From the Guidelines
To administer Urapidil 50mg/10ml in 100ml NaCl using a macrodip infusion set, the recommended protocol is to prepare the solution and calculate the drip rate based on the prescribed hourly dose, with careful monitoring of the patient's blood pressure and adjustment of the infusion rate as needed, as supported by the European Heart Journal study 1.
Preparation and Administration
To prepare the solution, add the 10ml of Urapidil (50mg) to 100ml of normal saline, creating a concentration of 0.45mg/ml (50mg divided by 110ml total volume). With a standard macrodip infusion set that delivers 20 drops per ml, calculate the drip rate based on the prescribed hourly dose. For example, if the prescribed rate is 15mg/hour, you would need to infuse 33ml/hour (15mg ÷ 0.45mg/ml), which equals approximately 11 drops per minute (33ml × 20 drops/ml ÷ 60 minutes).
Monitoring and Adjustment
Monitor the patient's blood pressure regularly during administration, as Urapidil is an antihypertensive agent that works by blocking alpha-1 adrenergic receptors, causing vasodilation and reducing peripheral resistance, as outlined in the study 1. Adjust the infusion rate according to blood pressure response and physician orders. Be vigilant for potential side effects including dizziness, headache, nausea, or excessive hypotension. Ensure the IV site remains patent throughout the infusion and maintain strict aseptic technique when handling the solution.
Key Considerations
- The recommended dose of Urapidil for hypertensive emergencies is 12.5–25 mg i.v. bolus, 5–40 mg/h as continuous infusion, as per the European Heart Journal study 1.
- Compared with nitroglycerine, urapidil gives a better BP reduction and improvement of arterial oxygen content without reflex tachycardia, making it a preferable option in certain cases 1.
- Concomitant administration of loop diuretics decreases volume overload and helps to further lower BP, which may be considered in the treatment protocol 1.
From the Research
Urapidil Infusion Protocol
- The standard protocol for urapidil infusion involves administering 50mg of urapidil in 100ml of NaCl solution, with a macrodip used for tough infusion 2.
- This protocol has been used in various studies to treat hypertensive emergencies and crises, with effective reduction of blood pressure observed in over 90% of patients 2, 3.
Efficacy and Safety of Urapidil
- Urapidil has been shown to be an effective antihypertensive agent, with a significant decrease in systolic and diastolic blood pressure observed within 2 minutes of administration 2.
- The maximum effect of urapidil is typically observed within 40 minutes of administration, with a decrease in heart rate also observed 2.
- Urapidil has been found to be well-tolerated, with minimal adverse effects reported, including dizziness, nausea, and fatigue 4, 3.
Clinical Applications of Urapidil
- Urapidil has been used to treat hypertensive emergencies and crises, including perioperative hypertension and pre-eclampsia 3.
- It has also been used to treat hypertension in infants and children, with effective reduction of blood pressure observed in all patients studied 5.
- Urapidil may have a potential role in the management of acute stroke, although further studies are needed to confirm this 3.