No

Respiratory Stimulant; Stimulant

Respiratory and CNS stimulant; stimulates respiration in patients with drug-induced CNS depression or postanesthesia respiratory depression; in hospitalized patients with COPD associated with acute hypercapnia

B

Hypersensitivity to doxapram or any component; epilepsy, cerebral edema, head injury, severe pulmonary disease, pheochromocytoma, cardiovascular disease, hypertension, hyperthyroidism

May cause severe CNS toxicity, seizures. Should be used with caution in newborns as the U.S. product contains benzyl alcohol (0.9%). Doxapram is neither a nonspecific CNS depressant antagonist nor an opiate antagonist.

1% to 10%:

Central nervous system: Headache

Gastrointestinal: Nausea, vomiting

Respiratory: Dyspnea

Symptoms of overdose include excessive increases in blood pressure, tachycardia, arrhythmias, muscle spasticity, and dyspnea. Supportive care is the preferred treatment. Seizures are unlikely and can be treated with benzodiazepines. Doxapram is not dialyzable.

Increased toxicity (elevated blood pressure): Sympathomimetics, MAO inhibitors

Stimulates respiration through action on respiratory center in medulla or indirectly on peripheral carotid chemoreceptors

Onset of action (respiratory stimulation): I.V.: Within 20-40 seconds

Peak effect: Within 1-2 minutes

Duration: 5-12 minutes

Serum half-life: Adults: 3.4 hours (mean half-life)

Not for use in newborns since doxapram contains a significant amount of benzyl alcohol (0.9%)

Initial: 1-1.5 mg/kg/hour

Maintenance: 0.5-2.5 mg/kg/hour, titrated to the lowest rate at which apnea is controlled

Adults: Respiratory depression following anesthesia: I.V.:

Initial: 0.5-1 mg/kg; may repeat at 5-minute intervals; maximum total dose: 2 mg/kg

I.V. infusion: Initial: 5 mg/minute until adequate response or adverse effects seen; decrease to 1-3 mg/minute; usual total dose: 0.5-4 mg/kg; maximum: 300 mg

Hemodialysis: Not dialyzable

May cause CNS stimulation, restlessness, irritability, or hallucinations

May cause hypertensive crisis if used with MAOIs

No information available to require special precautions

No effects or complications reported

This drug is generally used in an emergency. Teaching should be appropriate to patient education. Someone will be observing response at all times. Breast-feeding precautions: Consult prescriber if breast-feeding.

Dilute loading dose to a maximum concentration of 2 mg/mL and infuse over 15-30 minutes; for infusion, dilute in normal saline or dextrose to 1 mg/mL (maximum: 2 mg/mL); irritating to tissues; avoid extravasation

Monitor heart rate, blood pressure, reflexes, CNS status

Stability: Incompatible with aminophylline, thiopental, or sodium bicarbonate (alkali drugs)

Injection, as hydrochloride: 20 mg/mL (20 mL)

Barrington KJ, Finer NN, Torok-Both G, et al, "Dose-Response Relationship of Doxapram in the Therapy for Refractory Idiopathic Apnea of Prematurity," Pediatrics, 1987, 80(1):22-7.