Generic name: norepinephrine (nor ep i NEF rin)
Brand name: Levophed, Levophed Bitartrate
Dosage forms: injectable solution (16 mcg/mL-NaCl 0.9%; 16 mg/250 mL-NaCl 0.9%; 4 mg/250 mL-D5%; 8 mg/250 mL-D5%; 8 mg/250 mL-NaCl 0.9%); intravenous solution (1 mg/mL; 16 mg/250 mL-D5%; 16 mg/250 mL-NaCl 0.9%; 4 mg/250 mL-D5%; 4 mg/250 mL-NaCl 0.9%; 4 mg/500 mL-D5%; 8 mg/250 mL-D5%; 8 mg/250 mL-NaCl 0.9%; 8 mg/50 mL-NaCl 0.9%; 8 mg/500 mL-D5%)
Drug class: Catecholamines, Vasopressors
Norepinephrine is similar to adrenaline. It is used to treat life-threatening low blood pressure (hypotension) that can occur with certain medical conditions or surgical procedures. Norepinephrine is often used during CPR (cardio-pulmonary resuscitation).
Norepinephrine may also be used for purposes not listed in this medication guide.
Warnings
Tell your caregivers at once if you have a serious side effect such as a cold feeling anywhere in your body, blue lips or fingernails, trouble breathing, little or no urination, irritation or skin changes where the medicine was injected, slow heart rate, sudden numbness or weakness, severe headache, or problems with vision, speech, or balance.
Before taking this medicine
If possible before you receive norepinephrine, tell your caregivers if you have:
- high blood pressure (hypertension);
- diabetes;
- coronary artery disease;
- circulation problems;
- varicose veins;
- overactive thyroid; or
- asthma or a sulfite allergy.
Tell your doctor if you are pregnant or breastfeeding.
In an emergency, you may not be able to tell caregivers about your health conditions or if you are pregnant or breastfeeding. Make sure any doctor caring for you afterward knows you received norepinephrine.
How is norepinephrine given?
Norepinephrine is given as an infusion into a vein. A healthcare provider will give you this injection.
Norepinephrine is usually given for as long as needed until your body responds to the medication. Some people must receive norepinephrine for several days.
Your blood pressure, breathing, and other vital signs will be watched closely while you are receiving norepinephrine.
Tell your caregivers if you feel any pain, irritation, cold feeling, or other discomfort of your skin or veins where the medicine is injected. Norepinephrine can damage the skin or tissues around the injection site if the medicine accidentally leaks out of the vein.
What happens if I miss a dose?
Since norepinephrine is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include slow heartbeats, severe headache, sweating, vomiting, increased sensitivity to light, pale skin, and stabbing chest pain.
What should I avoid while receiving norepinephrine?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Norepinephrine side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers at once if you have:
- pain, burning, irritation, discoloration, or skin changes where the injection was given;
- sudden numbness, weakness, or cold feeling anywhere in your body;
- slow or uneven heart rate;
- blue lips or fingernails, mottled skin;
- little or no urination;
- trouble breathing;
- problems with vision, speech, or balance; or
- severe headache, blurred vision, pounding in your neck or ears.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect norepinephrine?
If possible before you receive norepinephrine, tell your doctor about all your other medicines, especially:
- an antidepressant;
- blood pressure medication; or
- an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
This list is not complete. Other drugs may affect norepinephrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.