Sodium nitroprusside (Intravenous)

Sodium nitroprusside injection is used to quickly lower blood pressure in adults and children with high blood pressure. This medicine is also used to decrease bleeding during surgery and to treat acute heart failure. This medicine works as a direct-acting vasodilator.

This medicine should only be given by or under the direct supervision of your doctor.

Your doctor will monitor your progress closely while you or your child are receiving this medicine. This will help your doctor determine if the medicine is effective and if you should keep receiving it. Blood tests may be necessary to check for side effects.

Using this medicine during pregnancy can harm your unborn baby. Use an effective form of birth control to avoid becoming pregnant. If you think you may be pregnant while using this medicine, inform your doctor immediately.

Do not use this medicine with riociguat (Adempas®), sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®). Taking these medicines together may cause side effects.

This medicine may lower your blood pressure too much and make you feel dizzy or lightheaded. If you feel dizzy, rise slowly from a sitting or lying position.

Inform your doctor right away if you or your child experience bluish-colored lips, fingernails, or palms, dark urine, difficulty breathing, unusual bleeding, bruising, or weakness while using this medicine.

In deciding to use a medicine, the risks of taking it must be weighed against the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also inform your healthcare professional about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies done so far have not shown any specific problems in children that would limit the usefulness of sodium nitroprusside injection.

Geriatric

There is no information on how age affects the use of sodium nitroprusside injection in older patients. However, older patients are more likely to have low blood pressure, which may require caution when using this medicine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. In these situations, your doctor may want to adjust the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication, or change some of the other medicines you take.

• Sildenafil

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at or around the time of eating food or certain types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect how you use this medicine. Make sure to tell your doctor if you have any other medical issues, especially:

• Anemia or
• Hypovolemia (low blood volume)—Should be corrected first before using this medicine.

• Anuria (trouble urinating) or
• Liver disease—Use with caution. May increase the risk of cyanide toxicity.

• Circulation problems or
• Heart disease (e.g., arteriovenous shunting, coarctation of the aorta) or
• Heart failure, acute caused by reduced peripheral vascular resistance or
• Leber's optic atrophy, congenital or
• Tobacco amblyopia—Should not be used in patients with these conditions.

• Head injury or
• Methemoglobinemia—Use with caution. May worsen these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may happen, if they do occur, they may need medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

Less common

• Chest pain or discomfort
• fast, pounding, or irregular heartbeat or pulse
• lightheadedness, dizziness, or fainting
• slow heartbeat
• trouble breathing
• unusual tiredness

Incidence not known

• Bluish-colored lips, fingernails, or palms
• blurred vision
• confusion
• dark urine
• difficulty with breathing
• fever
• headache
• pale skin
• rapid heart rate
• sore throat
• sweating
• unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Abdominal or stomach pain
• constipation
• depressed mood
• dizziness
• dry skin and hair
• feeling cold or warmth
• hair loss
• headache
• hoarseness or husky voice
• increased sweating
• irritation at the infusion site
• muscle cramps, stiffness, or twitching
• nausea
• rash
• redness of the face, neck, arms, and occasionally, upper chest
• weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nipride RTU
• Nitropress

Available Dosage Forms:

• Solution

Therapeutic Class: Peripheral Vasodilator

A nurse or other trained health professional will give you or your child this medicine in a hospital. This medicine is given through a needle placed in one of your veins.