PRESENTATION & STORAGE :
PRESENTATION & STORAGE An ampoule of white powder 25mg for reconstitution in 2 ml liquid– NEPRESOL IS dihydralazine
Tablets 25mg each
No special storage instructions
CONTRAINDICATIONS :
CONTRAINDICATIONS Tachycardia
Heart failure
MI, CVA
Renal impairment
Lupus Porphyria
SIDE EFFECTS :
SIDE EFFECTS Tachycardia, palpitation
chest pain
flushing,
Headache
These usually subside with length of use of drug.
USAGE :
USAGE For 3rd line treatment severe pre- eclampsia when BP is not responding to Aldomet/methyldopa (1st line) then Adalat/nifidepine (2nd line). No used on its own
(IV use for crisis e.g. eclampsia)
Usage depends on protocol in place. Some hospitals have Labetalol protocol others Nepresol protocol.
DOSAGE :
DOSAGE P.O. Up to 25mg BD
IV 5-10mg SLOWLY and can be repeated at 30 minute intervals if necessary.
IM- 6.25mg
Or Continuous infusion 25mg amp in 200ml NaCl. Run via IVAC @ 60ml/hr (10ml/minute) initially to get BP diastolic 90-100 -loading
Reduce flow rate once BP level has been reached to 15ml/hr –maintenance.
MONITORING :
MONITORING Must have IV line up even for oral administration
BP and pulse ½ hourly until stable BP then hourly-Inform patient of possible tachycardia.
CTG for viable foetus if using IV/IM regime for crisis intervention (imminent eclampsia or eclampsia)
For oral administration as 3rd antihypertensive patient must be in hospital to initiate –BP monitoring and IV line up as sudden could be a problem (hypotension)