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Pharmacy Services

New Guidelines For Appropriate Nesiritide (Natrecor) Use

July 20, 2005

The FDA expert panel of cardiology and heart failure experts has made specific recommendations for nesiritide (Natrecor) use, based on concerns about worsening renal function and increased mortality with this agent.

• Consider the risks (eg worsening renal function, mortality) and benefits to the patient before initiating therapy.
• Use nesiritide only in hospitalized patients with acutely decompensated congestive heart failure with dyspnea at rest.
• Avoid intermittent outpatient infusion of nesiritide.
• Avoid using nesiritide in place of diuretic therapy.
• Avoid regular repetitive use of nesiritide.
• Avoid use for off-label indications, including to enhance renal function or augment diuresis.

Additional information is available online at:

• MedWatch Alert:
  http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm151889.htm
• Letter to Healthcare Professionals:
  http://www.fda.gov/downloads/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/UCM164672.pdf
• Previous alert concerning renal function and mortality (5/20/05):
  http://healthcare.utah.edu/pharmacy/alerts/

Updated
July 20, 2005; University of Utah, Drug Information Service. Copyright 2009, Drug Information Service, University of Utah, Salt Lake City, UT.