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Nesiritide for Heart Failure - Natrecore and Heart Failure

Who Can Benefit From the Use of This Medication?

By Marc Lallanilla

Updated December 19, 2008

(LifeWire) - Natrecor (nesiritide) is a medication used to treat heart failure; it works by relaxing blood vessels and allowing them to widen. The widening of blood vessels allows the heart to pump blood more effectively with less effort.

Marketed under the brand name Natrecor, nesiritide is given intravenously on an emergency basis to patients with acute heart failure and dyspnea, a shortness of breath that can be life threatening. Another class of drugs known as loop diuretics are often the drug of choice in cases of heart failure and dyspnea, but for patients whose dyspnea does not respond to loop diuretics, nesiritide is considered the next line of defense.

Nesiritide may be given with another medication for heart failure or for high blood pressure, including angiotensin-converting enzyme (ACE) inhibitors, diuretics and a type of medicine known as inotropes, which includes dobutamine, dopamine or milrinone.

Because nesiritide has the potential for lowering blood pressure to dangerously low levels, it is not recommended for patients with a history of low blood pressure. The intravenous injection is given to patients in a hospital or other setting where blood pressure can be monitored.

Side effects associated with nesiritide include headache, low blood pressure, drowsiness, dizziness, abdominal pain, nausea and vomiting. Less common side effects, such as back pain, tingling or a prickly sensation in the skin, changes in vision, confusion, coughing up blood, fever and leg cramps have also been seen in patients receiving nesiritide. The drug is also associated with impaired kidney functioning. That's why close monitoring of kidney functioning is an important part of nesiritide use.

There is considerable discussion in the medical community about the potential misuse of nesiritide. In an article in The New England Journal of Medicine, Eric Topol, MD, a cardiologist with the Cleveland Clinic, writes that many patients are now receiving regular, long-term outpatient treatment with nesiritide, despite concerns that the drug is associated with kidney failure, patient death and the relatively high cost of the drug. Clinical trials of nesiritide are ongoing. These will continue to evaluate the safety and effectiveness of this drug in treating heart failure.

Read more here about the treatment of heart failure.

Sources:

Colucci, Wilson S. "Nesiritide in the Treatment of Acute Decompensated Heart Failure." uptodate.com. 12 May 2008. 8 Dec. 2008 <http://www.uptodate.com/online/content/topic.do?topicKey=hrt_fail/17210&selectedTitle=3~16&source=search_result>. (subscription)



Hiestand, B., and W.T. Abraham. "Safety and Efficacy of Nesiritide for Acute Decompensated Heart Failure: Recent Literature and Upcoming Trials." Current Cardiology Reports 9:3(2007): 182-6. 11 Dec. 2008 <http://www.ncbi.nlm.nih.gov/pubmed/17470330?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed%3E>.



"Medications Commonly Used to Treat Heart Failure." americanheart.org. 9 Jan. 2008. American Heart Association. 8 Dec. 2008 <http://www.americanheart.org/presenter.jhtml?identifier=118>.



"Nesiritide." drugs.com. 3 Dec. 2008. Drug Information Online. 8 Dec. 2008 <http://www.drugs.com/cdi/nesiritide.html>.



Topol, Eric J. "Nesiritide -- Not Verified." The New England Journal of Medicine 353:2(2005): 113-6. 8 Dec. 2008 <http://content.nejm.org/cgi/content/full/353/2/113>.



Yancy, C.W. "Benefit-Risk Assessment of Nesiritide in the Treatment of Acute Decompensated Heart Failure." Drug Safety 30:9(2007): 765-81. 11 Dec. 2008 <http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17722969&log$=activity%3E>.


LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Marc Lallanilla is a New York-based freelance writer and editor. He has written extensively on health, science, the environment, design, architecture, business, lifestyle and travel.

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