Nesiritide
Recombinant BNP for acute decompensated heart failure.
What it is
Nesiritide (Natrecor) is a recombinant version of human B-type natriuretic peptide (BNP), FDA-approved in 2001 for acute decompensated heart failure. After initial enthusiasm, clinical use declined following the ASCEND-HF trial and other studies showing limited benefit.
Mechanism of action
BNP receptor activation produces vasodilation (arterial and venous), natriuresis, diuresis, and suppression of the renin-angiotensin-aldosterone and sympathetic nervous systems. The hemodynamic effects address the congestion of acute heart failure decompensation.
Approved indications
Acute decompensated heart failure with dyspnea at rest or with minimal activity.
Why this is out of scope at The Tide
Hospital cardiology medication for acute heart failure. Requires IV administration with hemodynamic monitoring. Not appropriate for outpatient peptide clinic.
Where to learn more
Cardiology, particularly heart failure specialists.