In patients with underlying psychiatric disturbances, norepinephrine can induce more pronounced CNS effects of their pathologic state including panic, hallucinations, aggressive behavior, and expression of suicidal or homicidal tendencies. ECG changes, including ST-T wave changes can occur with or without cardiovascular symptomatology. Angina, dyspnea, pulmonary edema, and ischemia result from the increased workload and subsequent oxygen demands of the adrenergically stimulated heart. Extravasation of norepinephrine, especially with repeated injections or high infusion rates, can result in severe tissue damage and necrosis. Metabolic acidosis secondary to accumulation of lactic acid has been associated with long-term administration or overdose of norepinephrine.
Hypersensitivity reactions can occur to sulfites contained in norepinephrine injection.
Generic norepinephrine injections are not yet available. Norepinephrine is for infusion into a vein. It is given by a health-care professional in a hospital or clinic setting. This does not apply. These may affect the way your medicine works.