Intravenously in the form of infusion.
Naniprusom treatment is performed under stationary conditions with the ability to monitor blood pressure, carry out resuscitation measures and with the availability of funds to combat cyanide intoxication.
Intravenous bolus Naniprus is contraindicated!
Naniprus in the form of lyophilized powder should be used only for the preparation of a diluted infusion solution.
Preparation of the solution
The infusion solution is prepared immediately before use (no application of the solution is allowed after 4 hours after cooking).
Dilute the contents of 1 ampoule of the drug in a solvent (enclosed in the kit). The prepared solution is additionally diluted in 500 ml of a 5% solution of dextrose (glucose) or 0.9% sodium chloride solution, protecting the solution from exposure to light.
Infusion is performed by means of an infusion pump with continuous monitoring of blood pressure.
Infusion solution should not be mixed with other drugs!
Dosage
The dose is set individually at constant monitoring of blood pressure.
Adults: For patients who did not receive antihypertensive drugs, the dose is usually 3 μg / kg / min. Initial dose: 0.3-1.5 μg / kg / min. The dose is increased gradually (by 0.5 μg / kg / min every 5 minutes) until an anti-hypertensive effect is achieved. The dose is adjusted so that the reduction in blood pressure during the first hour of infusion does not exceed 25% of the baseline, because of the risk of myocardial, brain or kidney ischemia.The maximum dose for adults is 8-10 μg / kg / min.
If the administration for 10 minutes at a rate of 10 μg / kg per 1 minute does not cause an adequate lowering of blood pressure, it is recommended to immediately stop the infusion.
Do not exceed the dose of 500 μg / min.
To control arterial hypotension during surgery or against the background of taking antihypertensive drugs 3 hours before infusion, it is enough to enter a total dose of 1 mg / kg of body weight.
To avoid compensatory reaction (sharp increase in catecholamines and renin, tachycardia), especially in young patients, the dose should be increased gradually until the desired therapeutic effect is achieved. The rate of administration is also reduced gradually, within 10-30 min to avoid a sharp rise in blood pressure.
Children: experience in the use of Nanipress in children is limited. The usual dosage is the same as for adult patients.
Patients of advanced age (over 65 years): treatment starts with low doses, since older patients are more sensitive to the drug (faster development of antihypertensive effect).
Duration of treatment
When the antihypertensive effect is achieved, the administration should continue onlyseveral hours to avoid the risk of cyanide intoxication.
Treatment with Naniprus should not last more than 72 hours. After the termination it is necessary to begin alternative treatment by antihypertensive means for reception inside.
Heart failure
The initial dose should be 10-15 μg / min, with a gradual increase every 10 minutes to 10-15 μg / min. If necessary, to achieve a satisfactory therapeutic effect, the dose can be increased in the range of 10-200 μg / min.
If during the administration of the drug symptoms of arterial hypotension, hypoperfusion or some other side effects are observed, the rate of infusion should be reduced or discontinued.
Infusion introduction can be continued until the moment of safe transition to therapy inside. Usually the infusion should not exceed 3 days.