Nesiritide

Updated on Dec 09, 2024

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AHFS/Drugs.com Monograph ATC code C01DX19 (WHO) PubChem CID 16134381		Routes ofadministration IV only CAS Number 124584-08-3 DrugBank DB04899

Nesiritide (Natrecor) is the recombinant form of the 32 amino acid human B-type natriuretic peptide, which is normally produced by the ventricular myocardium. Nesiritide works to facilitate cardiovascular fluid homeostasis through counterregulation of the renin-angiotensin-aldosterone system, stimulating cyclic guanosine monophosphate, leading to smooth muscle cell relaxation.

Neseritide was believed initially to be beneficial for acute decompensated congestive heart failure. It received approval from the United States' Food and Drug Administration for this purpose in 2001 after initial non-approval. In July 2011 the results of the largest study so far for nesiritide was published in The New England Journal of Medicine; it showed that nesiritide was not associated with a change in mortality or re-hospitalizations.

Administration

Nesiritide is only administered intravenously, usually by bolus, followed by IV infusion. For most adults and the elderly, a normal dosage is 2 µg/kg followed by a continuous IV infusion of 0.01 µg/kg/min. This may be increased every three hours for a maximum of 0.03 µg/kg/min.

Controversy

In 2005, after several academic papers published by Jonathan Sackner-Bernstein on the efficacy and side effects of Nesiritide, Johnson & Johnson met with the FDA and altered its stated plans for the drug and agreed to revise its labeling.

Heart doctors at the Cleveland Clinic then voted unanimously not to permit the prescription of the drug to its patients. Following this, the United States Department of Justice announced an inquiry into the marketing of the drug.