Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 20mg/mL
COPD Associated with Acute Hypercapnia
1-2 mg/min IV infusion; not to exceed 3 mg/min or 2 hours; monitor arterial blood gases prior to initiation of infusion and at 30 min interval during the infusion to identify possible development of acidosis/CO2 retention
Respiratory Depression Postanesthesia
0.5-1 mg/kg IV injection; repeat at 5-min intervals in patients that show an initial response; not to exceed 2 mg/kg OR
Initial: 5 mg/min IV infusion (with 1 mg/mL solution) until adequate response or adverse effects occur; may reduce to 1-3 mg/min; total IV infusion not to exceed 4 mg/kg
Drug-Induced CNS Depression
Intermittent injection: 1-2 mg/kg IV injection priming dose, repeat in 1-2 hr priming dose; not to exceed 3 g/day; may repeat in 24 hr if necessary OR
IV infusion: 1-2 mg/kg IV injection, repeat in 5 min, if no response, wait 1-2 hr and repeat priming dose; if some stimulation noted, initiate infusion at 1-3 mg/min IV infusion not to exceed 2 hours; suspend infusion if patient begins to awaken; may repeat after a rest of 30-120 minutes, total dose not to exceed 3 g/day
Dosage Forms & Strengths
injectable solution
- 20mg/mL
<12 years
Safety & efficacy not established
>12 years
COPD Associated with Acute Hypercapnia
- 1-2 mg/min IV infusion; not to exceed 3 mg/min or 2 hours; monitor arterial blood gases prior to initiation of infusion and at 30 min interval during the infusion to identify possible development of acidosis/CO2 retention
Respiratory Depression Postanesthesia
- 0.5-1 mg/kg IV injection; repeat at 5-min intervals in patients that show an initial response; not to exceed 2 mg/kg OR
- IV infusion: 1-2 mg/kg IV injection, repeat in 5 min, if no response, wait 1-2 hr and repeat priming dose; if some stimulation noted, initiate infusion at 1-3 mg/min IV infusion not to exceed 2 hours; suspend infusion if patient begins to awaken; may repeat after a rest of 30-120 minutes, total dose not to exceed 3 g/day
Drug-Induced CNS Depression
- Intermittent injection: 1-2 mg/kg IV injection priming dose, repeat in 1-2 hr priming dose; not to exceed 3 g/day; may repeat in 24 hr if necessary OR
- IV infusion: 1-2 mg/kg IV injection, repeat in 5 min, if no response, wait 1-2 hr and repeat priming dose; if some stimulation noted, initiate infusion at 1-3 mg/min IV infusion not to exceed 2 hours; suspend infusion if patient begins to awaken; may repeat after a rest of 30-120 minutes, total dose not to exceed 3 g/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (35)
- benzphetamine
doxapram increases effects of benzphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- desflurane
doxapram, desflurane. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- dexfenfluramine
doxapram increases effects of dexfenfluramine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- dexmethylphenidate
doxapram increases effects of dexmethylphenidate by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- dextroamphetamine
doxapram increases effects of dextroamphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- diethylpropion
doxapram increases effects of diethylpropion by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- dobutamine
doxapram increases effects of dobutamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- dopamine
doxapram increases effects of dopamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- ephedrine
doxapram increases effects of ephedrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- epinephrine
doxapram increases effects of epinephrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- etomidate
doxapram, etomidate. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- fenfluramine
doxapram increases effects of fenfluramine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- isocarboxazid
doxapram increases effects of isocarboxazid by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- isoproterenol
doxapram increases effects of isoproterenol by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- ketamine
doxapram, ketamine. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- linezolid
doxapram increases effects of linezolid by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- lisdexamfetamine
doxapram increases effects of lisdexamfetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- methamphetamine
doxapram increases effects of methamphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- methylenedioxymethamphetamine
doxapram increases effects of methylenedioxymethamphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- methylphenidate
doxapram increases effects of methylphenidate by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- midodrine
doxapram increases effects of midodrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- norepinephrine
doxapram increases effects of norepinephrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- phendimetrazine
doxapram increases effects of phendimetrazine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- phenelzine
doxapram increases effects of phenelzine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- phentermine
doxapram increases effects of phentermine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- phenylephrine
doxapram increases effects of phenylephrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- phenylephrine PO
doxapram increases effects of phenylephrine PO by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- propofol
doxapram, propofol. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- propylhexedrine
doxapram increases effects of propylhexedrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- pseudoephedrine
doxapram increases effects of pseudoephedrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- serdexmethylphenidate/dexmethylphenidate
doxapram increases effects of serdexmethylphenidate/dexmethylphenidate by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- sevoflurane
doxapram, sevoflurane. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- tranylcypromine
doxapram increases effects of tranylcypromine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- xylometazoline
doxapram increases effects of xylometazoline by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- yohimbine
doxapram increases effects of yohimbine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
Monitor Closely (11)
- atracurium
doxapram decreases effects of atracurium by pharmacodynamic antagonism. Use Caution/Monitor.
- cisatracurium
doxapram decreases effects of cisatracurium by pharmacodynamic antagonism. Use Caution/Monitor.
- onabotulinumtoxinA
doxapram decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Use Caution/Monitor.
