Edge Pharma offers Norepinephrine Bitartrate in prefilled bags for hospitals. Edge Norepinephrine Bitartrate makes storage and administration of this medication simple and compliant for any organization.
Sterile Norepinephrine Bitartrate Injection
Sterile solution in single use bag for IV Injection NS. Preservative Free. Room temperature storage.
- Norepinephrine Bitartrate - 8mg/250mL
Edge Pharma is a USP 795, 797, 800 and CGMP compliant FDA-Registered 503B Outsourcing Facility that specializes in a wide array of sterile and non-sterile compounded medications. Edge provides high quality medications with longer Beyond Use Dating and batch testing for every lot manufactured. We pride ourselves on working with customers to solve their compounding needs. In addition, as an Outsourcing Facility, Edge is able to dispense these products to qualified practitioners and facilities without patient names.
Phenylephrine has been considered the “gold standard” vasopresser to treat women undergoing cesarean delivery with spinal anesthesia who experience hypotension.(1) “Phenylephrine can cause reflexive decreases in maternal heart rate and cardiac output.”(2) A 2015 randomized, double-blinded study of 104 patients undergoing cesarean delivery compared norepinephrine and phenylephrine for the maintenance of blood pressure during spinal anesthesia. The study background stated: “Norepinephrine has weak β-adrenergic receptor agonist activity in addition to potent α-adrenergic receptor activity and therefore may be suitable for maintaining blood pressure with less negative effects on heart rate and cardiac output compared with phenylephrine.”(2)
Patients in the study were randomized to have systolic blood pressure maintained with a computer-controlled infusion of norepinephrine or phenylephrine. While the primary outcome was cardiac output, blood pressure, heart rate, and neonatal outcomes were also noted and compared. The study found that norepinephrine was effective for maintaining blood pressure and associated with greater heart rate and cardiac output compared with phenylephrine.(2)
A systematic literature search using electronic databases including PubMed, MEDLINE, Embase, and the Cochrane CENTRAL register of controlled trials was conducted to compare the safety and efficacy of phenylephrine and norepinephrine. The literature search included reports on overall maternal outcomes, hypotension, bradycardia, intraoperative nausea and vomiting, maternal cardiac output, blood pressure, and neonatal Apgar scores and umbilical cord analyses. The study concluded: “This systematic review and meta-analysis shows norepinephrine provides similar efficacy to manage maternal hypotension compared to phenylephrine; additionally, showing advantage regarding certain side effects like bradycardia and intraoperative nausea and vomiting reduction. Accordingly, norepinephrine is a promising alternative to phenylephrine. However, before routine clinical application, more studies are warranted.” (1)
(1) Xu, S. MD, Shen, X. MD, Liu, S., MD, Yang, J. MD, Wang, X., Medicine, Efficacy and Safety of Norepinephrine versus Phenylephrine for the Management of Maternal Hypotension during Cesarean Delivery with Spinal Anesthesia, online article, https://journals.lww.com/
(2) Kee, N. MD, Lee, S., Ng F., Tan, P., Khaw, K., Anesthesiology, Randomized Double-blinded Comparison of Norepinephrine and Phenylephrine for Maintenance of Blood Pressure during Spinal Anesthesia for Cesarean Delivery, online article, https://www.ncbi.nlm.nih.gov/
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