Norepinephrine Rate Calculator
mcg/min (Non-weight based)
mcg/kg/min (Weight based)
Concentration:
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Infusion Rate (Pump Setting):
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Standard Dose Range Check:
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About Norepinephrine (Levophed) Dosing
This Norepinephrine Rate Calculator is designed for critical care nurses, paramedics, and physicians to determine the correct IV pump flow rate (mL/hr) based on the ordered dose and the concentration of the medication available.
Norepinephrine is a potent alpha-1 adrenergic receptor agonist and a beta-1 agonist used principally as a vasopressor to treat severe hypotension and shock (such as septic shock). Because of its potency, accurate calculation is vital for patient safety.
How to Calculate Norepinephrine Infusion Rates
The calculation involves two primary steps: determining the concentration of the infusion and then converting the desired dose into a milliliter per hour rate for the IV pump.
Step 1: Calculate Concentration
First, convert the total milligrams (mg) in the bag to micrograms (mcg) and divide by the total volume (mL).
Concentration (mcg/mL) = (Total mg × 1000) ÷ Total Volume (mL)
Example: 4 mg in 250 mL = (4000 mcg) / 250 mL = 16 mcg/mL.
Step 2: Calculate Flow Rate (mL/hr)
The formula depends on whether the order is weight-based or non-weight-based.
For mcg/min (Non-weight based):
Rate (mL/hr) = (Dose (mcg/min) × 60) ÷ Concentration (mcg/mL)
For mcg/kg/min (Weight based):
Rate (mL/hr) = (Dose (mcg/kg/min) × Weight (kg) × 60) ÷ Concentration (mcg/mL)
Standard Concentrations
Hospitals typically use standardized concentrations to reduce errors. Common preparations include:
- Standard: 4 mg in 250 mL (16 mcg/mL)
- Concentrated: 8 mg in 250 mL (32 mcg/mL)
- Double Concentrated: 16 mg in 250 mL (64 mcg/mL)
- Quad Strength: 32 mg in 250 mL (128 mcg/mL)
Clinical Considerations
Typical starting doses for norepinephrine range from 2-5 mcg/min or 0.01-0.05 mcg/kg/min, titrated to a MAP > 65 mmHg. Always follow your facility's specific titration protocols. Ensure central line access is established as soon as possible due to the risk of tissue necrosis from extravasation.