Levophed SF Special Precautions

Noradrenaline should only be administered by healthcare professionals who are familiar with its use.
Elderly patients may be especially sensitive to the effects of noradrenaline.
Particular caution should be observed in patients with coronary, mesenteric or peripheral vascular thrombosis because noradrenaline may increase the ischemia and extend the area of infarction. Similar caution should be observed in patients with hypotension following myocardial infarction, in patients with Prinzmetal's variant angina and in patients with diabetes, hypertension or hyperthyroidism.
Noradrenaline should be used with caution in patients who exhibit profound hypoxia or hypercarbia.
Noradrenaline should be used only in conjunction with appropriate blood volume replacement. When infusing noradrenaline, the blood pressure and rate of flow should be checked frequently to avoid hypertension.
Extravasation of the solution may cause local tissue necrosis. The infusion site should be checked frequently. If extravasation occurs, the infusion should be stopped and the area should be infiltrated with phentolamine without delay.
Prolonged administration of any potent vasopressor may result in plasma volume depletion which should be continuously corrected by appropriate fluid and electrolyte replacement therapy. If plasma volumes are not corrected, hypotension may recur when the infusion is discontinued, or blood pressure may be maintained at the risk of severe peripheral and visceral vasoconstriction (e.g., decreased renal perfusion) with diminution in blood flow and tissue perfusion with subsequent tissue hypoxia and lactic acidosis and possible ischemic injury.
Excipient with known effects: This medicinal product contains less than 1 mmol sodium (23 mg) per ampoule. Patients on low sodium diets can be informed that this medicinal product is essentially 'sodium-free'.
This medicinal product may be diluted with sodium containing solutions (see Dosage & Administration and Special Precautions for Disposal and Other Handling under Cautions for Usage) and this should be considered in relation to the total sodium from all sources that will be administered to the patient.
Effects on Ability to Drive and Use Machines: None stated.