What is the standard dilution for a norepinephrine (Levophed) drip?

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Last updated: November 28, 2025View editorial policy

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Standard Norepinephrine Dilution

The standard adult dilution for norepinephrine is 4 mg added to 250 mL of D5W, yielding a concentration of 16 mcg/mL. 1, 2

Standard Preparation

  • Add 4 mg of norepinephrine to 250 mL of D5W to create a 16 mcg/mL concentration - this is the most commonly used standard dilution in clinical practice 1, 2
  • The FDA label explicitly states: "Add the content of the vial (4 mg/4 mL) of LEVOPHED to 1,000 mL of a 5 percent dextrose containing solution. Each mL of this dilution contains 4 mcg of the base" - however, the 250 mL preparation (16 mcg/mL) is more practical and widely used 2
  • D5W or 5% dextrose with sodium chloride are the recommended diluents, as dextrose-containing fluids protect against potency loss from oxidation 2
  • Saline solution alone is NOT recommended as the primary diluent due to oxidation concerns 2

Alternative Concentrations

  • For anaphylaxis: 1 mg norepinephrine in 100 mL saline creates a 1:100,000 solution (10 mcg/mL), administered at 30-100 mL/h 1
  • More concentrated preparation: 4 mg in 250 mL yields 16 mcg/mL for patients requiring fluid restriction 1
  • More dilute preparation: Use concentrations less than 4 mcg/mL when large fluid volumes are clinically needed 2

Stability Considerations

  • Norepinephrine solutions at both 4 mcg/mL and 16 mcg/mL concentrations remain chemically stable for 7 days at room temperature under ambient light when diluted in either D5W or normal saline 3
  • Solutions maintain >95% of original concentration after 168 hours of storage 3

Critical Administration Requirements

  • Central venous access is strongly preferred to minimize extravasation risk and tissue necrosis 1, 2
  • If extravasation occurs, immediately infiltrate 5-10 mg phentolamine diluted in 10-15 mL saline at the site 1, 2
  • Never mix with sodium bicarbonate or alkaline solutions in the IV line, as norepinephrine is inactivated in alkaline environments 1, 2
  • Discard solution if color is pinkish or darker than slightly yellow, or if precipitate is present 2

References

Guideline

Norepinephrine Drip Administration Protocol

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Stability of norepinephrine infusions prepared in dextrose and normal saline solutions.

Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2008

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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