Sodium Nitroprusside
Sodium nitroprusside is a potent, rapid-acting, direct-acting vasodilator that relaxes both arteriolar and venous smooth muscle. It is used exclusively in critical care settings for the emergency management of severe hypertension and heart failure, requiring continuous blood pressure monitoring due to its rapid onset and short duration of action.
Dosage by Body Weight
Must be administered via continuous intravenous infusion using an infusion pump. Dosage must be individualized and titrated based on real-time blood pressure response. Standard starting pediatric and adult rate is 0.3 mcg/kg/min, titrated up to a maximum of 10 mcg/kg/min. Protect infusion solution from light.
- Body Weight
- Below 5 kg
- Dose
- 0.3 to 3 mcg/kg/min (approx. 0.9 to 12 mcg/min for a 3-4 kg infant)
- Frequency
- Continuous intravenous infusion
- Tracking Notes
- Administer only in an intensive care setting. Monitor continuously for profound hypotension and cyanide/thiocyanate toxicity.
- Body Weight
- 5-7 kg
- Dose
- 1.5 to 21 mcg/min (based on titration of 0.3 to 3 mcg/kg/min)
- Frequency
- Continuous intravenous infusion
- Tracking Notes
- Titrate slowly to target blood pressure. Monitor acid-base balance and blood lactate levels.
- Body Weight
- 8-10 kg
- Dose
- 2.4 to 30 mcg/min (based on titration of 0.3 to 3 mcg/kg/min)
- Frequency
- Continuous intravenous infusion
- Tracking Notes
- Avoid prolonged infusions (>72 hours) or maximum doses (>10 mcg/kg/min for >10 mins) to prevent toxic thiocyanate accumulation.
- Body Weight
- 11-15 kg
- Dose
- 3.3 to 45 mcg/min (based on titration of 0.3 to 3 mcg/kg/min)
- Frequency
- Continuous intravenous infusion
- Tracking Notes
- Ensure solution is prepared in 5% Dextrose and wrapped in light-resistant foil or material.
- Body Weight
- 16-20 kg
- Dose
- 4.8 to 60 mcg/min (based on titration of 0.3 to 3 mcg/kg/min)
- Frequency
- Continuous intravenous infusion
- Tracking Notes
- Monitor renal and hepatic function closely. Infusion must be stopped immediately if signs of metabolic acidosis or cyanide toxicity appear.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | 0.3 to 3 mcg/kg/min (approx. 0.9 to 12 mcg/min for a 3-4 kg infant) | Continuous intravenous infusion | Administer only in an intensive care setting. Monitor continuously for profound hypotension and cyanide/thiocyanate toxicity. |
| 5-7 kg | 1.5 to 21 mcg/min (based on titration of 0.3 to 3 mcg/kg/min) | Continuous intravenous infusion | Titrate slowly to target blood pressure. Monitor acid-base balance and blood lactate levels. |
| 8-10 kg | 2.4 to 30 mcg/min (based on titration of 0.3 to 3 mcg/kg/min) | Continuous intravenous infusion | Avoid prolonged infusions (>72 hours) or maximum doses (>10 mcg/kg/min for >10 mins) to prevent toxic thiocyanate accumulation. |
| 11-15 kg | 3.3 to 45 mcg/min (based on titration of 0.3 to 3 mcg/kg/min) | Continuous intravenous infusion | Ensure solution is prepared in 5% Dextrose and wrapped in light-resistant foil or material. |
| 16-20 kg | 4.8 to 60 mcg/min (based on titration of 0.3 to 3 mcg/kg/min) | Continuous intravenous infusion | Monitor renal and hepatic function closely. Infusion must be stopped immediately if signs of metabolic acidosis or cyanide toxicity appear. |
Formulation
Purpose
Immediate reduction of blood pressure in hypertensive crises, acute congestive heart failure, and controlled hypotension during surgery to reduce bleeding.
Generic Name
Sodium NitroprussideBranded Drug Names
Sodium Nitroprusside is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
Yes. This medicine should be supplied or used only according to applicable prescription and regulatory requirements.