac arrhythmias, and peripheral ischemia symptoms such as extremity necrosis. Additionally, headaches, dizziness, tremors, anxiety, nausea, vomiting, dyspnea, and necrosis at the injection site may occur. Long-term use may carry the risk of reduced plasma volume. This medication is used for shock treatment but raises blood pressure; therefore, excessive dosing may lead to serious side effects such as acute pulmonary edema or cardiac arrest, requiring frequent verification of the administration rate and blood pressure. Long-term use without blood volume restoration may cause severe vasoconstriction in peripheral and visceral vessels, leading to renal impairment and tissue hypoxia, so appropriate fluid therapy must accompany its use. If excessive blood pressure elevation occurs, vasodilators should be utilized. This drug may enhance the risk of cardiac arrhythmias or pulmonary edema when used with specific anesthetics or other cardiac-related medications, thus should not be combined. Also, care should be taken when used with antidepressants, antihistamines, thyroid medications, hypoglycemic agents, and drugs that induce blood pressure elevation. Administration during pregnancy poses risks due to possible fetal vessel constriction, thus it is not administered, and caution is also required during breastfeeding. In the elderly, blood pressure elevation may be significant, necessitating cautious administration. Overdose may present symptoms such as severe blood pressure elevation, decreased cardiac output, bradycardia, headache, and pulmonary edema, and treatment should be immediately ceased with appropriate interventions taken. When administered intravenously, care should be taken to prevent excessive blood pressure elevation, and frequent checks should be conducted on the injection site to avoid local tissue necrosis if the injection solution extravasates. This drug should be diluted with specific solutions and may not be compatible with other medications, hence instructions should be strictly followed.

Serious side effects

• Severe headache
• pallor
• difficulty breathing
• skin necrosis
• severe edema
• blood pressure elevation
• pulmonary edema.

Mild side effects

• Palpitations
• bradycardia
• thoracic pain
• abnormal blood pressure elevation
• arrhythmias
• headache
• dizziness
• tremors
• anxiety
• nausea

This medication may be sensitive to light, so it should be stored avoiding direct sunlight. Additionally, it is important to store it in a sealed container to prevent contact with air.

Appearance

A colorless, transparent injectable solution contained in a colorless ampule.

Package unit

10 ampules/box [4mL/ampule], 10 ampules/box [10mL/ampule]