LEVOPHED

AbsorptionFollowing initiation of intravenous infusion, the steady state plasma concentration is achieved in 5 min.

DistributionPlasma protein binding of norepinephrine is approximately 25%. It is mainly bound to plasma albumin and to a smaller extent to prealbumin and alpha 1-acid glycoprotein. The volume of distribution is 8.8 L. Norepinephrine localizes mainly in sympathetic nervous tissue. It crosses the placenta but not the blood-brain barrier.

EliminationThe mean half-life of norepineph...

The following adverse reactions are described in greater detail in other sections:

• Tissue Ischemia [see Warnings and Precautions (5.1) ]
• Hypotension [see Warnings and Precautions (5.2) ]
• Cardiac Arrhythmias [see Warnings and Precautions (5.3) ] The most common adverse reactions are hypertension and bradycardia. The following adverse reactions can occur: Nervous system disorders: Anxiety, headache Respiratory disorders: Respiratory difficulty, pulmonary edema Most common adverse reactions a...

None. None. ( 4 )

• Tissue Ischemia : Avoid extravasation of LEVOPHED into the tissues, as local necrosis might ensue due to the vasoconstrictive action of the drug. Infuse LEVOPHED into a large vein. To prevent sloughing and necrosis in areas in which extravasation has taken place, the area should be infiltrated as soon as possible with 10 mL to 15 mL of saline solution containing from 5 mg to 10 mg of an adrenergic blocking agent. ( 5.1 )
• Hypotension After Abrupt Discontinuation : Sudden cessation of the infu...

7 DRUG INTERACTIONS

• Monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types may result in hypertension. ( 7.1 )
• Cyclopropane and halothane anesthetics increase cardiac autonomic irritability. ( 7.4 ) 7.1 MAO-Inhibiting Drugs Co-administration of LEVOPHED with monoamine oxidase (MAO) inhibitors or other drugs with MAO-inhibiting properties (e.g., linezolid) ...