II. Background
- Janssen Pharmaceuticals discontinued Nesiritide production in U.S. in 2018
III. Indications
- Decompensated Congestive Heart Failure
IV. Mechanism
- Recombinant Human Brain Natriuretic Peptide
- Results in venous and arterial vasodilation
V. Dosing
- Bolus: 2 mcg/kg IV bolus
- Maintenance: 0.01 mcg/kg/min for 24-48 hours
VI. Efficacy
- Improves CHF symptoms
- INCREASES mortality within first 30 days
- Sackner-Bernstein (2005) JAMA 293:1900-5 [PubMed]
VII. Monitoring
- Blood Pressure during administration (Hypotension risk)
- Serum Creatinine
VIII. Adverse Effects
- Hypotension
- Headache
- Nnausea
- Back pain
IX. Resources
- Nesiritide (FDA Report)