MASSACHUSETTS GENERAL HOSPITAL
Department of Pharmacy
Department of Nursing
Critical Care
| Generic Name: | Norepinephrine |
| Trade Name: | Levophed |
| Action: | Adrenergic Agonist |
| Indications: | Hypotension Decreased Systemic Vascular Resistance |
| Administration Guidelines: | |
| Usual Dosage Range and Route: | 2 to 100 mcg/min IV as titrated to patient response |
| Standard Concentrations: | Central: Peripheral: N/A* MICROINFUSION: 4mg/50ml, 16mg/50ml, 50mg/50ml |
| Special Considerations: | *Central line required for administration;
in cases of emergency or profound hypotension, norepinephrine may be given peripherally
while preparation for central line is underway using the standard concentration of
4 mg / 250 ml. * Peripheral administration of the 4 mg / 250 ml concentration may be used for short term administration (e.g. pre-transplant and post-op management of labile blood pressure in which a central line is a relative contraindication) - PA line monitoring of cardiac output, cardiac index, PCWP, CVP, and SVR is encouraged during maintenance infusions. - Should be used with caution in patients with ischemic heart disease - Invasive blood pressure monitoring (e.g. a-line) should be considered when centrally administered vasoactive agents are used or when frequent changes in infusion rate are required. |
| Precautions and Side Effects: | - Bradycardia - Peripheral vasoconstriction, extremity necrosis - Hypertension - Oliguria - Diaphoresis - Restlessness, nasal congestion |