Noradrenaline Altan (Noradrenaline Tartrate)

Noradrenaline is a vasopressor acting on the catecholamine pathway to rapidly increase systemic vascular resistance and cardiac output.

• Hypotension: restores vascular tone and raises arterial pressure in acute low‑blood‑pressure states.
• Septic shock: improves perfusion by counteracting vasodilatory shock in severe infection.
• Cardiac arrest: supports circulation during resuscitation efforts by enhancing heart contractility.
• Acute heart failure: increases cardiac output and systemic pressure to stabilize hemodynamics.

• Noradrenaline acts as an agonist at α1‑adrenergic receptors, producing vasoconstriction that elevates systemic vascular resistance and arterial pressure. It also stimulates β1‑adrenergic receptors in the myocardium, increasing heart rate and contractility, thereby raising cardiac output. The combined α and β activity restores hemodynamic stability in shock states and acute circulatory failure. These actions are mediated through rapid intracellular signaling pathways that cause smooth‑muscle contraction and enhanced myocardial calcium influx.

Noradrenaline may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Hypertension: excessive rise in blood pressure.
• Tachycardia: increased heart rate.
• Arrhythmia: irregular cardiac rhythm.
• Headache: pressure‑type head discomfort.
• Nausea: feeling of sickness.
• Peripheral ischemia: reduced blood flow to extremities.

Serious or Rare Side Effects

• Myocardial ischemia: chest pain due to reduced coronary blood flow.
• Severe hypertension: dangerously high arterial pressure.
• Tissue necrosis at injection site: local tissue death from extravasation.
• Pulmonary edema: fluid accumulation in lungs.
• Anaphylaxis: severe allergic reaction.
• Cardiac arrest: sudden loss of heart function.

When using Noradrenaline, careful monitoring and specific precautions are essential to ensure patient safety.

• Blood pressure monitoring: continuous measurement to avoid excessive hypertension.
• Heart rate monitoring: observe for tachyarrhythmias or bradycardia.
• Coronary artery disease: use cautiously in patients with known ischemic heart disease.
• Dose titration: adjust infusion rate based on hemodynamic response.
• Extravasation risk: avoid infiltration; stop infusion immediately if signs appear.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Noradrenaline can interact with several medicines, influencing its efficacy or safety profile.

Major Interactions (Avoid)

• MAO inhibitors: risk of hypertensive crisis.
• Tricyclic antidepressants: potentiation of pressor effects.
• Beta‑blockers: may blunt β1‑mediated cardiac stimulation.

Moderate Interactions (Monitor Closely)

• ACE inhibitors: may enhance hypotensive episodes after infusion cessation.
• Diuretics: affect intravascular volume and response.