Noradrenaline is a potent vasoconstrictor used to treat profound hypotension, usually in combination with dopamine, when other inotropes have failed in sepsis patients. It is administered by IV infusion at an initial dose of 0.05-0.1 microgram/kg/minute, titrated up to a maximum of 1-1.5 microgram/kg/minute. The drug comes in 2mg/2mL ampoules and is diluted for infusion based on the baby's weight to achieve a rate of 0.1 microgram/kg/minute, administered over 24 hours and monitored for potential side effects like hypertension and local tissue damage from extravasation.

1. DRUG NORADRENALINE
PRESENTATION:
Ampoule: 2mg/2mL
ACTION &
INDICATION:
Potent vasoconstrictor. Usually added to dopamine to treat
profound hypotension, in the setting of sepsis when other
inotropes have failed.
DOSE: DOSE stated as Noradrenaline base
Initial Dose: 0.05 – 0.1 microgram/kg/minute
Titrate as required to a maximum dose:
1 – 1.5 microgram/kg/minute
PREPARATION: Use solution prepared in Pharmacy if available.
To give an infusion rate of 0.1microgram/kg/minute:
Take 0.75mg of noradrenaline base (0.75mL) per kilogram of
baby’s weight and dilute to 25mL with glucose or
glucose/saline solutions.
Infuse at 0.2mL/hour
ADMINISTRATION: IV Infusion
ADVERSE EFFECTS: Hypertension which may be associated with bradycardia.
Monitor BP continuously.
Extravasation can cause local tissue necrosis. The infusion site
should be checked regularly.
COMMENTS:
Do not cease infusion abruptly
Discard diluted solutions after 24 hours
Protect ampoules from light during storage and discard if
discoloured.
REFERENCES: Paediatric Pharmacopoeia 13th
Ed Royal Children’s Hospital
Melbourne
DATE: January 2011