Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Noradrenalin (norepinephrine)

Generic name
Noradrenalin (norepinephrine)
Brand name
ATC Code
C01CA03

Pharmacokinetics in children

No information

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

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Dosages

Circulatory insufficiency
  • Intravenous
    • Gestational age < 37 weeks
      • 0.05 - 0.5 microg./kg/minute, continuous infusion. Max: 1 microg./kg/minute. Titrate the dose to the desired effect.

      • Administer through a central IV line. If a central line is not present, administration may be started by peripheral IV and switched to central IV as soon as possible.

    • Term neonate
      • 0.05 - 0.5 microg./kg/minute, continuous infusion. Max: 2 microg./kg/minute. Titrate the dose to the desired effect.

      • Administer through a central IV line. If a central line is not present, administration may be started by peripheral IV and switched to central IV as soon as possible.

    • 1 month up to 18 years
      • 0.05 - 0.1 microg./kg/minute, continuous infusion. Max: 2 microg./kg/minute. Titrate the dose to the desired effect.

      • Administer through a central IV line. If a central line is not available, administration may be started by peripheral infusion and switched to a central line as soon as possible.

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Only for increasing peripheral resistance, not for inotropic effect. Blood pressure increases with the same cardiac output. The oxygen requirement of the myocardium increases.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Adrenergic and dopaminergic agents
C01CA24
C01CA07
C01CA04
C01CA26
C01CA02
C01CA17
C01CA24
C01CA06
Phosphodiesterase inhibitors
C01CE02
Other cardiac stimulants
C01CX08

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References

  1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
  2. APLS 2010
  3. Werkgroep Neonatale Farmacologie NVK sectie Neonatologie, Expert opinie, 28 maart 2018
  4. Kallimath A, et al., Hemodynamic effects of noradrenaline in neonatal septic shock: a prospective cohort study., J Trop Pediatr, 2024, 70(2)
  5. Tourneux P, et al., Noradrenaline for management of septic shock refractory to fluid loading and dopamine or dobutamine in full-term newborn infants., Acta Paediatr., 2008, 97(2), 177-80
  6. Gupta S, et al., The effect of norepinephrine on clinical and hemodynamic parameters in neonates with shock: a retrospective cohort study., Eur J Pediatr., 2022, 181(6), 2379-87
  7. Topjian AA, et al., Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care., Circulation, 2020, 142(16_suppl_2), S469-S523

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Changes

Changes