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Home / Drugs / Starting with N / Norepinephrine
 
Norepinephrine
 

Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [PubChem]
CategoriesVasoconstrictor Agents
Sympathomimetics
Adrenergic alpha-Agonists
ManufacturersHospira inc
PackagersBedford Labs
Cardinal Health
Draxis Specialty Pharmaceuticals Inc.
Hospira Inc.
Paddock Labs
Pharmedium
Sicor Pharmaceuticals
Teva Pharmaceutical Industries Ltd.
SynonymsArterenol
L-noradrenaline
L-Norepinephrine
Noradrenaline

indication

Mainly used to treat patients in vasodilatory shock states such as septic shock and neurogenic shock and has shown a survival benefit over dopamine. Also used as a vasopressor medication for patients with critical hypotension.

pharmacology

Noradrenaline acts on both alpha-1 and alpha-2 adrenergic receptors to cause vasoconstriction. Its effect in-vitro is often limited to the increasing of blood pressure through antagonising alpha-1 and alpha-2 receptors and causing a resultant increase in systemic vascular resistance.

mechanism of action

Norepinephrine functions as a peripheral vasoconstrictor by acting on alpha-adrenergic receptors. It is also an inotropic stimulator of the heart and dilator of coronary arteries as a result of it's activity at the beta-adrenergic receptors.

toxicity

In high dose and especially when it is combined with other vasopressors, it can lead to limb ischemia and limb death.

drug interactions

Amitriptyline: The tricyclic antidepressant, amitriptyline, increases the sympathomimetic effect of norepinephrine.

Amoxapine: The tricyclic antidepressant, amoxapine, increases the sympathomimetic effect of norepinephrine.

Clomipramine: The tricyclic antidepressant, clomipramine, increases the sympathomimetic effect of norepinephrine.

Desipramine: The tricyclic antidepressant, desipramine, increases the sympathomimetic effect of norepinephrine.

Desvenlafaxine: Desvenlafaxine may increase the tachycardic and vasopressor effects of norepinephrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache.

Doxepin: The tricyclic antidepressant, doxepin, increases the sympathomimetic effect of norepinephrine.

Entacapone: Entacapone increases the effect and toxicity of the sympathomimetic, norepinephrine.

Guanethidine: Norepinephrine may decrease the effect of guanethidine.

Imipramine: The tricyclic antidepressant, imipramine, increases the sympathomimetic effect of norepinephrine.

Isocarboxazid: Increased arterial pressure

Linezolid: Possible increase of arterial pressure

Methyldopa: Increased arterial pressure

Midodrine: Increased arterial pressure

Moclobemide: Moclobemide increases the sympathomimetic effect of norepinephrine.

Nortriptyline: The tricyclic antidepressant, nortriptyline, increases the sympathomimetic effect of norepinephrine.

Phenelzine: Increased arterial pressure

Rasagiline: Increased arterial pressure

Reserpine: Increased arterial pressure

Trimipramine: Trimipramine may increase the vasopressor effect of the direct-acting alpha-/beta-agonist, Norepinephrine. Avoid combination if possible. Monitor sympathetic response to therapy if used concomitantly.

Venlafaxine: Venlafaxine may increase the tachycardic and vasopressor effects of Norepinephrine. Consider alternate therapy or monitor for increased sympathomimetic effects, such as increased blood pressure, chest pain and headache.