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 Category: B Lactation: Excretion in milk unknown; use with cautionPregnancy 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. 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) 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 BRAND FORM. UNIT PRICE PILL IMAGE Dopram intravenous- 20 mg/mL vialDopram intravenous- 20 mg/mL vialdoxapram intravenous- 20 mg/mL vialCopyright © 2010 First DataBank, Inc.Print Patient Educationdoxapram 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. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. QL Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. ST Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription. OR Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. 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