Nesiritide
Also known as: Natrecor, Recombinant human BNP
Nesiritide is recombinant human BNP, historically used as an IV treatment for acute decompensated heart failure. Early hemodynamic improvement did not translate into better 30-day outcomes in the larger ASCEND-HF trial.
Quick Facts
A recombinant heart-derived hormone
Nesiritide, marketed as Natrecor, reproduces the 32-amino-acid human B-type natriuretic peptide released when ventricular pressure or volume stretches the heart. It was designed to enhance the natural vessel-relaxing and fluid-excreting signal in acute heart failure. FDA approval dates to 2001; the product has since been largely withdrawn for commercial reasons.
Natriuretic signaling
Binding natriuretic peptide receptor-A raises cyclic GMP in vascular walls and relaxes arteries and veins. This reduces cardiac afterload and filling pressure, reflected in pulmonary capillary wedge pressure. It also promotes renal sodium and water excretion and suppresses the renin–angiotensin–aldosterone system.
Hemodynamics versus clinical outcomes
| Trial | Result |
|---|---|
| VMAC | Greater reduction in filling pressure than nitroglycerin or placebo and improved breathing at three hours |
| ASCEND-HF | Small nonsignificant dyspnea effect; no reduction in 30-day death or rehospitalization; more hypotension |
Supporting references: no benefit.
Sources: [1]
Historical approval and current role
The 2001 FDA indication was acute decompensated heart failure with dyspnea at rest or minimal activity, treated intravenously in a monitored hospital setting. Neutral ASCEND-HF outcomes, evolving practice and broad market withdrawal have made contemporary use uncommon. Historical approval should not be interpreted as routine current availability.
Hypotension is the central risk
Blood-pressure lowering can be symptomatic, substantial or prolonged. Headache, nausea and slowed heart rate are other reported effects. Earlier concerns that the drug worsened renal function were not confirmed in ASCEND-HF. Improved short-term pressure measurements do not establish improved survival or rehospitalization outcomes.
References and further reading
This reference draws on Superpower’s Peptide Library and the research linked below. Peptide Dossier’s editorial team adapted and integrated the material on .
- 10.1056/NEJMoa1100171Hemodynamics versus clinical outcomesCited in: Hemodynamics versus clinical outcomes
Frequently Asked Questions About Nesiritide
Related Peptides
Continue exploring Nesiritide
Search all related references →Our library review is ongoing. Read how we evaluate evidence or report a correction.
Disclaimer: This article is for informational and educational purposes only. It is not intended as medical advice. The information presented is based on published research and should not be used as a substitute for professional medical guidance. Always consult a qualified healthcare provider before starting any peptide protocol. Some peptides discussed may not be approved for human use by the FDA or equivalent regulatory bodies.