Research compounds
Nesiritide
Natrecor, recombinant BNP
Nesiritide is recombinant human B-type natriuretic peptide, approved in 2001 for acutely decompensated heart failure. It was withdrawn from the US market in 2018 after later trials failed to show benefit.
Also known as: Natrecor, recombinant BNP, hBNP
- Status
- Nesiritide is a research compound and not approved by the FDA for human use.
- Evidence
- Human trials. Published clinical trials in people report results.
- Half-life
- Approximately 18 minutes.
- How it's taken
- Intravenous bolus followed by continuous infusion
- Mechanism
- Other
How Nesiritide works
BNP is released from ventricular myocardium in response to wall stress. It binds natriuretic peptide receptor A, raising intracellular cGMP, which produces venous and arterial vasodilation, natriuresis and diuresis, and suppression of the renin-angiotensin-aldosterone system. Nesiritide reproduces that signal exogenously to reduce filling pressures in decompensated heart failure.
What research has looked at
- It reduced pulmonary capillary wedge pressure and improved dyspnoea in the trials supporting its original approval.
- A mechanism distinct from diuretics and conventional vasodilators, acting through the natriuretic peptide system directly.
- Its history is instructive: it remains one of the clearest cautionary examples of approval on haemodynamic surrogate endpoints without outcome data.
Evidence level: Human trials. Published clinical trials in people report results. These are areas studied or reported, not promised effects.
Reported side effects and risks
- The large ASCEND-HF trial found no benefit on death or rehospitalisation, and no clinically meaningful improvement in dyspnoea. The product was subsequently discontinued.
- Earlier meta-analyses had raised concerns about worsening renal function and increased mortality, which drove the demand for the outcomes trial.
- Hypotension is common and can be prolonged, since the effect outlasts the infusion.
- It is no longer marketed in the United States.
- Endogenous BNP remains clinically important as a diagnostic biomarker, which is unrelated to the failure of nesiritide as a therapy.
Sources
- FDA approved-drug listing for nesiritide · U.S. Food & Drug Administration
- DailyMed prescribing information for nesiritide · NIH · DailyMed
- PubMed research on nesiritide ASCEND-HF outcomes · NIH · National Library of Medicine
- DrugBank record for nesiritide · DrugBank
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Related compounds
Nesiritide FAQ
What is Nesiritide?
Nesiritide is recombinant human B-type natriuretic peptide, approved in 2001 for acutely decompensated heart failure. It was withdrawn from the US market in 2018 after later trials failed to show benefit.
How does Nesiritide work?
BNP is released from ventricular myocardium in response to wall stress. It binds natriuretic peptide receptor A, raising intracellular cGMP, which produces venous and arterial vasodilation, natriuresis and diuresis, and suppression of the renin-angiotensin-aldosterone system. Nesiritide reproduces that signal exogenously to reduce filling pressures in decompensated heart failure.
Is Nesiritide FDA approved?
No. Nesiritide is a research compound and not approved by the FDA for human use. Evidence level: human trials. Published clinical trials in people report results.
What is the half-life of Nesiritide?
Reported half-life: Approximately 18 minutes.
How is Nesiritide taken?
Intravenous bolus followed by continuous infusion.
What side effects have been reported with Nesiritide?
Reported in the sources: The large ASCEND-HF trial found no benefit on death or rehospitalisation, and no clinically meaningful improvement in dyspnoea. The product was subsequently discontinued; Earlier meta-analyses had raised concerns about worsening renal function and increased mortality, which drove the demand for the outcomes trial; Hypotension is common and can be prolonged, since the effect outlasts the infusion; It is no longer marketed in the United States; Endogenous BNP remains clinically important as a diagnostic biomarker, which is unrelated to the failure of nesiritide as a therapy.
Educational summary compiled from the sources listed above. Not medical advice. Peptide Vault does not sell, source or recommend any compound. Talk to a qualified clinician before starting or changing anything.