Norepinephrine (medication)

Norepinephrine, also known as noradrenaline, is a medication used to treat people with very low blood pressure. It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids. It is the same molecule as the hormone and neurotransmitter norepinephrine. It is given by slow injection into a vein.

This article is about the medication. For this substance as a naturally occurring hormone, see Norepinephrine.
Norepinephrine
Skeletal formula of noradrenaline
Ball-and-stick model of the zwitterionic form of noradrenaline found in the crystal structure
Clinical data
Trade namesLevarterenol, Levophed, Norepin, other
Other namesNoradrenaline
(R)-(–)-Norepinephrine
l-1-(3,4-Dihydroxyphenyl)-2-aminoethanol
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: B3
Routes of
administration		Intravenous
ATC code
Physiological data
Source tissuesLocus coeruleus; sympathetic nervous system; adrenal medulla
Target tissuesSystem-wide
Receptorsα1, α2, β1, β3
AgonistsSympathomimetic drugs, clonidine, isoprenaline
AntagonistsTricyclic antidepressants, Beta blockers, antipsychotics
MetabolismMAO-A; COMT
Legal status
Legal status
Pharmacokinetic data
MetabolismMAO-A; COMT
ExcretionUrine (84–96%)
Identifiers
  • 4-[(1R)-2-amino-1-hydroxyethyl]benzene-1,2-diol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC8H11NO3
Molar mass169.180 g·mol−1
3D model (JSmol)
Density1.397±0.06 g/cm3
Melting point217 °C (423 °F) (decomposes)
Boiling point442.6 °C (828.7 °F) ±40.0°C
  • Oc1ccc(cc1O)[C@@H](O)CN
  • InChI=1S/C8H11NO3/c9-4-8(12)5-1-2-6(10)7(11)3-5/h1-3,8,10-12H,4,9H2/t8-/m0/s1 Y
  • Key:SFLSHLFXELFNJZ-QMMMGPOBSA-N Y
  (verify)

Common side effects include headache, slow heart rate, and anxiety. Other side effects include an irregular heartbeat. If it leaks out of the vein at the site it is being given, norepinephrine can result in limb ischemia. If leakage occurs the use of phentolamine in the area affected may improve outcomes. Norepinephrine works by binding and activating alpha adrenergic receptors.

Norepinephrine was discovered in 1946 and was approved for medical use in the United States in 1950. It is available as a generic medication.

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