Nitric Oxide (4 brand names, 1 dosage form, 1 route)
Available dosage forms: GAS.
Routes of administration: INHALATION.
Brand Names
- GENOSYL
- INOMAX
- NOXIVENT
- ULSPIRA
Related Health Topics
Indications and Usage
Noxivent ™ is a vasodilator indicated to improve oxygenation and reduce the need for extracorporeal membrane oxygenation in term and near-term (>34 weeks gestation) neonates with hypoxic respiratory failure associated with clinical or echocardiographic evidence of pulmonary hypertension in conjunction with ventilatory support and other appropriate agents.
Dosage and Administration
The recommended dose is 20 ppm, maintained for up to 14 days or until the underlying oxygen desaturation has resolved ( 2.1). Doses greater than 20 ppm are not recommended ( 2.1, 5.2) Administration: • Avoid abrupt discontinuation ( 2.2, 5.1).
Contraindications
Neonates dependent on right-to-left shunting of blood ( 4).
Warnings and Precautions
Rebound: Abrupt discontinuation of Noxivent™ may lead to worsening oxygenation and increasing pulmonary artery pressure ( 5.1). Methemoglobinemia: Methemoglobin increases with the dose of nitric oxide; following discontinuation or reduction of nitric oxide, methemoglobin levels return to baseline over a period of hours ( 5.2). Elevated NO 2Levels: Monitor NO 2levels ( 5.3). Heart Failure: In patients with pre-existing left ventricular dysfunction, Noxivent™ may increase pulmonary capillary wedge pressure leading to pulmonary edema ( 5.4).
Adverse Reactions
The most common adverse reaction is hypotension. ( 6). To report SUSPECTED ADVERSE REACTIONS, contact contact Vero Biotech at 1-833-669-8368 and http://www.vero-biotech.com/ or FDA at 1-800-FDA-1088 or or www.fda.gov/medwatch.
Drug Interactions
Nitric oxide donor compounds may increase the risk of developing methemoglobinemia ( 7).
Overdosage
Overdosage with Noxivent™ is manifest by elevations in methemoglobin and pulmonary toxicities associated with inspired NO 2. Elevated NO 2 may cause acute lung injury. Elevations in methemoglobin reduce the oxygen delivery capacity of the circulation. In clinical studies, NO 2 levels >3 ppm or methemoglobin levels >7% were treated by reducing the dose of, or discontinuing, nitric oxide. Methemoglobinemia that does not resolve after reduction or discontinuation of therapy can be treated with intravenous vitamin C, intravenous methylene blue, or blood transfusion, based upon the clinical situation.