Nesiritide
Also known as: B-type natriuretic peptide, BNP recombinant, hBNP, Natrecor, recombinant human BNP
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Summary
Recombinant human B-type natriuretic peptide (nesiritide) was approved for intravenous treatment of acute decompensated heart failure; later indications were withdrawn due to limited efficacy and safety concerns.
Mechanism of Action
Binds natriuretic peptide receptor-A, activating guanylate cyclase and increasing cGMP, leading to vasodilation, natriuresis, and inhibition of renin-angiotensin system.
Routes of Administration
Goals & Uses
- Reduction of preload and afterloadHemodynamicHigh
- Natriuresis and diuresisFluid/electrolyte ManagementModerate
- Relief of dyspnea in acutely decompensated heart failureCardiovascularHigh
- Reduction of BNP/neurohormonal activationNeurohormonalModerate
- Acute decompensated heart failure symptom reliefCardiovascularModerate
Contraindications
- Hypersensitivity to nesiritide or any componentAllergyHigh
- Systolic blood pressure < 90 mmHgHemodynamicHigh
- Cardiogenic shockCardiovascularHigh
- Low cardiac filling pressureHemodynamicHigh
- Recent myocardial infarction (≤30 days)CardiovascularModerate
- Severe hypotensionCardiovascularHigh
Adverse Effects
- HeadacheNeurologicCommonPain in the head or upper neck
- HypotensionCardiovascularCommonLow blood pressure
- Renal dysfunctionRenalUncommon
- NauseaGastrointestinalUncommonFeeling of sickness or urge to vomit
- Back painMusculoskeletalUncommonPain in the back
- BradycardiaCardiovascularRare
- Worsening renal functionRenalUncommon
Drug Interactions
- Other vasodilators (e.g., nitroglycerin, hydralazine)Moderate
- Antihypertensives (e.g., ACE inhibitors, ARBs, calcium channel blockers)Moderate
- Vasodilators (e.g., nitrates, hydralazine)Moderate
- DiureticsModerateMay worsen dehydration or electrolyte imbalance
Population Constraints
- Pregnancy (Category C)ReproductiveRelative
- Renal impairmentOrgan ImpairmentRelative
- Pediatric patientsAgeRelative
- Elderly patientsAgeRelative
- Pregnant womenReproductiveRelative
- Patients with systolic BP < 90 mmHgCardiovascularAbsolute
Regulatory Status
- European UnionUnapprovedNever received marketing authorization.
- United StatesWithdrawnIndication withdrawn 2015; product discontinued 2017.
- United KingdomUnapprovedNot licensed.
FDA approved 2001; indication for acute decompensated heart failure withdrawn 2015; commercial discontinuation 2017. Not approved in EU or UK.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Nesiritide?
Recombinant human B-type natriuretic peptide (nesiritide) was approved for intravenous treatment of acute decompensated heart failure; later indications were withdrawn due to limited efficacy and safety concerns.
What is Nesiritide used for?
Nesiritide is educationally associated with: Reduction of preload and afterload, Natriuresis and diuresis, Relief of dyspnea in acutely decompensated heart failure, Reduction of BNP/neurohormonal activation, Acute decompensated heart failure symptom relief. Educational only — not medical advice.
How is Nesiritide administered?
Recorded routes of administration: Intravenous.
What are the potential side effects of Nesiritide?
Reported adverse effects include: Headache, Hypotension, Renal dysfunction, Nausea, Back pain, Bradycardia, Worsening renal function. This list is not exhaustive — consult a qualified clinician.
Who should avoid Nesiritide?
Recorded contraindications: Hypersensitivity to nesiritide or any component, Systolic blood pressure < 90 mmHg, Cardiogenic shock, Low cardiac filling pressure, Recent myocardial infarction (≤30 days), Severe hypotension. Consult a qualified clinician before use.