What is nitroprusside?

Sodium nitroprusside is disodium pentacyanonitrosylferrate(2-) dihydrate, a hypotensive agent whose structural formula is whose molecular formula is Na 2 [Fe(CN) 5 NO] • 2H 2 O, and whose molecular weight is 297.95. Dry sodium nitroprusside is a reddish-brown powder, soluble in water. In an aqueous solution infused intravenously, sodium nitroprusside is a rapid-acting vasodilator, active on both arteries and veins. Sodium nitroprusside solution is rapidly degraded by trace contaminants, often with resulting color changes. (See DOSAGE AND ADMINISTRATION section.) The solution is also sensitive to certain wavelengths of light, and it must be protected from light in clinical use. Sodium Nitroprusside Injection is available as: 50 mg Amber tubular glass vials – Each 2 mL vial contains the equivalent of 50 mg sodium nitroprusside dihydrate in sterile water for injection. Image

What kind of drug is nitroprusside?

The FDA classifies nitroprusside as a vasodilator. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.

Can you take nitroprusside with other medicines?

It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run nitroprusside against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.

What brand names is nitroprusside sold under?

We track 3 nitroprusside-containing products in the U.S.: Nitropress, Nipride and Nipride Rtu in Sodium Chloride 0.9%. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.

What forms does nitroprusside come in?

Across the brands we track, nitroprusside is currently marketed as injectable, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.

Is there a generic nitroprusside?

We do not currently list a generic-labelled nitroprusside product. That does not always mean none exists — it means none appears under a generic name in the FDA data we track. Ask your pharmacist.

Nitroprusside: uses, dosing, side effects & brands

Nitroprusside is a vasodilator sold in the U.S. under 3 brand and generic names, for heart failure, malignant hypertension and intraoperative complications. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.

By the pharmaranks editorial teamReviewed against the FDA (openFDA label, NDC Directory & Enforcement) sourcesHow we research

Key facts

Drug class: Vasodilator
Treats: Heart Failure, Malignant Hypertension and Intraoperative Complications
Available as: Injectable
Sold as: 3 products — Nitropress, Nipride and Nipride Rtu in Sodium Chloride 0.9%
Prescription?: Prescription only
Generic available?: Not in our catalog
Boxed warning: Boxed warning

How nitroprusside is dosed

From the FDA label for Nitropress (application NDA018450). Other nitroprusside products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.

Dilution to proper strength for infusion: Depending on the desired concentration, the solution containing 50 mg of sodium nitroprusside must be further diluted in 250-1000 mL of sterile 5% dextrose injection. The diluted solution should be protected from light, using the supplied opaque sleeve, aluminum foil, or other opaque material. It is not necessary to cover the infusion drip chamber or the tubing. Verification of the chemical integrity of the product: Sodium nitroprusside solution can be inactivated by reactions with trace contaminants. The products of these reactions are often blue, green, or red, much brighter than the faint brownish color of unreacted sodium nitroprusside injection. Discolored solutions, or solutions in which particulate matter is visible, should not be used. If properly protected from light, the freshly diluted solution is stable for 24 hours. No other drugs should be administered in the same solution with sodium nitroprusside. Avoidance of excessive hypotension : While the average effective rate in adult and pediatric patients is about 3 mcg/kg/min, some patients will become dangerously hypotensive when they receive sodium nitroprusside injection at this rate. Infusion of sodium nitroprusside should therefore be started at a very low rate (0.3 mcg/kg/min), with upward titration every few minutes until the desired effect is achieved or the maximum…

Nitroprusside side effects

The most important adverse reactions to sodium nitroprusside are the avoidable ones of excessive hypotension and cyanide toxicity, described above under WARNINGS. The adverse reactions described in this section develop less rapidly and, as it happens, less commonly. Methemoglobinemia: As described in CLINICAL PHARMACOLOGY above, sodium nitroprusside infusions can cause sequestration of hemoglobin as methemoglobin. The back-conversion process is normally rapid, and clinically significant methemoglobinemia (>10%) is seen only rarely in patients receiving sodium nitroprusside injection. Even patients congenitally incapable of back-converting methemoglobin should demonstrate 10% methemoglobinemia only after they have received about 10 mg/kg of sodium nitroprusside, and a patient receiving sodium nitroprusside at the maximum recommended rate (10 mcg/kg/min) would take over 16 hours to reach this total accumulated dose. Methemoglobin levels can be measured by most clinical laboratories. The diagnosis should be suspected in patients who have received >10 mg/kg of sodium nitroprusside and who exhibit signs of impaired oxygen delivery despite adequate cardiac output and adequate arterial pO2. Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air. When methemoglobinemia is diagnosed, the treatment of choice is 1-2 mg/kg of…

Every nitroprusside product we track (3)

Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.

Nitroprusside products
#	Drug	Rating	Type	Form	Generic?	Typical price
1	Nitropress Boxed warning	70/100	Prescription	Injectable	—	—	View →
2	Nipride

Frequently asked questions

What is nitroprusside?: Sodium nitroprusside is disodium pentacyanonitrosylferrate(2-) dihydrate, a hypotensive agent whose structural formula is whose molecular formula is Na 2 [Fe(CN) 5 NO] • 2H 2 O, and whose molecular weight is 297.95. Dry sodium nitroprusside is a reddish-brown powder, soluble in water. In an aqueous solution infused intravenously, sodium nitroprusside is a rapid-acting vasodilator, active on both arteries and veins. Sodium nitroprusside solution is rapidly degraded by trace contaminants, often with resulting color changes. (See DOSAGE AND ADMINISTRATION section.) The solution is also sensitive to certain wavelengths of light, and it must be protected from light in clinical use. Sodium Nitroprusside Injection is available as: 50 mg Amber tubular glass vials – Each 2 mL vial contains the equivalent of 50 mg sodium nitroprusside dihydrate in sterile water for injection. Image
What kind of drug is nitroprusside?: The FDA classifies nitroprusside as a vasodilator. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take nitroprusside with other medicines?: It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run nitroprusside against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is nitroprusside sold under?: We track 3 nitroprusside-containing products in the U.S.: Nitropress, Nipride and Nipride Rtu in Sodium Chloride 0.9%. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does nitroprusside come in?: Across the brands we track, nitroprusside is currently marketed as injectable, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.

Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.