Sodium Nitroprusside

Trade name

DBL Sodium Nitroprusside, Nitroprusside SXP, Sodium Nitroprusside (Baxter), Sodium Nitroprusside (Medsurge)

Presentation and preparation

25 mg/mL (volume: 2 mL)

IV administration

Must be diluted prior to administration.

Dilute to 50 to 200 microgram/mL and give as a continuous infusion using a syringe pump with DERS.

Maximum concentration if necessary: 1 mg/mL.

RCH Standard Concentrations:

NICU:

0 to < 2 kg: 5 mg/25 mL (0.2 mg/mL)

2 kg+: 15 mg/25 mL (0.6 mg/mL)

PICU:

0 to < 10 kg: 10 mg/50 mL (0.2 mg/mL) low dose; 30 mg/50 mL (0.6 mg/mL)

10 kg+: 50 mg/50 mL or 100 mg/100 mL (1 mg/mL)

Other routes of administration

IM: Not recommended.

SC: Not recommended.

Compatible IV fluids

Glucose 5%

Y-site only:

Hartmann's

Sodium chloride 0.9%

Potassium chloride 20 mmol/L

Y-site only and sodium nitroprusside 600 microgram/mL or weaker:

Plasma-Lyte 148

Additional information

Extravasation risk.

Administration may cause significant hypotension. Patients should remain lying down during administration.

Monitor blood pressure and heart rate.

Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.

Monitor for cyanide and thiocyanate toxicity, particularly in patients with renal dysfunction and/or where high dose rates or prolonged infusions are necessary.

Taper the infusion slowly when discontinuing treatment; abrupt discontinuation may cause rebound hypertension.

Protect from light during storage and administration by covering infusion bag/syringe with either the opaque sleeve provided, aluminium foil or a light-excluding pouch.

Solutions are clear and slightly reddish-brown in colour.

Discard any unused vial contents.