- pancuronium
doxapram decreases effects of pancuronium by pharmacodynamic antagonism. Use Caution/Monitor.
- procarbazine
doxapram increases effects of procarbazine by pharmacodynamic synergism. Use Caution/Monitor. Additive pressor effect.
- rapacuronium
doxapram decreases effects of rapacuronium by pharmacodynamic antagonism. Use Caution/Monitor.
- rocuronium
doxapram decreases effects of rocuronium by pharmacodynamic antagonism. Use Caution/Monitor.
- solriamfetol
doxapram and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- succinylcholine
doxapram decreases effects of succinylcholine by pharmacodynamic antagonism. Use Caution/Monitor.
- theophylline
doxapram, theophylline. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Increased skeletal muscle activity, agitation, hyperactivity.
- vecuronium
doxapram decreases effects of vecuronium by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (0)
Adverse Effects
Frequency Not Defined
Pyrexia
Flushing
Sweating
Pruritus & paresthesia, burning/hot sensation especially in genitalia & perineum
Disorientation
Pupillary dilatation
Hallucinations
Involuntary movements
Muscle spasticity, muscle fasciculations, increased deep tendon reflexes, clonus, bilateral Babinski, convulsions
Dyspnea
Cough
Hyperventilation/ rebound hypoventilation
Tachypnea
Laryngospasm
Bronchospasm
Hiccough
Phlebitis
Variations in heart rate
Lowered T-waves, arrhythmias
Chest pain, tightness in chest
Increase in blood pressure
Stimulation of urinary bladder with spontaneous voiding, urinary retention
Elevation of BUN, albuminuria
Hemolysis (with rapid infusion)
Decrease in Hgb, Hct, or RBC count
Decrease in WBC (pts with leukopenia)
Warnings
Contraindications
Hypersensitivity
Epilepsy, convulsive disorder
Existing/suspected pulmonary embolism
Mechanical obstruction, muscle paresis, flail chest, pneumothorax, acute bronchial asthma, pulmonary fibrosis
Head injury, CVA, cerebral edema
Disorders of ventilation including mechanical obstruction, neuromuscular blockade, muscle paresis
Cerebral vascular accident, head injury
Significant cardiovascular impairment, uncompensated heart failure, severe coronary artery disease, severe HTN including hypertension associated with hyperthyroidism or pheochromocytoma)
Cautions
Narrow margin of safety
Do not use concurrently with mechanical ventilation
Contains benzyl alcohol (associated with potentially fatal "Gasping Syndrome" in neonates)
Avoid using same injection site over long period of time & avoid rapid infusion
Concurrency with sympathomimetic or MAOIs
Hepatic/renal impairment
May cause severe CNS stimulation resulting in seizures; anticonvulsants should be available
May cause dysrhythmias; monitor
If sudden hypotension develops discontinue therapy
Use caution in patients with cerebrovascular disease
Use caution in hepatic and renal impairment
Use caution when used concurrently with MAO inhibitors, volatile anesthetics, or sympathomimetics
Avoid extravasation
Pregnancy & Lactation
Pregnancy Category: B
Lactation: Excretion in milk unknown; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Produces respiratory stimulation in medulla (which propagates stimulation to other parts of brain & spinal cord) through peripheral carotid chemoreceptors
Pharmacokinetics
Onset: 20-40 sec
Duration: 5-12 min (single IV injection)
Peak Plasma Time: 1-2 min
Half-life: 3.4 hr (2.4-4.1 hr)
Administration
IV Incompatibilities
Additive: aminophylline, thiopental, sodium bicarbonate, furosemide, minocycline, ticarcillin
Syringe: aminophylline, ascorbic acid, cefoperazone, cefotaxime, cefotetan, cefuroxime, dexamethasone sodium phosphate, diazepam, folic acid, furosemide, hydrocortisone sodium succinate, methylprednisolone sodium succinate, minocycline, thiopental, ticarcillin
Y-site: clindamycin
IV Preparation
Add 250 mg doxapram to 250 mL D5W, D10W or NS to obtain a 1 mg/mL soln
For COPD: add 400 mg doxapram to 180 mL D5W, D10W or NS to a final concentration of 2 mg/mL
IV Administration
COPD
- Initial infusion at 1-2 mg/min; may incr to NMT 3 mg/min
- No more than 2 hr
- ABG should be determined before administering doxapram & q30min during 2 hr of infusion
- Discontinue if ABG show evidence of deterioration
Anesthesia
- If infusing, use 1 mg/mL at an initial rate of 5 mg/min
- When the desired response is obtained or if adverse effects appear, may be reduce to 1-3 mg/min
- Do not increase infusion rate in debilitated patients in an attempt to lower pCO2 because of associated increased work in breathing
CNS Depression
- If infusing, infuse at 1-3 mg/min until patient begins to awaken, but NMT 2 hr
- May repeat after a 30 min-2 hr rest period, provided max daily dose of 3 g has not been exceeded
Storage
Store at 20-25°C
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| doxapram intravenous - | 20 mg/mL vial |  | |
| Dopram intravenous - | 20 mg/mL vial |  | |
| Dopram intravenous - | 20 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
doxapram intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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