nesiritide (Natrecor)
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Indications
Contraindications
- scheduled repetitive use
- to improve renal function
- to enhance diuresis[4]
Dosage
IV, 1 vial/day for 2 days ($400/vial)
Adverse effects
- may be better tolerated than IV nitroglycerin
- less likely than dobutamine to cause tachycardia or arrhythmias
- may cause more prolonged hypotension than nitroglycerin
- may be associated with increased risk of death[3]
- may or may not be associated with renal failure[3][5]
Mechanism of action
- recombinant type-B natriuretic peptide
- reduces systemic vascular resistance
- improves dyspnea & fatigue in patients with CHF
Clinical trials
- [7] nesiritide does not improve dyspnea, reduce rehospitalization or improve all-cause mortality in patients with acute heart failure[7]
Notes
Manufacturer: Scios
More general terms
References
- ↑ Prescriber's Letter 8(9):50 2001
- ↑ Journal Watch 25(11):89, 2005 Sackner-Bernstein JD, Kowalsi M, Fox M Aaronson, K Short-term Risk of Death After Treatment with Nesiritide for Decompensated Heart Failure: A pooled analysis of randomized controlled trials. JAMA 293(April 20): 1900, 2005
- ↑ 3.0 3.1 3.2 FDA MedWatch http://www.fda.gov/medwatch/SAFETY/2005/safety05.htm#natrecor http://www.fda.gov/medwatch/safety/2005/safety05.htm#Natrecor2
- ↑ 4.0 4.1 4.2 Journal Watch 25(15):124, 2005 http://www.natrecor.com/pdf/Braunwald_Panel_Release_&_Report.pdf
- ↑ 5.0 5.1 5.2 Witteles RM et al, Impact of nesritide on renal function in patients with acute decompensated heart failure and pre-existing renal dysfunction: A randomized, double-blind, placebo-controlled clinical trial. J Am Coll Cardiol 2007, 50:1835 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17980284
Silver MA and Yancy CW Using homeostatic peptides in decompenstated heart failure: A reasonable paradigm but a flawed practice? J Am Coll Cardiol 2007, 50:1841 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17980249 - ↑ Yancy CW et al for the FUSION II Investigators Safety and efficacy of outpatient nesiritide in patients with advanced heart failure: Results of the Second Follow-Up Serial Infusions of Nesiritide (FUSION II) trial. Circ Heart Fail 2008, 1:9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19808265
Yancy CW et al for the FUSION II Investigators The Second Follow-up Serial Infusions of Nesiritide (FUSION II) trial for advanced heart failure: study rationale and design. Am Heart J. 2007 Apr;153(4):478-84. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17383282 - ↑ 7.0 7.1 7.2 O'Connor CM Effect of Nesiritide in Patients with Acute Decompensated Heart Failure N Engl J Med 2011; 365:32-43 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21732835
- ↑ 8.0 8.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015