Norepinephrine (medication)

This article is about the medication. For this substance as a naturally occurring hormone, see Norepinephrine.
Norepinephrine
Skeletal formula of noradrenaline
Ball-and-stick model of the zwitterionic form of noradrenaline found in the crystal structure[1]
Clinical data
Trade namesLevarterenol, Levophed, Norepin, other
Other namesNoradrenaline
(R)-(–)-Norepinephrine
l-1-(3,4-Dihydroxyphenyl)-2-aminoethanol
3,4,β-Trihydroxyphenethylamine
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: B3
Routes of
administration		Intravenous
Drug classAdrenergic receptor agonist; Sympathomimetic
ATC code
Physiological data
Source tissuesLocus coeruleus; sympathetic nervous system; adrenal medulla
Target tissuesSystem-wide
Receptorsα1, α2, β1, β3
AgonistsSympathomimetic drugs, clonidine, isoprenaline
AntagonistsTricyclic antidepressants, Beta blockers, antipsychotics
MetabolismMAO-A; COMT
Legal status
Legal status
Pharmacokinetic data
MetabolismMAO-A; COMT
ExcretionUrine (84–96%)
Identifiers
  • 4-[(1R)-2-amino-1-hydroxyethyl]benzene-1,2-diol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC8H11NO3
Molar mass169.180 g·mol−1
3D model (JSmol)
Density1.397±0.06 g/cm3
Melting point217 °C (423 °F) (decomposes)
Boiling point442.6 °C (828.7 °F) ±40.0°C
  • Oc1ccc(cc1O)[C@@H](O)CN
  • 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 checkY
  • Key:SFLSHLFXELFNJZ-QMMMGPOBSA-N checkY
  (verify)

Norepinephrine, also known as noradrenaline and sold under the brand name Levophed among others, is a medication used to treat people with very low blood pressure.[2] It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids.[3] It is the same molecule as the hormone and neurotransmitter norepinephrine.[2] It is given by slow injection into a vein.[2]

Common side effects include headache, slow heart rate, and anxiety.[2] Other side effects include an irregular heartbeat.[2] If it leaks out of the vein at the site it is being given, norepinephrine can result in limb ischemia.[2] If leakage occurs the use of phentolamine in the area affected may improve outcomes.[2] Norepinephrine works by binding and activating alpha adrenergic receptors.[2]

Norepinephrine was discovered in 1946 and was approved for medical use in the United States in 1950.[2][4] It is available as a generic medication.[2]

  1. ^ Andersen AM (1975). "Structural studies of metabolic products of dopamine. IV. Crystal and molecular structure of (-)-noradrenaline". Acta Chemica Scandinavica B. 29 (8): 871–876. doi:10.3891/acta.chem.scand.29b-0871. PMID 1202890.
  2. ^ a b c d e f g h i j "Norepinephrine Bitartrate". The American Society of Health-System Pharmacists. Archived from the original on 26 March 2017. Retrieved 26 March 2017.
  3. ^ Latifi R (2016). Surgical Decision Making: Beyond the Evidence Based Surgery. Springer. p. 67. ISBN 9783319298245. Archived from the original on 2017-03-27.
  4. ^ Encyclopedia of the Neurological Sciences. Academic Press. 2014. p. 224. ISBN 9780123851581. Archived from the original on 2017-03-27.