Norepinephrine (drug)

Norepinephrine

Systematic (IUPAC) name
4-[(1R)-2-amino-1-hydroxyethyl]benzene-1,2-diol
Clinical data
Trade names	Levarterenol, Levophed, Norepin
AHFS/Drugs.com	monograph
License data	US FDA: Norepinephrine
Pregnancy category	AU: B3 US: C (Risk not ruled out)
Routes of administration	Intravenous
Legal status
Legal status	AU: S4 (Prescription only) CA: ℞-only UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Metabolism	Hepatic
Excretion	Urine (84–96%)
Identifiers
CAS Number	51-41-2
ATC code	C01CA03 (WHO)
PubChem	CID 439260
IUPHAR/BPS	505
DrugBank	DB00368
ChemSpider	388394
UNII	X4W3ENH1CV
KEGG	D00076
ChEBI	CHEBI:18357
ChEMBL	CHEMBL1437
Synonyms	Noradrenaline (R)-(–)-Norepinephrine l-1-(3,4-Dihydroxyphenyl)-2-aminoethanol
Chemical data
Formula	C8H11NO3
Molar mass	169.18 g/mol
SMILES Oc1ccc(cc1O)[C@@H](O)CN
InChI InChI=1S/C8H11NO3/c9-4-8(12)5-1-2-6(10)7(11)3-5/h1-3,8,10-12H,4,9H2/t8-/m0/s1 Key:SFLSHLFXELFNJZ-QMMMGPOBSA-N
Physical data
Density	1.397±0.06 g/cm^3
Melting point	217 °C (423 °F) (decomposes)
Boiling point	442.6 °C (828.7 °F) ±40.0°C
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Norepinephrine, also known as noradrenaline, is a medication used to treat people with very low blood pressure. It is manufactured with the same formulation as the hormone and neurotransmitter norepinephrine. It is given intravenously.

At high doses, and especially when it is combined with other vasopressors, it can lead to limb ischemia and limb death.

Medical uses

Norepinephrine is used mainly as a sympathomimetic drug to treat people in vasodilatory shock states such as septic shock and neurogenic shock, while showing fewer adverse side-effects compared to dopamine treatment.^[1]

Mechanism of action

It acts on both α₁ and α₂ adrenergic receptors to cause blood vessel contraction. Its effects are often limited to the increasing of blood pressure through agonist activity on α₁ and α₂ receptors, and causing a resultant increase in peripheral vascular resistance.

Names

Norepinephrine is the INN while noradrenaline is the BAN.

References

1. De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL (March 2010). "Comparison of dopamine and norepinephrine in the treatment of shock". The New England Journal of Medicine 362 (9): 779–89. doi:10.1056/nejmoa0907118. PMID 20200382.