Last reviewed 2026-04-20 · How we verify

Sodium Nitroprusside (NITROPRUSSIDE)

Sodium Nitroprusside, also known as Nitroprusside, is a vasodilator medication originally developed by Roche and currently owned by the same company. It targets the atrial natriuretic peptide receptor 1 and is used to treat various cardiovascular conditions, including acute heart failure, controlled hypotension, and malignant essential hypertension. The medication is a small molecule and was FDA-approved in 1974. As a commercial product, its status is patented, and it is not yet available as a generic. Key safety considerations include its potential for cyanide toxicity and the need for close monitoring in patients with renal impairment.

At a glance

Approved indications

• Acute exacerbation of chronic congestive heart failure
• Acute heart failure
• Controlled Hypotension
• Decompensated cardiac failure
• Hypertensive disorder
• Hypertensive urgency
• Malignant essential hypertension

Boxed warnings

• BOXED WARNING Sodium nitroprusside injection is not suitable for direct injection. The solution must be further diluted in sterile 5% dextrose injection before infusion. Sodium nitroprusside injection can cause precipitous decreases in blood pressure (see DOSAGE AND ADMINISTRATION ). In patients not properly monitored, these decreases can lead to irreversible ischemic injuries or death. Sodium nitroprusside should be used only when available equipment and personnel allow blood pressure to be continuously monitored. Except when used briefly or at low (< 2 mcg/kg/min) infusion rates, sodium nitroprusside gives rise to important quantities of cyanide ion, which can reach toxic, potentially lethal levels (see WARNINGS ). The usual dose rate is 0.5 to 10 mcg/kg/min, but infusion at the maximum dose rate should never last more than 10 minutes. If blood pressure has not been adequately controlled after 10 minutes of infusion at the maximum rate, administration of sodium nitroprusside should be terminated immediately. Although acid-base balance and venous oxygen concentration should be monitored and may indicate cyanide toxicity, these laboratory tests provide imperfect guidance.

Common side effects

• Methemoglobinemia
• Thiocyanate toxicity
• Excessive hypotension
• Cyanide toxicity
• Bradycardia
• Electrocardiographic changes
• Tachycardia
• Rash
• Hypothyroidism
• Ileus
• Decreased platelet aggregation
• Increased intracranial pressure

Key clinical trials

• Role of Sympathetic Vasoconstriction on Insulin-Mediated Microvascular Recruitment and Glucose Uptake in Obesity (PHASE1)
• HeartPhone Cancer Survivors Trial 2019 (PHASE1,PHASE2)
• Dapagliflozin and Endothelin Receptor Antagonism in Large Vessel Vasculitis (DERAIL-LVV) (PHASE2)
• Sodium Nitroprusside in Early Course Schizophrenia (PHASE2)
• The Impact of Gestational Diabetes Mellitus on Cerebral Blood Flow and Cerebrovascular Function After Pregnancy (PHASE1)
• Early Neurovascular Adaptations in Aging Women (EARLY_PHASE1)
• Testosterone Deficiency and Endothelial Dysfunction After Spinal Cord Injury
• Endothelial Dysfunction After SCI

Primary sources

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Competitive intelligence

For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:

• Sodium Nitroprusside CI brief — competitive landscape report
• Sodium Nitroprusside updates RSS · CI watch RSS
• Roche portfolio CI