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NIPRIDE RTU

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Overview

What is NIPRIDE RTU?

Sodium nitroprusside is disodium pentacyanonitrosylferrate(2-) dihydrate, a hypotensive agent whose structural formula is

Sodium Nitroprusside has molecular formula Na[Fe(CN)NO] • 2HO and molecular weight of 297.95. Dry sodium nitroprusside is a reddish-brown powder, soluble in water.

Sodium nitroprusside solution is rapidly degraded by trace contaminants, often with resulting color changes

[see Dosage and Administration ()]

.

NIPRIDE RTU is supplied as a sterile, unpreserved, colorless to red-brown solution packaged in a single-use 100-mL vial.  Each 100 mL of solution in vial contains 50 mg of sodium nitroprusside (0.5 mg/mL),  900 mg of sodium chloride, USP (9 mg/mL), in sterile water for injection, USP.

NIPRIDE RTU is also supplied as a sterile, unpreserved, colorless to red-brown solution packaged in a single-use 50-mL vial. Each 50 mL of solution in vial contains 10 mg of sodium nitroprusside (0.2 mg/mL), 450 mg of sodium chloride, USP (9 mg/mL), in sterile water for injection, USP.



What does NIPRIDE RTU look like?



What are the available doses of NIPRIDE RTU?

Injection: 50 mg of sodium nitroprusside in 100 mL of 0.9% sodium chloride (0.5 mg/mL) in 100 mL single-use vials and 10 mg of sodium nitroprusside in 50 mL of 0.9% sodium chloride (0.2 mg/mL) in 50 mL single-us vials ().

What should I talk to my health care provider before I take NIPRIDE RTU?

How should I use NIPRIDE RTU?

Sodium nitroprusside is indicated for the immediate reduction of blood pressure of adult and pediatric patients in hypertensive crises.

Inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit. Sodium nitroprusside should be a clear colorless to red/brown color; do not use if solution is blue, green, or bright red.


What interacts with NIPRIDE RTU?

Sorry No Records found


What are the warnings of NIPRIDE RTU?

Sorry No Records found


What are the precautions of NIPRIDE RTU?

Sorry No Records found


What are the side effects of NIPRIDE RTU?

Sorry No records found


What should I look out for while using NIPRIDE RTU?

Diseases with compensatory hypertension (e.g. coarctation of the aorta, arteriovenous shunting) ().

Inadequate cerebral circulation or moribund patients (A.S.A. Class 5E) coming to emergency surgery ().

Congenital (Leber’s) optic atrophy or tobacco amblyopia ().

Acute heart failure with reduced peripheral vascular resistance ().

Concomitant use with sildenafil, tadalafil, vardenifil, or riociguat ()

(A) EXCESSIVE HYPOTENSION:

Sodium Nitroprusside can cause precipitous decreases in blood pressure which can lead to irreversible ischemic injuries or death. Use only with continuous blood pressure monitoring

(B) CYANIDE TOXICITY: 

Sodium nitroprusside metabolism produces dose-related cyanide, which can be lethal.  A patient’s ability to buffer cyanide will be exceeded in less than one hour at the maximum dose rate (10 mcg/kg/min); limit infusions at the maximum rate to as short a duration as possible


What might happen if I take too much NIPRIDE RTU?

Overdosage of nitroprusside can be manifested as excessive hypotension or cyanide toxicity or as thiocyanate toxicity . Cyanide toxicity causes venous hyperoxemia with bright red venous blood.  Cells become unable to extract the oxygen delivered to them, leading to air hunger, confusion and death. Lactic acidosis may occur, but its emergence may lag other life-threatening manifestations of cyanide toxicity.

Cyanide levels can be measured by many laboratories, and blood-gas studies that can detect venous hyperoxemia or acidosis are widely available. Acidosis may not appear until more than an hour after the appearance of dangerous cyanide levels. Suspicion of cyanide toxicity is adequate grounds for initiation of treatment.

Treatment of cyanide toxicity consists of:

Hemodialysis is ineffective in removal of cyanide, but it will eliminate most thiocyanate.

Sodium nitrite is available in a 3% solution, and 4-6 mg/kg (about 0.2 mL/kg) should be injected over 2-4 minutes. This dose can be expected to convert about 10% of the patient’s hemoglobin into methemoglobin; this level of methemoglobinemia is not associated with any important hazard of its own. 

Immediately after infusion of the sodium nitrite, sodium thiosulfate should be infused. This agent is available in 10% and 25% solutions, and the recommended dose is 150-200 mg/kg; a typical adult dose is 50 mL of the 25% solution. Thiosulfate treatment of an acutely cyanide-toxic patient will raise thiocyanate levels, but not to a dangerous degree.

The nitrite/thiosulfate regimen may be repeated, at half the original doses, after two hours.

Cyanide antidote kits are available.


How should I store and handle NIPRIDE RTU?

Store at room temperature 20°C to 25°C (68°F to 77°F) with excursions permitted between 15°C and 30°C (between 59°F and 86°F). NIPRIDE RTU is supplied in amber-colored, single-dose, 50 mg/100 mL (0.5 mg/mL) Fliptop Vials (NDC 51754-1006-1) and 10 mg/50 mL (0.2 mg/mL) Fliptop Vials (NDC 51754-1018-1). Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].To protect NIPRIDE RTU from light, vial should be stored in its carton until used.NIPRIDE RTU is supplied in amber-colored, single-dose, 50 mg/100 mL (0.5 mg/mL) Fliptop Vials (NDC 51754-1006-1) and 10 mg/50 mL (0.2 mg/mL) Fliptop Vials (NDC 51754-1018-1). Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].To protect NIPRIDE RTU from light, vial should be stored in its carton until used.NIPRIDE RTU is supplied in amber-colored, single-dose, 50 mg/100 mL (0.5 mg/mL) Fliptop Vials (NDC 51754-1006-1) and 10 mg/50 mL (0.2 mg/mL) Fliptop Vials (NDC 51754-1018-1). Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].To protect NIPRIDE RTU from light, vial should be stored in its carton until used.