Medicine Overview of Levofed 2mg/2ml Injection
Acute Hypotension, Cardiac Arrest, Sepsis & Septic Shock
IV Preparation & Administration
Infuse using a solution of 4 mcg/ml in glucose 5%, or sodium chloride 0.9% and glucose 5% at a rate of 2-3 ml/minute. Adjust according to BP response. Average maintenance dose: 0.5-1 ml/minute (2-4 mcg/minute). Infuse via a central venous catheter or into a large vein.
Intravenous
Adult:
Acute Hypotension, Cardiac Arrest
Initial: 8-12 mcg/min IV infusion; titrate to effect
Maintenance: 2-4 mcg/min IV infusion
Sepsis & Septic Shock
0.01-3 mcg/kg/min IV infusion
Child:
Acute Hypotension, Cardiac Arrest
Initial: 0.05-0.1 mcg/kg/min IV infusion; titrate to effect
Maximum: 1-2 mcg/kg/min
Shock
0.05-0.1 mcg/kg/min IV infusion; titrate to effect; not to exceed 2 mcg/kg/min
Hypersensitivity. Hypertension. Pregnancy. Patients with peripheral or mesenteric vascular thrombosis unless necessary as a life-saving procedure.
Concomitant use with some general anesthetics: Chloroform, trichloroethylene, cyclopropane, halothane
Not a substitute for replacement of blood, plasma, fluids, and/or electrolytes; correct volume depletion prior to admin. Identify and correct hypoxia, hypercapnia and acidosis prior to or during admin. Avoid extravasation as tissue necrosis may occur. Avoid inj into leg veins, especially in elderly or those with occlusive vascular diseases, arteriosclerosis, DM or Buerger’s disease. Hypertensive or hyperthyroid patients. In conjunction with local anaesthetics, do not use in fingers, toes, ears, nose or genitalia. Lactation.
Lactation: Not known if excreted into breast milk; avoid use during breastfeeding
Guanethidine, methyldopa, reserpine, TCAs may increase pressor response to norepinephrine.
Potentially Fatal: Increased risk of arrhythmias with cocaine, cyclopropane or halogenated hydrocarbon anaesthetics. Hypertensive crisis may occur with MAOIs. Hypertensive effects may be increased by nonselective β-blockers.
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