Doxapram
- Atc Codes:R07AB01
- CAS Codes:7081-53-0#113-07-5#309-29-5
- PHARMGKB ID:7081-53-0#113-07-5#309-29-5
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Belgium: Dopram; Denmark: Dopram; Finland: Dopram; France: Dopram; Germany: Dopram; Ireland: Doxapram; Malta: Dopram; Netherlands: Dopram; UK: Dopram, Doxapram.
North America
USA: Dopram, Doxapram.
Asia
Japan: Dopram.
Drug combinations
Chemistry
Doxapram Hydrochloride: C~24~H~30~N~2~O~2~ HCl H~2~O. Mw: 432.98. (1) 2-Pyrrolidinone, 1-ethyl-4-[2-(4-morpholinyl)ethyl]-3,3-diphenyl-, monohydrochloride, monohydrate, (±)-; (2)(±)-1-Ethyl-4-(2-morpholinoethyl)-3,3-diphenyl-2-pyrrolidinone monohydrochloride monohydrate. CAS-7081-53-0; CAS-113-07-5(anhydrous); CAS-309-29-5 (doxapram)(1962).
Pharmacologic Category
Anorexigenic Agents and Respiratory and Cerebral Stimulants, Miscellaneous. Respiratory Stimulant. (ATC-Code: R07AB01).
Mechanism of action
Stimulates respiration through action on respiratory center in medulla or indirectly on peripheral carotid chemoreceptors.
Therapeutic use
Used in conjunction with supportive measures to treat respiratory depression associated with overdosage of CNS-depressant drugs. Short-term use in acute respiratory insufficiency associated with COPD. Treatment of drug-induced postanesthetic respiratory depression or apnea not caused by skeletal muscle relaxants. However, doxapram has a limited role in the contemporary management of these conditions.
Pregnancy and lactiation implications
Teratogenic effects not observed in animal studies. Product contains benzyl alcohol and is associated with toxicity in neonates. Caution if used in nursing women.
Unlabeled use
Has been used for treatment of neonatal apnea, principally in combination with theophylline or caffeine, although there is no apparent advantage over methylxanthines for this use and risk of substantial adverse effects with doxapram therapy exists.
Contraindications
Hypersensitivity to doxapram or any component of the formulation. Cardiovascular disease (i.e. uncompensated heart failure, severe coronary artery disease). Head injury, cerebrovascular accident, or cerebral edema. Seizure disorders. Hyperthyroidism. Mechanical disorders of ventilation (e.g. mechanical obstruction, muscle paresis, flail chest, pneumothorax, acute bronchial asthma, pulmonary fibrosis or other restrictive lung diseases). Pulmonary embolism. Severe hypertension including that associated with hyperthyroidism or pheochromocytoma.
Warnings and precautions
Use with caution in history of bronchial asthma, severe tachycardia, cardiac arrhythmias, or acute respiratory failure secondary to COPD. Use with caution in hepatic or renal impairment (possible decrease in rate of metabolism or clearance). The drug should not be used in history of hypersensitivity to drug or in conjunction with mechanical ventilation. Use in neonates is not recommended (injection contains benzyl alcohol). Possible changes in heart rate, lowered T-waves, and dysrhythmias (e.g. ventricular tachycardia, ventricular fibrillation, QT interval prolongation). Chest pain and tightness in chest reported. Lowered carbon dioxide tension induced by hyperventilation may cause cerebral vasoconstriction and decreased cerebral circulation. May cause seizures and other adverse effects due to general CNS stimulation. Potential for local reactions including thrombophlebitis.