Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
August 2005
  • Treatment of acute hypertension refractory to standard therapeutic measures
Reconstitution and Stability: 
  • Stable at room temperature when protected from light.  In light, the solution will darken and should not be used
  • Store between 2-30°C
  • DO NOT dilute

- Solutions Compatible: no information

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

Incompatible: do not mix with other medications or IV solutions


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Push

YES   Blood Pressure Monitoring
Usual dilution: undiluted
Infusion time: <30 seconds

IV Intermittant Infusion NO
IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • Hypertensive crisis: 1-3 mg/kg/dose IV (maximum: 150 mg/dose).  May repeat in 5-15 minutes until blood pressure adequately reduced and then Q 4-24 hours PRN


Potential hazards of parenteral administration: 
  • Extravasation will cause severe burning, pain and inflammation, cellulitis, phlebitis
  • Infrequently:  severe hypotension, myocardial or cerebral ischemia, CHF, edema                                          
  • Transient tachycardia                                    
  • Sodium and water retention, hyperglycemia, ketoacidosis, hyperuricemia       
  • Nausea and vomiting, flushing with headache
  • Leukopenia, thrombocytopenia
  • Overdose: severe hypotension and/or hyperglycemia and/or electrolyte disturbances
  • Contraindicated in patients hypersensitive to thiazides and sulfonamide derivatives
  • Monitor patient's blood pressure frequently after administration (ie. every 1-5 minutes until stabilized and hourly thereafter), heart rate, blood glucose, serum uric acid, CBC, platelets
  • Patient should remain in recumbent position during and for 60 minutes after injection to avoid hypotension
  • Should only be used short term
  • Not recommended in compensatory hypertension
  • Dilution of solution, too slow injection, or addition to infusion fluids will result in decreased antihypertensive activity
  • Sympathomimetic agents may be used for hypotension; insulin for hyperglycemia; and diuretics for sodium retention

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