Nitroprusside Sodium
Pronunciation: (nye-troe-PRUS-ide SO-dee-um).
- Generic name
- Nitroprusside sodium
- Brand names
- Nitroprusside, Nitropress, Nitroprussiate, Nipride, Nitrovas, Sodium Nitroprusside
- Drug class
- Vasodilator; Antihypertensive agent
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What Nitroprusside sodium is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Nitroprusside sodium works
Nitroprusside sodium acts as a direct-acting peripheral vasodilator. It releases nitric oxide (NO) upon entering the bloodstream, which activates guanylate cyclase in vascular smooth muscle. This increases cyclic GMP, leading to smooth muscle relaxation, vasodilation of both arterioles and venules, and rapid reduction in systemic vascular resistance and blood pressure. (1)
What Nitroprusside sodium is used for
Hypertensive emergencies
Hypertensive emergencies (1)
Acute decompensated heart failure with reduced ejection fraction
Acute decompensated heart failure with reduced ejection fraction (1)
Controlled hypotension during surgery
Controlled hypotension during surgery (1)
Aortic dissection
Aortic dissection (1)
Before taking Nitroprusside sodium
Do not take / not appropriate for
- Known hypersensitivity, compensatory hypertension (e.g., due to arteriovenous shunt or coarctation of the aorta), acute heart failure with reduced peripheral resistance. (Contraindication) (1)
Tell your clinician about
(1)How to take Nitroprusside sodium
- General Instructions: Nitroprusside sodium is administered by continuous intravenous infusion in a hospital setting. It is never taken by mouth or self-administered.. Adult Dosing: Initial dose: 0.3 mcg/kg/min IV infusion, titrated every few minutes as needed. Usual effective dose: 0.5–10 mcg/kg/min. Maximum recommended dose: 10 mcg/kg/min for no more than 10 minutes.. Pediatric Dosing: Children: Start at 0.3–0.5 mcg/kg/min IV infusion, titrate as needed. Maximum: 8–10 mcg/kg/min.. Administration: Given by slow, continuous IV infusion using a controlled infusion pump. Blood pressure and vital signs must be monitored continuously.. When To Stop: The infusion should be stopped or reduced if blood pressure drops too low, if signs of toxicity develop, or as directed by your healthcare provider.. Storage: Store unopened vials at room temperature, protected from light. Once prepared, the solution should be shielded from light and used within 24 hours.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Not applicable, as nitroprusside sodium is administered in a hospital setting by healthcare professionals. If a dose is interrupted, your care team will adjust as needed.
Overdose
Symptoms of overdose include severe hypotension, metabolic acidosis, and cyanide toxicity (rapid breathing, confusion, seizures). Immediate supportive care, discontinuation of infusion, and administration of specific antidotes (e.g., sodium thiosulfate) may be required. Seek emergency medical attention immediately. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Hypotension
Incidence: Reported in the clinician-authored database; frequency not established
Tachycardia
Incidence: Reported in the clinician-authored database; frequency not established
Palpitations
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Cyanide toxicity
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
Risk of cyanide and thiocyanate toxicity, especially with prolonged or high-dose infusions — serious
Symptoms: Risk of cyanide and thiocyanate toxicity, especially with prolonged or high-dose infusions. Continuous blood pressure and vital sign monitoring is mandatory. Not for use in patients with compensatory hypertension or certain acute heart failure cases. Use with caution in patients with renal or hepatic impairment. May cause severe hypotension and reflex tachycardia.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications: Known hypersensitivity, compensatory hypertension (e.g., due to arteriovenous shunt or coarctation of the aorta), acute heart failure with reduced peripheral resistance.<br>Precautions: Use with caution in renal or hepatic impairment (risk of toxicity), pregnancy, and in elderly patients. Avoid prolonged infusions and high doses to minimize risk of cyanide/thiocyanate accumulation.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Nitroprusside sodium may interact with other antihypertensive agents, diuretics, and medications that affect blood pressure. Concomitant use with phosphodiesterase inhibitors (e.g., sildenafil) or other vasodilators may increase the risk of hypotension. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
The FDA label reviewed for this page states there are no adequate, well-controlled studies of sodium nitroprusside in pregnant women; it is not known whether it can cause fetal harm. In pregnant ewe studies, nitroprusside crossed the placenta and its cyanide metabolite reached fatal fetal levels at higher infusion rates. Sodium nitroprusside should be given to a pregnant patient only if clearly needed, decided by the treating clinician. (1)
Breastfeeding
The clinician-authored record and the FDA label reviewed for this page do not establish breastfeeding safety data for sodium nitroprusside; given its cyanide/thiocyanate metabolites and use only in acute monitored settings, breastfeeding decisions should be made with the treating clinical team. (1)
Children
Frequency: Continuous intravenous infusion.. Weight Based: Not established; dosing is based on clinical response.. Max Daily Dose: Not established; use with caution.. Max Single Dose: Not applicable as dosing is continuous infusion.. Age Restrictions: Safety not established in children. (1)
Renal_impairment
Renal: the FDA label states that thiocyanate (the secondary metabolite) is cleared primarily by the kidneys, normally with a half-life of about 3 days; in renal failure this half-life can be doubled or tripled, raising the risk of thiocyanate accumulation and toxicity — renal function should be monitored closely during infusion, especially if prolonged. Hepatic: the label has no dedicated hepatic-impairment section, but notes the liver's role (with thiosulfate) in converting cyanide to thiocyanate, so significant hepatic dysfunction may also affect cyanide clearance; hepatic status should be assessed by the treating clinician. (1)
Hepatic_impairment
Renal: the FDA label states that thiocyanate (the secondary metabolite) is cleared primarily by the kidneys, normally with a half-life of about 3 days; in renal failure this half-life can be doubled or tripled, raising the risk of thiocyanate accumulation and toxicity — renal function should be monitored closely during infusion, especially if prolonged. Hepatic: the label has no dedicated hepatic-impairment section, but notes the liver's role (with thiosulfate) in converting cyanide to thiocyanate, so significant hepatic dysfunction may also affect cyanide clearance; hepatic status should be assessed by the treating clinician. (1)
Monitoring
(1)Storage
The FDA label reviewed for this page directs that sodium nitroprusside injection be stored at 20-25°C (68-77°F) (USP Controlled Room Temperature), protected from light in its carton until use; once diluted, the infusion solution must also be protected from light (light-protective sleeve) and any unused solution discarded 24 hours after dilution.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Hypertensive emergencies
Dose summary: Initial infusion rate of 0.3 mcg/kg/min, titrated to effect.
