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Nitropress

Sodium nitroprusside
Sodium-nitroprusside-2D.png
Sodium-nitroprusside-sample.jpg
Idealized depiction of this compound (top), and a picture of a sample (bottom).
Clinical data
Trade names Nipride, Nitropress, others
AHFS/Drugs.com Monograph
License data
Pregnancy
category
  • AU: C
  • US: C (Risk not ruled out)
Routes of
administration
intravenous
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 100% (intravenous)
Metabolism By haemoglobin being converted to cyanmethaemoglobin and cyanide ions
Onset of action nearly immediate
Biological half-life <2 minutes (3 days for thiocyanate metabolite)
Duration of action 1 to 10 minutes
Excretion kidney (100%; as thiocyanate)
Identifiers
Synonyms SNP
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
ChEMBL
Chemical and physical data
Formula C5FeN6Na2O
Molar mass 261.918
3D model (JSmol)
Density 1.72 g/cm3
Solubility in water 100 mg/mL (20 °C)

Sodium nitroprusside (SNP), sold under the brand name Nitropress among others, is a medication used to lower blood pressure. This may be done if the blood pressure is very high and resulting in symptoms, in certain types of heart failure, and during surgery to decrease bleeding. It is used by continuous injection into a vein. Onset is typically immediate and effects last for up to ten minutes.

Common side effects include low blood pressure and cyanide toxicity. Other serious side effects include methemoglobinemia. It is not generally recommended during pregnancy due to concerns of side effects. High doses are not recommended for more than ten minutes. It works by causing the dilation of blood vessels.

Sodium nitroprusside was discovered as early as 1850 and found to be useful in medicine in 1928. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In the United States a course of treatment costs less than 25 USD.

Sodium nitroprusside is intravenously infused in cases of acute hypertensive crises. Its effects are usually seen within a few minutes.

Nitric oxide reduces both total peripheral resistance and venous return, thus decreasing both preload and afterload. So, it can be used in severe congestive heart failure where this combination of effects can act to increase cardiac output. In situations where cardiac output is normal, the effect is to reduce blood pressure. It is sometimes also used to induce hypotension (to reduce bleeding) for surgical procedures (for which it is also FDA, TGA, and MHRA labelled).


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