Heart Health High Blood Pressure Treatment Sodium Nitroprusside for Hypertension Treatment By Craig O. Weber, MD Craig O. Weber, MD Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years. Learn about our editorial process Updated on January 25, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Richard N. Fogoros, MD Medically reviewed by Richard N. Fogoros, MD Facebook LinkedIn Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our Medical Expert Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print Sodium nitroprusside is a powerful anti-hypertension medicine that is only used in certain situations when blood pressure must be immediately and dramatically reduced. For example, patients who are experiencing a hypertensive emergency or very high blood pressure following heart or blood vessel surgery may be given sodium nitroprusside, which has a trade name of Nitropress. Hero Images / Getty Images In addition to treating hypertension, nitroprusside is used to treat other conditions such as congestive heart failure and also to maintain low blood pressure during certain surgeries. Sodium Nitroprusside Administration Because it can only be administered intravenously, the use of sodium nitroprusside is restricted to the hospital setting. In addition, sodium nitroprusside can cause large and rapid blood pressure decreases that require careful monitoring. How Sodium Nitroprusside Works Sodium nitroprusside belongs to a class of drugs known as NO-releasing agents because it works by releasing nitric oxide. Like all other drugs in that class, sodium nitroprusside works by relaxing blood vessels. Once in the body, sodium nitroprusside is quickly broken down into nitric oxide, a powerful vasodilator. This nitric oxide works as a vasodilator, causing the muscles surrounding blood vessels to relax, allowing the blood vessels themselves to expand. As the blood vessels expand, blood pressure drops. The breakdown of sodium nitroprusside to nitric oxide happens very quickly, so there is virtually no delay between administration of the drug and blood pressure reduction. Along with its blood pressure-reducing actions, sodium nitroprusside also alters the pattern of blood flow through the vessels that feed the heart, making it useful in the treatment of patients with heart problems. Other Drugs Like Sodium Nitroprusside Several nitrate-based drugs are used for the treatment of high blood pressure and heart problems. Two common nitrates are isosorbide dinitrate and nitroglycerin. All of the nitrate drugs can be used to treat heart problems, and some, like nitroglycerin, are used almost exclusively for that purpose. Sodium Nitroprusside Side Effects The most serious potential side effect of sodium nitroprusside is cyanide poisoning. The conversion of sodium nitroprusside to nitric oxide produces cyanide as a byproduct. In small amounts, this cyanide is managed by the liver, which changes it into a less toxic chemical that is quickly excreted in the urine. In cases of long-term use, or if too much is used at one time, the cyanide can overwhelm the liver and lead to cyanide poisoning. For that reason, the administration should be discontinued if blood pressure is not properly controlled after 10 minutes at the maximum dosage. Warning signs include: ConfusionNauseaFatigue The primary treatment is simply to stop the sodium nitroprusside and give supportive care until the body eliminates the cyanide. Choosing a Treatment Only you and your healthcare provider can decide on proper medication for the treatment of high blood pressure. Be sure to notify your healthcare provider if you are pregnant or breastfeeding, and to supply the names of any other medicines and/or supplements you are taking. Remember to include over-the-counter medicines, like aspirin or Advil (ibuprofen), and herbal/natural supplements. Was this page helpful? Thanks for your feedback! Looking to start a diet to better manage your high blood pressure? Our nutrition guide can help. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Belani K, Hottinger D, Kozhimannil T, Prielipp R, Beebe D. Sodium nitroprusside in 2014: A clinical concepts review. J Anaesthesiol Clin Pharmacol. 2014;30(4):462. doi. 10.4103%2F0970-9185.142799 Prescriber's Digital Reference. sodium nitroprusside. ClinicalTrials.gov. Sodium NitroPrusside Treatment in Acute Heart Failure. University of Michigan Health. isosorbide dinitrate. Landon MB. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th edition. Elsevier Inc; 2020. Aronson JK, ed. Meyler’s Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. 16. ed. Elsevier; 20.