Nesiritide BNP Brand Name– Natrecor
What is Nesiritide BNP
Nesiritide is an intravenous recombinant purified preparation of human B-type natriuretic peptide (hBNP), a naturally-occurring hormone produced in the ventricles of the heart. The drug is produced in E. coli using recombinant DNA technology.
Nesiritide is indicated for the acute treatment of decompensated congestive heart failure (CHF), and has primarily been studied in patients with elevated pulmonary capillary wedge pressure (PCWP) more than 18 to 20 mmHg.
In decompensated heart failure, the use of nesiritide reduces PCWP and has been shown to improve the symptoms of heart failure, including global clinical status, dyspnea, and fatigue.
The overall safety of nesiritide has been questioned based on the results of two publications which have reported an increased risk of worsening renal function and a trend toward increased mortality in nesiritide-treated patients versus placebo.
Indications
- heart failure
For the treatment of acutely decompensated congestive heart failure in patients who have dyspnea at rest or with minimal activity
Side Effects
- abdominal pain
- amblyopia
- anemia
- angina
- anxiety
- apnea
- atrial fibrillation
- azotemia
- back pain
- bradycardia
- confusion
- cough
- diaphoresis
- dizziness
- drowsiness
- fever
- headache
- hemoptysis
- hypoglycemia
- hypotension
- injection site reaction
- insomnia
- muscle cramps
- nausea
- orthostatic hypotension
- paresthesias
- premature ventricular contractions (PVCs)
- pruritus
- rash
- renal failure (unspecified)
- sinus tachycardia
- syncope
- tremor
- ventricular tachycardia
- vomiting
Monitoring Parameters
- serum creatinine/BUN
- weight
Contraindications
- aortic stenosis
- atrial fibrillation
- atrial flutter
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cardiogenic shock
- cardiomyopathy
- cerebrovascular disease
- children
- constrictive pericarditis
- coronary artery disease
- E. coli protein hypersensitivity
- geriatric
- hypotension
- hypovolemia
- idiopathic hypertrophic subaortic stenosis
- infants
- mitral stenosis
- neonates
- orthostatic hypotension
- pericardial effusion
- pregnancy
- renal disease
- renal failure
- renal impairment
- respiratory depression
- valvular heart disease
- ventricular arrhythmias
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Propoxyphene
- Alfentanil
- Alpha-blockers
- Amyl Nitrite
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Belladonna; Opium
- Beta-adrenergic blockers
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Calcium-channel blockers
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cardiac glycosides
- Central-acting adrenergic agents
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Dexmedetomidine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dobutamine
- Dopamine
- Epinephrine
- Eplerenone
- Epoprostenol
- Fentanyl
- General anesthetics
- Ginger, Zingiber officinale
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Ibuprofen; Oxycodone
- Iloprost
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Levorphanol
- Loop diuretics
- Mecamylamine
- Meperidine
- Meperidine; Promethazine
- Methadone
- Methohexital
- Morphine
- Morphine; Naltrexone
- Nitrates
- Nitroglycerin
- Opiate Agonists
- Oxycodone
- Oxymorphone
- Potassium-sparing diuretics
- Prilocaine; Epinephrine
- Propoxyphene
- Remifentanil
- Reserpine
- Sildenafil
- Sufentanil
- Thiazide diuretics
- Thiopental
- Treprostinil
- Vasodilators