Last reviewed 2026-04-22 · How we verify

Norepinephrine (10 µg boluses)

Norepinephrine is a catecholamine that binds to alpha and beta adrenergic receptors to increase heart rate, cardiac contractility, and peripheral vasoconstriction, thereby raising blood pressure and improving tissue perfusion.

Norepinephrine is a catecholamine that binds to alpha and beta adrenergic receptors to increase heart rate, cardiac contractility, and peripheral vasoconstriction, thereby raising blood pressure and improving tissue perfusion. Used for Acute hypotension in critical care settings, Cardiogenic shock, Septic shock (adjunctive therapy).

At a glance

Mechanism of action

Norepinephrine acts as both a neurotransmitter and sympathomimetic agent, activating alpha-1 adrenergic receptors (causing vasoconstriction) and beta-1 adrenergic receptors (increasing heart rate and contractility). In bolus form, it produces rapid but short-lived hemodynamic effects, making it useful for acute hypotensive episodes. The drug increases systemic vascular resistance and cardiac output, restoring perfusion pressure to vital organs.

Approved indications

• Acute hypotension in critical care settings
• Cardiogenic shock
• Septic shock (adjunctive therapy)

Common side effects

• Hypertension
• Tachycardia
• Arrhythmias
• Anxiety
• Headache
• Tissue necrosis (extravasation)

Key clinical trials

• Noradrenaline Versus Standard Blood Pressure Management for Perioperative Hypotension in Non-cardiac Surgery (PHASE3)
• Management of Post-Induction Hypotension in Emergency Abdominal Surgery (PHASE4)
• Norepinephrine Boluses in Liver Transplantation (PHASE1, PHASE2)

Primary sources

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