Nitric Oxide
- Atc Codes:R07AX01
- CAS Codes:10102-43-9
- PHARMGKB ID:10102-43-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Inhibits
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: INOmax; Bulgaria: INOmax; Czech Republic: INOmax; Denmark: INOmax; Estonia: INOmax; Finland: INOmax; France: INOmax; Germany: INOmax; Greece: INOmax; Hungary: INOmax; Ireland: INOmax; Italy: INOmax; Latvia: INOmax; Lithuania: INOmax; Luxembourg: INOmax; Malta: INOmax; Netherlands: INOmax; Poland: INOmax; Portugal: INOmax, VasoKINOX; Romania: INOmax; Slovakia: INOmax; Slovenia: INOmax; Spain: INOmax, Vasokinox; Sweden: INOmax; UK: INOmax.
North America
Canada: INOmax; USA: INOmax.
Drug combinations
Chemistry
Nitric Oxide: NO. Mw: 30.01. CAS-10102-43-9.
Pharmacologic Category
Vasodilating Agents; Nitrates and Nitrites. Pulmonary Vasodilator. (ATC-Code: R07AX01).
Mechanism of action
In neonates with persistent pulmonary hypertension, nitric oxide improves oxygenation. Nitric oxide relaxes vascular smooth muscle by binding to heme moiety of cytosolic guanylate cyclase, activating guanylate cyclase and increasing intracellular levels of cyclic guanosine 3′,5′-monophosphate, which leads to vasodilation. When inhaled, pulmonary vasodilation occurs and an increase in partial pressure of arterial oxygen results. Dilation of pulmonary vessels in well-ventilated lung areas redistributes blood flow away from lung areas where ventilation/perfusion ratios are poor.
Therapeutic use
Treatment of term and near-term (>34 weeks) neonates with hypoxic respiratory failure associated with pulmonary hypertension. Used concurrently with ventilatory support and other agents.
Pregnancy and lactiation implications
Unlabeled use
Treatment of adult respiratory distress syndrome.
Contraindications
Hypersensitivity to nitric oxide or any component of the formulation. Neonates dependent on right-to-left shunting of blood. Nitric oxide not indicated for use in adults.
Warnings and precautions
Abrupt discontinuation may lead to worsening hypotension, oxygenation, and increasing pulmonary artery pressure (PAP). Doses above 20 ppm should not be used due to increased risk of methemoglobinemia and elevated nitrogen dioxide (NO~2~) levels. Methemoglobin levels and NO~2~ should be monitored. Worsening oxygenation and increasing PAP may occur in patients who do not respond.