Indications for INOMAX:
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.
20ppm for up to 14 days or until underlying oxygen desaturation resolved. >20ppm: not recommended.
Neonates dependent on right-to-left shunting of blood.
Avoid abrupt discontinuation. Rebound pulmonary hypertension syndrome; if occurs, restart treatment immediately. Measure methemoglobin within 4–8hrs after initiation and periodically during therapy. Monitor for hypoxemia. Airway injury due to nitrogen dioxide (NO2). Monitor for PaO2 and inspired NO2 during administration. Pre-existing left ventricular dysfunction; worsening heart failure may occur (eg, pulmonary edema, increased pulmonary capillary wedge pressure, systemic hypotension, others); discontinue and treat if develops.
Increased risk of methemoglobinemia with concomitant nitric oxide donor agents (eg, prilocaine, sodium nitroprusside, nitroglycerine).
Hypotension; hypoxemia, worsening heart failure.
Generic Drug Availability:
Cylinders (Size D)—353L; (Size 88)—1963L