doxapram

Contraindicated in:

Hypersensitivity;
Patients on mechanical ventilation;
Head trauma;
Seizures;
Flail chest;
Pulmonary embolism;
Pneumothorax;
Pulmonary fibrosis;
Acute asthma;
Extreme dyspnea;
Cardiovascular or cerebrovascular disease;
Pedi: Newborns (contains benzyl alcohol).

Use Cautiously in:

Asthma;
Arrhythmias;
Hyperthyroidism;
Pheochromocytoma;
Serious uncorrected metabolic disorders;
Renal impairment;
Hepatic impairment;
OB: Use during pregnancy only if clearly needed;
Lactation: Safety not established during breastfeeding;
Pedi: Children <12 yr (safety and effectiveness not established);

Adv. Reactions/Side Effects ⬆ ⬇

CV: arrhythmias, chest pain, ECG changes (T wave inversion), hypertension

Derm: flushing, pruritus, sweating

EENT: mydriasis

GI: diarrhea, nausea, vomiting

GU: albuminuria, perineal/genital burning sensation, spontaneous voiding, urinary retention

Hemat: hemolysis

Local: phlebitis

MS: involuntary movement, muscle spasticity, skeletal muscle hyperactivity

Neuro: apprehension, disorientation, dizziness, generalized clonus, headache, paresthesia, positive bilateral Babinski’s sign, SEIZURES

Resp: bronchospasm, cough, dyspnea, hiccups, LARYNGOSPASM, rebound hypoventilation, tachypnea

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

Pressor effects may be ↑ by concurrent use of adrenergic amines (sympathomimetics) or MAO inhibitors.
May mask residual effects of skeletal muscle relaxants. Initial release of epinephrine caused by doxapram may cause adverse reactions when given concurrently with anesthetics known to sensitize the myocardium to the effects of cathecholamines (wait 10 min following discontinuation of anesthetic to administer doxapram).
Aminophylline or theophylline may worsen skeletal muscle hyperactivity.

Availability ⬆ ⬇

Solution for injection (contains benzyl alcohol): 20 mg/mL

Route/Dosage ⬆ ⬇

Respiratory Depression following Anesthesia

IV (Adults and Children ≥12 yr): Intermittent injection: 0.5–1 mg/kg (not to exceed 1.5 mg/kg) initially; may repeat every 5 min to a total of 2 mg/kg. Infusion: Initiate at 5 mg/min until response is obtained; then ↓rate to 1–3 mg/min (total dose by infusion method should not exceed 4 mg/kg).

Drug-Induced CNS Depression

IV (Adults and Children ≥12 yr): Intermittent injection:Give priming dose of 1–2 mg/kg; repeat in 5 min. May repeat at 1–2 hr intervals until sustained consciousness or total of 3 g/24 hr given. Infusion: Give priming dose of 1–2 mg/kg by direct injection; repeat in 5 min. If no response, continue supportive measures for 1–2 hr and repeat priming dose. If some respiratory stimulation occurs, initiate infusion at 1–3 mg/min. Discontinue infusion if patient begins to awaken or after 2 hr. Infusion may be restarted (along with priming dose) after rest interval of 30–120 min. Do not exceed 3 g/24 hr.

Acute Hypercapnea Secondary to COPD

IV (Adults ): Infusion: 1–2 mg/min (up to 3 mg/min). Should not be used for >2 hr.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

In low doses, stimulates breathing by activating carotid receptors.
Larger doses directly stimulate the respiratory center in medulla as well as produce generalized CNS stimulation.

Therapeutic effects:

Transient increase in tidal volume, small increase in respiratory rate. Oxygenation is not increased.

Classifications ⬆ ⬇

Therapeutic Classification: central nervous system stimulants

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Rapidly metabolized; metabolites mostly excreted by the kidneys.

Half-Life: 2.4–4 hr.

Time/Action Profile ⬆ ⬇

(↑ in minute volume)

ROUTE	ONSET	PEAK	DURATION
IV	20–40 sec	1–2 min	5–12 min

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy, as able.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Instruct patient to notify health care professional immediately if shortness of breath worsens.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0641- Hikma Pharmaceuticals USA Inc.
- 0641-6018- Dopram
  - 0641-6018-01- 20 mL in 1 VIAL (0641-6018-01)

0641- Hikma Pharmaceuticals USA Inc.
- 0641-6018- Dopram
  - 0641-6018-06- 6 VIAL in 1 CARTON (0641-6018-06) / 20 mL in 1 VIAL (0641-6018-01)

51662- HF Acquisition Co LLC, DBA HealthFirst
- 51662-1404- DOXAPRAM HYDROCHLORIDE
  - 51662-1404-1- 1 VIAL in 1 CARTON (51662-1404-1) / 20 mL in 1 VIAL

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Indications ⬇

Contraind./Precautions ⬆ ⬇