Nesiritide

Nesiritide is a prescription medication used to treat the symptoms of Acutely Decompensated Chronic Heart Failure (CHF) with Shortness of Breath (Dyspnea) at Rest. 

• Nesiritide is available under the following different brand names: Natrecor

Common side effects of Nesiritide include:

• Headache,
• Mild dizziness,
• Nausea,
• Vomiting,
• Back pain,
• Numbness or tingly feeling,
• Tremors, and
• Vision changes

Serious side effects of Nesiritide include:

• Hives,
• Difficulty breathing,
• Swelling of the face, lips, tongue, or throat,
• Confusion,
• Lightheadedness,
• Fainting,
• Fast, slow, or irregular heartbeats,
• Urinating less than usual,
• Chest pain,
• Fever, and
• Unusual weakness or tiredness

Rare side effects of Nesiritide include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out. 

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Injectable solution

• 1.5 mg/vial

Acutely Decompensated CHF with Dyspnea at Rest

Adult dosage

• 2 mcg/kg Intravenous bolus over 1 minute, THEN
• 0.01mcg/kg/min Intravenous infusion  
• If hypotension, discontinue until stabilized, then restart at a 30% lower dose
• Limited data available for use longer than 48 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Nesiritide has serious interactions with no other drugs.
• Nesiritide has severe interactions with no other drugs.
• Nesiritide has moderate interactions with the following drugs
  • benazepril
  • bretylium
  • captopril
  • enalapril
  • fosinopril
  • lisinopril
  • maraviroc
  • moexipril
  • perindopril
  • quinapril
  • ramipril
  • trandolapril
• Nesiritide has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Atrial/ventricular arrhythmias, constrictive pericarditis, restrictive or obstructive cardiomyopathy, pericardial tamponade, significant valvular stenosis, suspected low cardiac filling pressures
• Hypersensitivity
• Primary treatment for patients with cardiogenic shock
• Persistent systolic BP below 100 mm Hg

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Nesiritide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Nesiritide?”

Cautions

• Hypotension effects may be additive when using other agents that cause hypotension
• Potential for nephrotoxicity
• Use only in a hospital setting
• Caution in patients with renal impairment

Pregnancy and Lactation

• There are no data to assess a drug-associated risk of major birth defects, miscarriage, or adverse maternal-fetal outcomes with therapy use in pregnant women; in animal reproduction studies, intravenous administration to pregnant rabbits, during the period of organogenesis at 100 times the maximum recommended human dose (MRHD) did not result in any toxicities to the rabbits or their developing fetuses
• Pregnant women with heart failure are at increased risk for preterm birth; heart failure may worsen with pregnancy and lead to maternal death or stillbirth
• Lactation
  • There are no data on the presence of nesiritide in human or animal breast milk, or regarding the effect on the breastfed child or milk production