·        Nesiritide is recommended to be added to the formulary for use in patients who have failed or are intolerant to nitroglycerin, nitroprusside, dobutamine and/or milrinone.  It is not recommended as a first line agent as it has not be proven to be a superior agent and is much more expensive than other FDA approved agents. As additional studies become available nesiritide's formulary status will be re-reviewed.

·        A cardiology consult is recommended for all patients receiving nesiritide.