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Metahydroxylamine (commonly used as the bitartrate salt) is a small molecule vasopressor agent primarily indicated for the prevention and treatment of acute hypotension during intraspinal (spinal or epidural) anesthesia. It is also used as adjunctive therapy for hypotension resulting from hemorrhage, drug allergy, surgical complications, brain trauma or tumor with shock, cardiogenic shock, and septicemia. The mechanism of action involves direct stimulation of alpha-adrenergic receptors leading to vasoconstriction and a sustained increase in both systolic and diastolic blood pressure. The effective enantiomer is the (1R,2S)-isomer. Metahydroxylamine bitartrate is marketed under the brand name Aramine in Australia and other countries[1][7][9].
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