Norepinephrine pharmacolexicology: a chronological review of dose reporting and the implications of salt formulations.

Abstract

Uncertainties in norepinephrine dose reporting due to variable labeling practices secondary to salt formulation considerations have resulted in significant clinical and research challenges, potentially leading to impaired comparability across studies. The objective of this review was to summarize the chronology of the available literature on the issue of norepinephrine salt formulations and dose reporting. A systematic search of PubMed/MEDLINE, EMBASE, and Google Scholar databases was conducted to identify pertinent studies addressing the variability in norepinephrine salt formulations and labeling practices, the evolution of pharmacological understanding, and recent developments in proposed guidelines. The included investigations were then synthesized in a narrative fashion and subsequently organized chronologically to trace the progression of findings over time, thus highlighting the implications of dosing variability, and provide insight into strategies that may be used to attain global harmonization in norepinephrine dose reporting. National efforts-such as the United States Salt Policy and the French implementation model-offer a structured pathway toward harmonization. Consistency in norepinephrine dose reporting globally is of upmost importance such that trials may be designed appropriately, evidence syntheses may be interpreted appropriately, and research findings may be appropriately used to inform clinical practice.