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.
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 Nipride Rtu in Sodium Chloride 0.9% (application NDA209387). Other nitroprusside products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Initiate infusion of sodium nitroprusside at a rate of 0.3 mcg/kg/min, and titrate every few minutes until the desired effect is achieved OR the maximum recommended infusion rate of 10 mcg/kg/min has been reached ( 2.2 ). 2.1 Inspection Inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit. Sodium nitroprusside should be a clear colorless to red/brown color; do not use if solution is blue, green, or bright red. 2.2 Dosing Continuously monitor blood pressure in patients receiving sodium nitroprusside. Start infusion of sodium nitroprusside at a rate of 0.3 mcg/kg/min. Evaluate blood pressure for at least 5 minutes before titrating to a higher or lower dose to achieve the desired blood pressure. The dose may be titrated upward until: • the desired effect is achieved, • systemic blood pressure cannot be further reduced without compromising the perfusion of vital organs, or • the maximum recommended infusion rate of 10 mcg/kg/min has been reached, whichever occurs first. In patients with eGFR <30 mL/min/1.73 m 2 , limit the mean infusion rate to less than 3 mcg/kg/min. In anuric patients, limit the mean infusion rate to 1 mcg/kg/min. 2.3 Administration Do not administer other drugs in the same solution with sodium nitroprusside. Sodium nitroprusside must be delivered by a volumetric infusion pump…
Nitroprusside side effects
The following adverse reactions are described, or described in greater detail, in other sections: • Hypotension [see Warnings and Precautions ( 5.1 )] • Cyanide Toxicity [see Warnings and Precautions ( 5.2 )] • Thiocyanate Toxicity [see Warnings and Precautions ( 5.3 )] • Methemoglobinemia [see Warnings and Precautions ( 5.4 )] • Increased Intracranial Pressure [see Warnings and Precautions ( 5.5 )] • Anemia and Hypovolemia [see Warnings and Precautions ( 5.6 )] Less common adverse reactions include: Cardiovascular: Bradycardia, electrocardiographic changes, tachycardia, palpitations, retrosternal discomfort Dermatologic: Rash Endocrine: Hypothyroidism Gastrointestinal: Ileus, nausea, abdominal pain Hematologic: Decreased platelet aggregation Musculoskelatal: Muscle twitching Neurologic: Increased intracranial pressure, dizziness, headache Miscellaneous: Flushing, diaphoresis, venous streaking, irritation at the infusion site Most common adverse reactions are hypotension and cyanide toxicity ( 6 ). To report SUSPECTED ADVERSE REACTIONS, Contact Exela Pharma Sciences, LLC at 1-888-451-4321 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Who shouldn’t take nitroprusside
Diseases with compensatory hypertension (e.g., coarctation of the aorta, arteriovenous shunting). • Inadequate cerebral circulation or in moribund patients (A.S.A. Class 5E) coming to emergency surgery. • Patients with congenital (Leber’s) optic atrophy or with tobacco amblyopia. • Acute heart failure associated with reduced peripheral vascular resistance. • Concomitant use with sildenafil, tadalafil, vardenifil, or riociguat. • Diseases with compensatory hypertension (e.g. coarctation of the aorta, arteriovenous shunting) ( 4 ). • Inadequate cerebral circulation or moribund patients (A.S.A. Class 5E) coming to emergency surgery ( 4 ). • Congenital (Leber’s) optic atrophy or tobacco amblyopia ( 4 ). • Acute heart failure with reduced peripheral vascular resistance ( 4 ). • Concomitant use with sildenafil, tadalafil, vardenifil, or riociguat ( 4 )
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.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Injectable | No data | — | View → | |
| 2 | Not yet rated | Prescription | Injectable | No data | — | View → | |
| 3 | Not yet rated | Prescription | Injectable | No data | — | View → |
How long nitroprusside keeps
The date on a sealed pack is not the only one: some nitroprusside labels start a second clock once the product is opened or mixed, as short as 24 hours.
Does nitroprusside expire? The in-use limits and storage rules from its labelsNitroprusside and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for nitroprusside: levels in milk, effects in breastfed infants, and the drugs it would consider insteadBreastmilk levels of nitroprusside sodium have not been measured after exogenous administration. Because of its short half-life of 2 minutes, it is unlikely to appear in breastmilk. However, its toxic metabolite, thiocyanate, is excreted into milk and can be directly toxic to the infant as well as inhibiting iodide transport into breastmilk. Cyanide is another toxic metabolite of nitroprusside that may enter breastmilk. An alternate drug is therefore preferred during breastfeeding. If use of nitroprusside sodium is unavoidable, the mother should refrain from breastfeeding.
National Institute of Child Health and Human Development, record revised November 15, 2024. LactMed states its information is not a substitute for professional judgement.
Related calculators
Frequently asked questions
What is nitroprusside?
Nipride Rtu in Sodium Chloride 0.9% (Sodium Nitroprusside) is a vasodilator used to treat Heart Failure, Malignant Hypertension, Intraoperative Complications.
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.
Cite this page
- APA
- pharmaranks. (2026, July 24). Nitroprusside: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/nitroprusside
- MLA
- “Nitroprusside: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/nitroprusside.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
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.
Read the full FDA label for nitroprusside on DailyMed (NIH) ↗ — including its boxed warning in full.