For blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions). As an adjunct in the treatment of cardiac arrest and profound hypotension.
Theropeutic Class
Alpha and Beta-adrenergic agonist
Pharmacology
Levofed 2 mg/2 ml is a direct-acting sympathomimetic which stimulates β1- and α-adrenergic receptors. Its α-agonist effects cause vasoconstriction, thereby raising systolic and diastolic BP with reflex slowing of heart rate.
Dosage & Administration of Levofed 2 mg/2 ml
Upper gastrointestinal haemorrhage:
Adult: Intraperitoneal admin: 8 mg in 250 ml of 0.9% sodium chloride inj. Alternatively, instill 8 mg in 100 ml of 0.9% sodium chloride solution through a nasogastric tube every hr for 6–8 hr, then every 2 hr for 4–6 hr. Withdraw drug gradually.
Acute hypotensive states:
Adult: Initially, 8-12 mcg/minute, up to 8-30 mcg/minute in refractory shock. Infuse using a solution of 4 mcg/ml in glucose 5%, or sodium chloride 0.9% and glucose 5% at a rate of 2-3 ml/minute. Adjust according to BP response. Average maintenance dose: 0.5-1 ml/minute (2-4 mcg/minute). Infuse via a central venous catheter or into a large vein.
Child: Administer at a rate of 2 mcg/minute. Alternatively, 2 mcg/m2/minute. Adjust rate according to BP response and perfusion.
Elderly: Initial dose should be at low end of dose range.
Interaction of Levofed 2 mg/2 ml
Guanethidine, methyldopa, reserpine, TCAs may increase pressor response to Levofed 2 mg/2 ml.
Contraindications
Hypertension. Pregnancy. Patients with peripheral or mesenteric vascular thrombosis unless necessary as a life-saving procedure.
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Precautions & Warnings
Not a substitute for replacement of blood, plasma, fluids, and/or electrolytes; correct volume depletion prior to admin. Identify and correct hypoxia, hypercapnia and acidosis prior to or during admin. Avoid extravasation as tissue necrosis may occur. Avoid inj into leg veins, especially in elderly or those with occlusive vascular diseases, arteriosclerosis, DM or Buerger's disease. Hypertensive or hyperthyroid patients. In conjunction with local anaesthetics, do not use in fingers, toes, ears, nose or genitalia. Lactation.
Store at room temperature (25°C) and protect from light.
Reconstitution
Intravenous: Dilute with 5% glucose inj, with or without sodium chloride; dilution with sodium chloride inj alone is not recommended.
Frequently Asked Questions
What is Levofed 2 mg/2 ml used for?
For blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions). As an adjunct in the treatment of cardiac arrest and profound hypotension.
What is the dosage of Levofed 2 mg/2 ml?
Upper gastrointestinal haemorrhage: Adult: Intraperitoneal admin: 8 mg in 250 ml of 0.9% sodium chloride inj. Alternatively, instill 8 mg in 100 ml of 0.9% sodium chloride solution through a nasogastric tube every hr for 6–8 hr, then every 2 hr for 4–6 hr. Withdraw drug gradually. Acute hypotensive states: Adult: Initially, 8-12 mcg/minute, up to 8-30 mcg/minute in refractory shock. Infuse using a…
Hypertension. Pregnancy. Patients with peripheral or mesenteric vascular thrombosis unless necessary as a life-saving procedure.
What precautions should be taken with Levofed 2 mg/2 ml?
Not a substitute for replacement of blood, plasma, fluids, and/or electrolytes; correct volume depletion prior to admin. Identify and correct hypoxia, hypercapnia and acidosis prior to or during admin. Avoid extravasation as tissue necrosis may occur. Avoid inj into leg veins, especially in elderly or those with occlusive vascular diseases, arteriosclerosis, DM or Buerger's disease. Hypertensive o…
Is Levofed 2 mg/2 ml safe during pregnancy and breastfeeding?
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Disclaimer
The information provided is accurate to our best practices, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy. The absence of specific information about a drug should not be seen as an endorsement. We are not responsible for any consequences resulting from this information, so consult a healthcare professional for any concerns or questions.