Renal context: The FDA label states thiocyanate (the secondary metabolite) is cleared primarily by the kidneys with a normal half-life of about 3 days; in renal failure this half-life can be doubled or tripled, increasing the risk of thiocyanate toxicity. Closer monitoring and lower infusion rates/duration are warranted in renal impairment, at the treating clinician's discretion. (1)
Hepatic guidance
The FDA label reviewed for this page has no dedicated hepatic-impairment section for sodium nitroprusside, but the liver participates (together with thiosulfate) in converting cyanide to thiocyanate; significant hepatic dysfunction may therefore affect cyanide clearance. No specific dose adjustment is given; hepatic status should be assessed by the treating clinician.
Frequently asked questions
What is nitroprusside sodium used for?
Nitroprusside sodium is primarily used to treat hypertensive emergencies (severely high blood pressure) and acute heart failure. It is also sometimes used during surgery to control blood pressure.
How does nitroprusside sodium work?
It works by relaxing and widening blood vessels (vasodilation), which lowers blood pressure and reduces the heart's workload.
Is nitroprusside sodium safe for children?
Yes, it can be used in children under strict medical supervision, with dosing carefully adjusted based on weight and response.
What are the signs of nitroprusside toxicity?
Signs include sudden confusion, rapid breathing, seizures, muscle cramps, and blue or gray skin. These may indicate cyanide or thiocyanate toxicity and require immediate medical attention.
Can I take nitroprusside sodium at home?
No, nitroprusside sodium is only administered in a hospital setting by healthcare professionals due to the need for close monitoring.
What should I tell my doctor before receiving nitroprusside sodium?
Inform your doctor about any kidney or liver problems, all medications you are taking, and any allergies or previous reactions to medications.
How quickly does nitroprusside sodium lower blood pressure?
Nitroprusside sodium acts within seconds to minutes after starting the infusion, making it effective for rapid blood pressure control.
What happens if I take too much Nitroprusside sodium?
Taking too much Nitroprusside sodium can lead to severe hypotension, cyanide toxicity, and metabolic acidosis. Symptoms may include dizziness, extreme weakness, confusion, and difficulty breathing. If you suspect an overdose, seek immediate emergency medical attention. Prompt treatment is crucial to manage these life-threatening complications.
Can I drink alcohol while taking Nitroprusside sodium?
It is generally advised to avoid alcohol while receiving Nitroprusside sodium. As a vasodilator, Nitroprusside sodium already lowers blood pressure. Alcohol can further exacerbate this effect, leading to dangerously low blood pressure (hypotension), dizziness, and fainting. Always consult your healthcare provider regarding alcohol consumption with any medication.
Is Nitroprusside sodium safe during pregnancy?
Nitroprusside sodium's safety during pregnancy is not definitively established, and it is generally categorized as a medication where the risks to the fetus may outweigh the benefits, especially with prolonged use. It is crucial to consult your doctor if you are pregnant or planning to become pregnant, as they will weigh the potential benefits against the risks and determine the most appropriate treatment for your specific situation.
What is the mechanism of action of Nitroprusside sodium?
Nitroprusside sodium acts as a direct-acting peripheral vasodilator. It releases nitric oxide (NO) upon entering the bloodstream, which activates guanylate cyclase in vascular smooth muscle. This increases cyclic GMP, leading to smooth muscle relaxation, vasodilation of both arterioles and venules, and rapid reduction in systemic vascular resistance and blood pressure. (1)
What is the generic name of Nitroprusside Sodium?
The generic name is Nitroprusside sodium. It is sold under brand names including Nitroprusside, Nitropress, Nitroprussiate, Nipride, Nitrovas, Sodium Nitroprusside.
What class of drug is Nitroprusside sodium?
Nitroprusside Sodium is classed as: Vasodilator; Antihypertensive agent.
References
- Nitroprusside Sodium — Prescribing InformationU.S. DailyMed (FDA) · United States · accessed 2026-08-07 · source 1
- SODIUM NITROPRUSSIDE (SODIUM NITROPRUSSIDE) INJECTION [MICRO LABS LIMITED] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Sodium Nitroprusside — FDA approval record (Drugs@FDA ANDA214971)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 3
- Nitroprusside — RxNorm normalized drug concept (RXCUI 7476)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 4
Brand names by country
Single-ingredient Nitroprusside sodium names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- NIPRIDE RTU.5 mg/mL, .2 mg/mL · exela pharma sciences, llc
Canada
- NIPRIDE