• Acutely decompensated HF in hospitalized patients who have dyspnea at rest or with minimal activity; has been used with digoxin, diuretics, and ACE inhibitors. Should not be used for intermittent outpatient infusion, scheduled repetitive use, as a diuretic or to improve renal function.

Contraindicated in:

• Hypersensitivity
• Cardiogenic shock
• Systolic BP <100 mm Hg
• Low cardiac filling pressure, significant valvular stenosis, restrictive/subtractive cardiomyopathy, constrictive pericarditis/cardiac tamponade, or other conditions in which cardiac output is dependent on venous return.

Use Cautiously in:

• Heart failure where renal function is dependent on activity of the renin/angiotensin/aldosterone system (may cause azotemia)
• Cardiogenic shock (should not be used as primary therapy)
• OB: Lactation: Pedi: Pregnancy, lactation, or children (safety not established)
• Geri: May have ↑ sensitivity to effects.

CNS: anxiety, confusion, dizziness, headache, hypotension (dose related), insomnia, drowsiness.

EENT: amblyopia.

Resp: APNEA, cough, hemoptysis.

CV: hypotension, arrhythmias, bradycardia.

GI: abdominal pain, nausea, vomiting.

GU: ↑serum creatinine, renal failure.

Derm: itching, rash, sweating.

Hemat: anemia.

Local: injection site reactions.

MS: back pain, leg cramps.

Neuro: paresthesia, tremor.

Misc: ALLERGIC REACTIONS, fever.

Drug-Drug:

• None reported.

• Powder for injection: 1.5 mg/vial;

• IV (Adults): 2 mcg/kg bolus followed by 0.01 mcg/kg/min as a continuous infusion. May ↑ by 0.005 mcg/kg/min every 3 hr up to a maximum infusion rate of 0.03 mcg/kg/min (based on response).

Natrecor

• Binds to guanyl cyclase receptors in vascular smooth muscle and endothelial cells, producing increased intracellular guanosine 3´5´-cyclic monophosphate (cGMP) and smooth muscle cell relaxation. cGMP acts as a "second messenger" to dilate veins and arteries.

• Dose-dependent reduction in pulmonary capillary wedge pressure (PCWP) and systemic arterial pressure in patients with heart failure with resultant decrease in dyspnea.

Therapeutic Classification: n/a

Pharmacologic Classification: vasodilators (human B-type natriuretic peptide)

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Cleared from circulation by binding to cell surface clearance receptors resulting in cellular internalization and proteolysis, proteolytic breakdown by endopeptidases, and renal filtration.

Half-life: 18 min.

(effects on cardiovascular parameters)

†Longer with higher than recommended doses.

• Explain purpose of nesiritide to patient and family.
• Advise patient to notify health care professional immediately if signs and symptoms of allergic reaction occurs.

ne-SIR-i-tide

NDC Code^*

• 65847- Scios LLC
  • 65847-205- NATRECOR
    • 65847-205-25- 1 VIAL, SINGLE-USE in 1 CARTON (65847-205-25) > 5 mL in 1 VIAL, SINGLE-USE