Dopram (doxapram HCl)

Because doxapram has a narrow margin of safety, the minimum effective dosage should be used and maximum recommended dosages should not be exceeded. Analeptic use of doxapram hydrochloride is strongly discouraged by most clinicians.

Doxapram hydrochloride may be administered by IV injection or infusion. An adequate airway and oxygenation should be established before administering the drug, and care should be taken to prevent vomiting and aspiration of vomitus. Monitoring of blood pressure, heart rate, and deep tendon reflexes is recommended to prevent overdosage; dosage or rate of infusion should be adjusted on the basis of these parameters. Arterial blood gases should be monitored prior to and at 30-minute intervals during administration of doxapram to guard against the development of respiratory acidosis; the drug should be discontinued if arterial carbon dioxide tension increases, oxygen tension decreases, or mechanical ventilation is initiated. The drug also should be discontinued if sudden hypotension or dyspnea occurs. Because narcosis may recur after administration of doxapram, close observation of the patient should be continued until the patient has been fully alert for 30 minutes to 1 hour. If recurrence of unconsciousness or respiratory depression occurs, supportive care should be provided as required. Doxapram is not an antagonist to muscle relaxant drugs nor a specific opiate antagonist. When doxapram is used to manage respiratory depression following anesthesia, adequacy of ventilation should be assessed with specific tests (e.g., peripheral nerve stimulation, airway pressures, head lift, pulse oximetry, end-tidal carbon dioxide) prior to administration.

For IV infusion, a doxapram hydrochloride solution containing approximately 1 mg/mL can be prepared by adding 250 mg of doxapram hydrochloride (12.5 mL of the commercially available injection) to 250 mL of 5 or 10% dextrose or 0.9% sodium chloride injection. A solution containing a final concentration of 2 mg/mL can be prepared by adding 400 mg of doxapram hydrochloride (20 mL of the commercially available injection) to 180 mL of 5 or 10% dextrose or 0.9% sodium chloride injection.

No dosing information is available for this tab.

No dosing information is available for this tab.

Doxapram should be used with caution in patients who are receiving sympathomimetic drugs or monoamine oxidase inhibitors, because a synergistic pressor effect may occur. Doxapram also should be used with caution in those who have received muscle relaxants because doxapram may temporarily mask their residual effects. Because animal studies show that doxapram causes an increase in epinephrine release and because self-limiting arrhythmias have been noted in patients receiving doxapram and general anesthetics known to sensitize the myocardium to catecholamines, the manufacturer recommends that administration of doxapram be delayed until the anesthetic has been excreted. Concomitant use of doxapram and theophyllines (e.g., theophylline, aminophylline) may increase skeletal muscle activity, agitation, and hyperactivity.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

• Acute asthma attack
• Acute decompensated heart failure
• Cerebral edema
• Cerebrovascular accident
• Flail chest
• Lower seizure threshold
• Neuromuscular blockade
• Pheochromocytoma
• Pneumothorax
• Pulmonary fibrosis
• Pulmonary thromboembolism
• Respiratory obstruction
• Seizure disorder
• Severe coronary artery disease
• Severe uncontrolled hypertension

• Hyperthyroidism
• Hypotension
• Mechanical ventilation

• Cardiac arrhythmia
• Disease of liver
• Kidney disease with reduction in glomerular filtration rate (GFr)
• Leukopenia

There is no enhanced messaging for this drug.

Rare or Very Rare

• Cardiac arrhythmia
• Chest pain
• Chest tightness
• Dyspnea
• Hemolysis
• Hypertension
• Tachycardia
• Tachypnea
• Thrombophlebitis
• Wheezing

Less Frequent

• Acute cognitive impairment
• Cough
• Diarrhea
• Dizziness
• Dysuria
• Flushing
• Headache disorder
• Hiccups
• Hyperhidrosis
• Nausea
• Vomiting

No enhanced messaging available.

No enhanced messaging available.

The safety of doxapram in pregnant women has not been established. The manufacturer recommends that the drug be used during pregnancy only when clearly needed.

No enhanced messaging available.

No enhanced messaging available.