Norfine Adverse Reactions

Table 2 lists adverse reactions that have been experienced following treatment with Norepinephrine. This data has largely been collected from spontaneous reporting, and due to the problems in calculating reporting frequencies from spontaneous reporting, the frequency of the listed adverse reactions is 'not known' (cannot be estimated from the available data). The adverse reactions are reported in decreasing order of frequency within each system order class (SOC). (See Table 2.)

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The continuous administration of vasopressor to maintain blood pressure in absence of blood volume replacement may cause the following symptoms: severe peripheral and visceral vasoconstriction; decrease in renal blood flow; decrease in urine production; hypoxia; increase in lactate serum levels.
In case of hypersensitivity or overdose, the following effects may appear more frequently: hypertension, photophobia, retrosternal pain, pharyngeal pain, pallor, intense sweating and vomiting.
The vasopressor effect (resulting from the adrenergic action on the vessels) can be reduced by the concomitant administration of an alpha blocking agent (phentolamine mesilate) whereas the administration of a beta blocking agent (propranolol) may result in a reduction of the stimulating effect of the product on the heart and in an increase of the hypertensor effect (through reduction of arteriolar dilatation), resulting from beta-1 adrenergic stimulation.
Prolonged administration of any potent vasopressor may result in plasma volume depletion which should be continuously corrected by appropriate water and electrolyte replacement therapy. If plasma volumes are not corrected, hypotension may recur when the Norepinephrine infusion is discontinued, or blood pressure may be maintained with the risk of severe peripheral and visceral vasoconstriction with diminution in blood flow.
Hypertension may occur, which may be associated with bradycardia as well as headache and peripheral ischemia, including gangrene of the extremities.