Natrecor Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Natrecor Injection (nesiritide) is a natriuretic peptide medicine given intravenously in the hospital to treat acute flare-ups of heart failure, specifically for shortness of breath at rest or with minimal activity. It works like a natural heart hormone, relaxing and widening blood vessels to ease strain on the heart. It is given as an initial bolus followed by continuous infusion, with close blood pressure monitoring throughout treatment.

What is Natrecor Injection

Natrecor is a man-made form of a hormone that the heart naturally makes during heart failure to help it work more efficiently. It is given as an intravenous (IV) infusion in a hospital setting for people having an acute flare-up of heart failure.

Natrecor Injection uses

• Treatment of patients with acutely decompensated heart failure who have shortness of breath (dyspnea) at rest or with minimal activity
• For hospitalized patients with acute episodes of heart failure who did not respond to treatment with diuretic drugs for two hours

Benefits of Natrecor Injection

• Reduced pulmonary capillary wedge pressure (a measure of fluid pressure in the heart/lungs)
• Improved short-term (3-hour) symptoms of dyspnea (shortness of breath)
• Improves the heart's ability to function and relieves symptoms of heart failure, including breathlessness

How Natrecor Injection works

Natrecor works like a natural heart hormone that relaxes and widens blood vessels. It attaches to receptors on blood vessel walls, which causes the smooth muscles in veins and arteries to relax and widen, lowering blood pressure and reducing strain on the heart.

Natrecor Injection dosage

Natrecor is given only by intravenous (IV) infusion in a hospital setting, never taken by mouth. It is given as an initial IV bolus (quick injection) followed by a continuous IV infusion over a longer period. Blood pressure must be monitored closely throughout treatment, and there is limited experience giving this medicine for longer than the studied treatment durations.

The loading (bolus) dose may not be suitable for patients with low blood pressure before starting treatment or those recently given other blood-pressure-lowering medicines. Dose increases, if needed, are not done more often than every 3 hours. If low blood pressure occurs, the dose may be reduced or the infusion stopped, and the drug may be restarted later at a lower dose once the patient is stable.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Injection

Side effects of Natrecor Injection

Common

• Low blood pressure (hypotension)
• Nausea
• Vomiting
• Back pain
• Headache
• Dizziness
• Numbness or tingly feeling
• Tremors
• Vision changes

Serious

• Hives
• Difficulty breathing
• Swelling of face, lips, tongue, or throat
• Confusion
• Lightheadedness
• Fainting
• Fast, slow, or irregular heartbeats
• Urinating less than usual
• Chest pain
• Fever
• Unusual weakness or tiredness
• Worsening kidney function (increased creatinine)
• Serious allergic/hypersensitivity reactions

Warnings and precautions

• This medicine should not be given to patients with cardiogenic shock (when the heart cannot pump enough blood for the body), persistent low systolic blood pressure before starting treatment, or known allergy to any of its ingredients.
• This medicine should be avoided in people who are suspected or known to have low cardiac filling pressures, and is not recommended for certain heart conditions where vasodilating drugs are inappropriate.
• This medicine can cause low blood pressure, which may last for a long time. It should only be given where blood pressure can be closely watched and quickly treated if needed.
• Serious allergic reactions have occurred with this medicine, especially in people who have reacted to similar lab-made proteins in the past.
• This medicine has not been studied in children and is not recommended for use in anyone under 18.
• There isn't enough information to know if this medicine is safe during pregnancy. It should only be used if the potential benefit to the mother is thought to outweigh any possible risk to the unborn baby.
• It is not known whether this medicine passes into breast milk, so caution is advised and you should talk to your doctor before breastfeeding.
• This medicine can affect kidney function, so your kidney function (creatinine levels) will be monitored during and after treatment.
• Tell your doctor if you have or have ever had liver problems before starting this medicine.

Storage

• Store below 25°C (Store at 2-25°C in Canadian labeling). Do not freeze.
• Keep the vial in the outer carton to protect from light.
• Do not use after the expiry date stated on the label and carton.
• Keep out of the reach of children.
• Reconstituted vials may be stored for up to 24 hours as directed by healthcare staff.

When to see a doctor

• Get medical help right away if you notice hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Seek medical care immediately if you have confusion, lightheadedness, fainting, an irregular or unusual heartbeat, reduced urination, chest pain, fever, or unusual weakness or tiredness.
• Seek emergency medical care right away for serious eye symptoms like sudden vision loss, blurred vision, tunnel vision, eye pain, swelling, or seeing halos around lights.
• Seek emergency care right away for serious heart symptoms such as a fast, irregular, or pounding heartbeat, fluttering in the chest, shortness of breath, or sudden dizziness or passing out.
• Seek emergency care right away for a severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, heavy sweating, or tremors.

Alternatives

• Nitroglycerin
• Milrinone
• Furosemide