Indicated for the treatment of patients with acutely decompensated heart failure who have dyspnea at rest or with minimal activity. In this population, the use of NATRECO reduced pulmonary capillary wedge pressure and improved short term (3 hours) symptoms of dyspnea.

NATRECOR is for intravenous (IV) use only. There is limited experience with administering NATRECOR  for longer than 96 hours. Monitor blood pressure closely during NATRECOR administration.

NATRECOR should not be given as the main treatment for patients with shock due to abnormal heart function, systolic blood pressure less than 90 mm Hg.

Avoid administration of NATRECOR in patients suspected of having, or known to have, low cardiac filling pressures.

NATRECOR binds to heparin and therefore could bind to the heparin lining of a heparin-coated catheter, decreasing the amount of NATRECOR delivered to the patient for some period of time. Therefore, do not administer NATRECOR through a central heparin-coated catheter.

NATRECOR is physically and/or chemically incompatible with injectable formulations of heparin, insulin, ethacrynate sodium, bumetanide, enalaprilat, hydralazine, and furosemide. Do not co-administer these drugs with NATRECOR through the same IV catheter. The preservative sodium metabisulfite is incompatible with NATRECOR. Do not administer injectable drugs that contain sodium metabisulfite in the same infusion line as NATRECOR. Flush the catheter between administration of NATRECOR and incompatible drugs.

NATRECOR is not recommended for patients for whom vasodilating agents are not appropriate, such as patients with significant valvular stenosis, restrictive or obstructive cardiomyopathy, constrictive pericarditis, pericardial tamponade, or other conditions in which cardiac output is dependent upon venous return, or for patients suspected to have low cardiac filling pressures.

NATRECOR may decrease renal function as judged by increases in serum creatinine. Monitor serum creatinine both during and after therapy has been completed.

NATRECOR is contraindicated in patients with:

• Persistent systolic blood pressure <100 mm Hg prior to therapy because of an increased risk of symptomatic hypotension
• Cardiogenic shock

The co-administration of NATRECOR with nitroprusside, milrinone, or IV ACE inhibitors has not been evaluated.

There are no data to assess a drug associated risk of major birth defects, miscarriage, or adverse maternal fetal outcomes with NATRECOR use in pregnant women.

There are no data on the presence of nesiritide in human or animal breast milk, or regarding the effect on the breastfed child, or on milk production.

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• Prophylactic and long-term use. GoToSource

• Pulmonary hypertension, bronchospasm in chronic lung disease and use as a antifibrotic/anti-remodeling therapy or bridge to cardiac transplant. GoToSource

Worsening kidney function.  GoToSource 

Anaphylactic reaction (potentially life-threatening allergic reaction). GoToSource

Hypotension (low blood pressure), nonsustained ventricular tachycardia (fast heart rate) and angina pectoris (chest pain). GoToSource

Lawsuits filed for death, kidney failure and stroke.