Reviewed by Dr David Knight and Dorothy Cooper
April 1997
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Sodium Nitroprusside Administration



Charted on fluid chart giving:

Also charted on drug chart under continuous infusions giving:


Continuous IV Infusion

  1. Administered by a nurse with Neonatal IV Drug Certification.
  2. Reconstitute with D5W to 10 mg/ml immediately prior to use.
10 mg/ml
Powder space: 0.0 ml
D5W to be added: 5.0 ml
  50 mg in 5.0 ml
  1. Dilute to make 100 mcg/ml in D5W by adding 5 mg sodium nitroprusside to make 50ml with D5W. Do NOT use any other diluent. Mix well. Filter prior to administration through a 5 micron filter.
  2. Cover tubing and syringe in aluminium foil or other opaque material to protect from light.
  3. Compatible ONLY with D5W. Do NOT mix with other drugs, IV solutions, blood or blood products. Use a separate line for sodium nitroprusside. Do NOT flush line.
  4. Administer via a syringe pump.
  5. Change solution and tubing every 24 hours.
  6. Discard solution if any change in colour occurs.

Observation and Documentation

  1. Assess for signs of adverse effects.
  2. Continuous cardiorespiratory monitoring.
  3. Continuous blood pressure monitoring.
  4. Monitor arterial blood gases for metabolic acidosis.
  5. Monitor fluid balance.
  6. Document vital signs hourly.
  7. Monitor Hb. Nitroprusside binds to Hb.


Selected References

1 Roberts RJ. Drug therapy in infants: Pharmacologic principles and clinical experience. Philadelphia, WB Saunders, 1984; p 184-86.
2 Greaney M, Saunders R (eds). NE Compendium: Detailed prescribing information. Auckland, Adis Press 1990; p129-31.
3 Pawlak RP, Herfert LAT. Drug administration in the NICU. 2nd Ed 1991. Neonatal Network p190-191.