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Brand Names: Levophed Bitartrate

Generic Name: norepinephrine (Pronunciation: nor ep i NEF rin)

What is norepinephrine (Levophed Bitartrate)?

Norepinephrine is similar to adrenaline. It works by constricting (narrowing) the blood vessels and increasing blood pressure and blood glucose (sugar) levels.

Norepinephrine is used to treat life-threatening low blood pressure (hypotension) that can occur with certain medical conditions or surgical procedures. This medication is often used during CPR (cardio-pulmonary resuscitation).

Norepinephrine may also be used for purposes other than those listed in this medication guide.

What are the possible side effects of norepinephrine (Levophed Bitartrate)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have any of these serious side effects:

  • muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, nausea with vomiting;
  • fast, slow, or uneven heart rate;
  • blue lips or fingernails, mottled skin;
  • urinating less than usual or not at all;
  • irritation of the skin or vein where the medicine is injected;
  • sudden numbness or weakness, especially on one side of the body; or
  • sudden headache, confusion, problems with vision, speech, or balance.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about norepinephrine (Levophed Bitartrate)?

Before receiving norepinephrine, tell your doctor if you have high blood pressure (hypertension), overactive thyroid, asthma, or a sulfite allergy.

Tell your caregivers right away about any serious side effects such as muscle pain or weakness, numb or cold feeling, trouble breathing, urinating less than usual, irritation of the skin or vein where the medicine is injected, uneven heart rate, sudden numbness or weakness, especially on one side of the body, or sudden headache, confusion, or problems with vision, speech, or balance.

Symptoms of a norepinephrine overdose may include slow heart rate, severe headache, blurred vision, trouble concentrating, increased sensitivity to light, stabbing chest or back pain, pale skin, sweating, vomiting, or seizure (convulsions).

What should I discuss with my health care provider before receiving norepinephrine (Levophed Bitartrate)?

Before receiving norepinephrine, tell your doctor if you are allergic to any drugs, or if you have:

  • high blood pressure (hypertension);
  • overactive thyroid; or
  • asthma or a sulfite allergy;

If you have any of these conditions, you may not be able to receive norepinephrine, or you may need dosage adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It not known whether norepinephrine passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is norepinephrine given (Levophed Bitartrate)?

Norepinephrine is given as an injection through a needle placed into a large vein.

You will receive this injection in a hospital or emergency setting. Norepinephrine is usually given for as long as needed until your body responds to the medication. Some people must receive norepinephrine for several days.

To be sure norepinephrine is not causing harmful effects, your blood pressure and breathing will be checked during the entire time you are receiving this medication.

Tell your caregivers if you have 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 medication accidentally leaks out of the vein.

What happens if I miss a dose (Levophed Bitartrate)?

Since norepinephrine is usually given as needed in a hospital or emergency setting, it is not likely that you will miss a dose.

What happens if I overdose (Levophed Bitartrate)?

Symptoms of a norepinephrine overdose may include slow heart rate, severe headache, blurred vision, trouble concentrating, increased sensitivity to light, stabbing chest or back pain, pale skin, sweating, vomiting, or seizure (convulsions).

What should I avoid while receiving norepinephrine (Levophed Bitartrate)?

Follow your doctor's instructions about any restrictions in food, beverages, activities, or other medications after treatment with norepinephrine.

What other drugs will affect norepinephrine (Levophed Bitartrate)?

Before receiving norepinephrine, tell your doctor if you are using any of the following drugs:

  • blood pressure medications;
  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate); or
  • an antidepressant such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

If you are using any of these drugs, you may not be able to receive norepinephrine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect norepinephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist has information about norepinephrine written for health professionals that you may read.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 1.03. Revision date: 4/12/2009.

Your use of the content provided in this service indicates that you have read,understood and agree to the End-User License Agreement,which can be accessed by clicking on this link.

Healthwise

Last Updated: April 12, 2009


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