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Isoprenaline hydrochloride parenteral

Updated 2 Feb 2023 | Inotropic sympathomimetics

Presentation

Parenteral formulations of isoprenaline hydrochloride.

Drugs List

  • isoprenaline 1mg/5ml concentrate for solution for infusion ampoule
  • Therapeutic Indications

    Uses

    Permanent bradycardia due to atrioventricular block
    Temporary prevention/control of Stokes-Adams attacks

    Treatment of permanent bradycardia due to atrio-ventricular block pending or in the case of contraindication of a pacemaker.

    Treatment of Adams-Stokes syndrome.

    Dosage

    The lowest dose of isoprenaline hydrochloride should be carefully titrated under close monitoring to obtain a heart rate of 50 to 60 beats per minute. The rate of infusion should be adjusted based on the heart rate of the patient.

    Adults

    Initial dose of 10nanograms/kg/minute. The dose can be increased in increments of 10nanograms/kg/minute until a maximum dose of 150nanograms/kg/minute.

    Additional Dosage Information

    Concomitant use with adrenaline
    Do not inject isoprenaline hydrochloride at the same time as adrenaline in any circumstances. However, if required isoprenaline hydrochloride and adrenaline can be given alternately every 4 hours.

    Administration

    For intravenous use only.

    Contraindications

    Cardiac glycoside toxicity
    Angina
    Breastfeeding
    Recent myocardial infarction
    Tachyarrhythmia
    Uncontrolled hyperthyroidism
    Ventricular arrhythmias

    Precautions and Warnings

    Cardiac arrhythmias
    Cardiovascular disorder
    Coronary arteriosclerosis
    Diabetes mellitus
    Epileptic disorder
    Hypertension
    Hyperthyroidism
    Hypovolaemia
    Pregnancy
    Ventricular tachycardia

    Must be diluted before use
    Monitor ECG

    Treatment with isoprenaline hydrochloride requires ECG monitoring and reduction of doses in the case of ventricular myocardial hyperexcitability (polymorphic extrasystoles, repetitive burst pacing or ventricular tachycardia).

    Caution should be taken when doses are sufficient to reach a heart rate of 130 beats per minute.

    Caution when treating patients who respond to sympathomimetic amines in an unusual a manner.

    Hypertension may occur due to the high vasopressor effect of sympathomimetic vasoconstrictors.

    Pregnancy and Lactation

    Pregnancy

    Use isoprenaline hydrochloride with caution during pregnancy.

    The manufacturer advises carefully weighing up the clinical benefits against the possible risk to mother and child if using isoprenaline hydrochloride during pregnancy. Available reports indicate no increased risk of teratogenic or developmental effects.

    Lactation

    Isoprenaline hydrochloride is contraindicated during breastfeeding.

    The manufacturer does not recommend breastfeeding whilst taking isoprenaline hydrochloride. Effects on exposed infants are unknown.

    Side Effects

    Arrhythmias
    Asthenia
    Decrease in blood pressure
    Dizziness
    Headache
    Increased blood pressure
    Increased heart rate
    Nausea
    Nervousness
    Precordial pain
    Shaking

    Overdosage

    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Further Information

    Last Full Review Date: June 2021

    Reference Sources

    Summary of Product Characteristics: Isoprenaline Macure 0.2mg/ml concentrate for solution for infusion. Macure Pharma UK Ltd. Revised December 2020.

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