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NATRECOR

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Overview

What is NATRECOR?

NATRECOR (nesiritide) is a sterile, purified preparation of human B-type natriuretic peptide (hBNP), and is manufactured from using recombinant DNA technology. Nesiritide has a molecular weight of 3464 g/mol and an empirical formula of CHNOS. Nesiritide has the same 32 amino acid sequence as the endogenous peptide, which is produced by the ventricular myocardium.

NATRECOR is formulated as the citrate salt of rhBNP, and is provided in a sterile, single-use vial. Each 1.5 mg vial contains a white- to off-white lyophilized powder for intravenous (IV) administration after reconstitution. The quantitative composition of the lyophilized drug per vial is: nesiritide 1.58 mg, citric acid monohydrate 2.1 mg, mannitol 20.0 mg, and sodium citrate dihydrate 2.94 mg.



What does NATRECOR look like?



What are the available doses of NATRECOR?

Single-use vial: 1.5 mg vial ()

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

How should I use NATRECOR?

NATRECOR (nesiritide) is indicated for the treatment of patients with acutely decompensated heart failure who have dyspnea at rest or with minimal activity. In this population, the use of NATRECOR reduced pulmonary capillary wedge pressure and improved short term (3 hours) symptoms of dyspnea.

NATRECOR (nesiritide) is for intravenous (IV) use only. There is limited experience with administering NATRECOR for longer than 96 hours. Monitor blood pressure closely during NATRECOR administration.


What interacts with NATRECOR?

Sorry No Records found


What are the warnings of NATRECOR?

Sorry No Records found


What are the precautions of NATRECOR?

Sorry No Records found


What are the side effects of NATRECOR?

Sorry No records found


What should I look out for while using NATRECOR?

NATRECOR is contraindicated in patients with:


What might happen if I take too much NATRECOR?

Overdose with NATRECOR therapy has been reported and is primarily the result of either a miscalculated NATRECOR dose or a mechanical error such as an infusion-pump malfunction or an infusion-pump programming error. The most frequently reported adverse event reported with NATRECOR overdose is hypotension, which may be symptomatic and may persist for several hours. Asymptomatic hypotensive events may resolve with drug stoppage. In some cases hypotension may persist for several hours beyond discontinuation. In the event of an overdose, discontinue NATRECOR and support blood pressure .


How should I store and handle NATRECOR?

STORE NATRECOR (nesiritide) is provided as a sterile lyophilized powder in 1.5 mg, single-use vials. Each carton contains one vial and is available in the following package:1 vial/carton (NDC 65847-205-25)Store below 25°C. Do not freeze. Keep the vial in the outer carton in order to protect from light.NATRECOR (nesiritide) is provided as a sterile lyophilized powder in 1.5 mg, single-use vials. Each carton contains one vial and is available in the following package:1 vial/carton (NDC 65847-205-25)Store below 25°C. Do not freeze. Keep the vial in the outer carton in order to protect from light.NATRECOR (nesiritide) is provided as a sterile lyophilized powder in 1.5 mg, single-use vials. Each carton contains one vial and is available in the following package:1 vial/carton (NDC 65847-205-25)Store below 25°C. Do not freeze. Keep the vial in the outer carton in order to protect from light.


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Human BNP (hBNP) is secreted by the ventricular myocardium in response to stretch and exists in several isoforms in the human body. Elevated levels of BNP have been associated with advanced heart failure and are considered to be a compensatory mechanism in this disease. Human BNP binds to the particulate guanylate cyclase receptor of vascular smooth muscle and endothelial cells, leading to increased intracellular concentrations of guanosine 3'5'-cyclic monophosphate (cGMP) and smooth muscle cell relaxation. Cyclic GMP serves as a second messenger to dilate veins and arteries. Nesiritide has been shown to relax isolated human arterial and venous tissue preparations that were precontracted with either endothelin-1 or the alpha-adrenergic agonist, phenylephrine.

In animals, nesiritide had no effects on cardiac contractility or on measures of cardiac electrophysiology such as atrial and ventricular effective refractory times or atrioventricular node conduction.

Non-Clinical Toxicology
NATRECOR is contraindicated in patients with:

This drug may enhance the effects of: other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression.

NATRECOR may cause hypotension. In the ASCEND-HF trial, the incidence of symptomatic hypotension was 7.1% in NATRECOR-treated patients compared to 4.0% in placebo-treated patients on a background of standard care. The risk of hypotension may be increased by the concomitant use of NATRECOR with drugs affecting the renin-angiotensin system (i.e., angiotensin receptor blockers and/or angiotensin-converting enzyme inhibitors) or other afterload reducers. In the VMAC trial, in patients given the recommended dose (2 mcg/kg bolus followed by a 0.01 mcg/kg/min infusion) or the adjustable dose, the incidence of symptomatic hypotension in the first 24 hours was similar for NATRECOR (4%) and IV nitroglycerin (5%). When hypotension occurred, however, the duration of symptomatic hypotension was longer with NATRECOR (mean duration was 2.2 hours) than with nitroglycerin (mean duration was 0.7 hours).

Administer NATRECOR only in settings where blood pressure can be monitored closely and hypotension aggressively treated. Reduce the dose of or discontinue NATRECOR in patients who develop hypotension .

Avoid administration of NATRECOR in patients suspected of having, or known to have, low cardiac filling pressures.

NATRECOR is not recommended for patients for whom vasodilating agents are not appropriate, such as patients with significant valvular stenosis, restrictive or obstructive cardiomyopathy, constrictive pericarditis, pericardial tamponade, or other conditions in which cardiac output is dependent upon venous return, or for patients suspected to have low cardiac filling pressures .

The following are discussed in more detail in other sections of the labeling:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Interactions

Interactions

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