Applies to nitroprusside: intravenous solution.
Warning
Intravenous route (Solution)
Sodium nitroprusside may cause precipitous decreases in blood pressure and may lead to irreversible ischemic injuries or death. Continuous blood pressure monitoring is required. Sodium nitroprusside metabolism produces dose-related cyanide and may be lethal. Limit infusions at the maximum rate (10 mcg/kg/min) to the shortest duration possible as patient's ability to buffer cyanide will be exceeded in less than 1 hour at this rate.
Intravenous route (Solution)
Sodium nitroprusside is not suitable for direct injection; the reconstituted solution must be further diluted in sterile 5% dextrose injection before infusion. Sodium nitroprusside can cause precipitous decreases in blood pressure; monitor blood pressure continuously while patient is on therapy. Nitroprusside can cause cyanide toxicity which can be lethal. Infusion at the maximum dose rate (10 mcg/kg/min) should never last more than 10 minutes. Monitor acid-base balance and venous oxygen concentration while on therapy; these tests may indicate cyanide toxicity.
Serious side effects of Nitroprusside
Along with its needed effects, nitroprusside may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking nitroprusside:
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
Other side effects of Nitroprusside
Some side effects of nitroprusside 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
For Healthcare Professionals
Applies to nitroprusside: intravenous powder for injection, intravenous solution.
General
The most important adverse reactions are excessive hypotension and cyanide toxicity.[Ref]
Cardiovascular
Frequency not reported: Hypotension, excessive hypotension, palpitations, bradycardia, electrocardiographic changes, tachycardia, flushing, venous streaking, retrosternal discomfort[Ref]
Gastrointestinal
Frequency not reported: Abdominal pain, nausea, retching, ileus[Ref]
Hematologic
Frequency not reported: Methemoglobinemia, platelet aggregation decreased, anemia[Ref]
Metabolic
Frequency not reported: Cyanide toxicity, thiocyanate toxicity, hypovolemia[Ref]
Nervous system
Frequency not reported: Dizziness, headache, intracranial pressure increased[Ref]
Dermatologic
Frequency not reported: Diaphoresis, rash[Ref]
Psychiatric
Frequency not reported: Apprehension, restlessness[Ref]
Endocrine
Frequency not reported: Hypothyroidism[Ref]
Local
Frequency not reported: Infusion site irritation[Ref]
Musculoskeletal
Frequency not reported: Muscle twitching[Ref]
