How to initiate noradrenaline (norepinephrine) in patients with septic shock?

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Last updated: October 26, 2025View editorial policy

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Initiating Noradrenaline (Norepinephrine) in Septic Shock

Norepinephrine should be initiated as the first-choice vasopressor in septic shock patients, with an initial target mean arterial pressure (MAP) of 65 mmHg, administered through a central venous catheter and titrated based on continuous arterial blood pressure monitoring. 1, 2, 3

Preparation and Administration

  • Dilute norepinephrine before administration: add 4 mg (4 mL) to 1,000 mL of 5% Dextrose Injection or sodium chloride solutions containing 5% dextrose to produce a 4 mcg/mL solution 4
  • Administer through a central venous catheter into a large vein (avoid leg veins in elderly or patients with occlusive vascular disease) 4
  • Place an arterial catheter as soon as practical for continuous blood pressure monitoring 3, 5
  • Ensure adequate fluid resuscitation before or concurrent with vasopressor initiation (at least 30 mL/kg of IV crystalloid fluid within the first 3 hours) 1, 5

Initial Dosing and Titration

  • Begin with an initial dose of 8-12 mcg per minute via intravenous infusion 4
  • Monitor blood pressure every 2 minutes until desired hemodynamic effect is achieved, then every 5 minutes for the duration of the infusion 4
  • Titrate to maintain a MAP of at least 65 mmHg 1, 2, 3
  • Typical maintenance intravenous dosage is 2-4 mcg per minute 4
  • Higher MAP targets (80-85 mmHg) may be considered in patients with chronic hypertension 5

Monitoring and Assessment

  • Continuously monitor arterial blood pressure 3, 5
  • Assess tissue perfusion through multiple parameters: blood lactate concentrations, skin perfusion, mental status, and urine output 1
  • Consider measuring cardiac output when using vasopressors to ensure adequate tissue perfusion 5

Management of Refractory Hypotension

  • If target MAP cannot be achieved with maximum doses of norepinephrine, add vasopressin (0.01-0.03 U/min, up to 0.03 U/min) 1, 3, 5
  • Early addition of vasopressin (within 3 hours) may lead to faster shock resolution 6
  • Epinephrine can be added as an alternative second agent when norepinephrine and vasopressin are insufficient 1, 3
  • Dopamine should only be used as an alternative to norepinephrine in highly selected patients with low risk of tachyarrhythmias or with bradycardia 1, 5
  • Phenylephrine is not recommended except in specific circumstances (e.g., when norepinephrine causes serious arrhythmias) 1, 2

Discontinuation

  • When discontinuing the infusion, reduce the flow rate gradually 4
  • Avoid abrupt withdrawal to prevent rebound hypotension 4
  • Continue fluid resuscitation while weaning vasopressors 1

Important Considerations and Pitfalls

  • Correct hypovolemia before or during norepinephrine therapy; if patient doesn't respond to therapy, suspect occult hypovolemia 4
  • Norepinephrine has been shown to be superior to dopamine with lower rates of arrhythmias and improved mortality 1, 7
  • Store diluted norepinephrine solution for up to 24 hours at room temperature and protect from light 4
  • Avoid contact with iron salts, alkalis, or oxidizing agents 4
  • Whole blood or plasma, if indicated to increase blood volume, should be administered separately 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Norepinephrine vs. Phenylephrine in Septic Shock Patients with Tachycardia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Vasopressor Management in Septic Shock

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Vasopressor Management in Septic Shock

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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