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INOmax

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Overview

What is INOmax?

INOmax (nitric oxide gas) is a drug administered by inhalation. Nitric oxide, the active substance in INOmax, is a pulmonary vasodilator. INOmax is a gaseous blend of nitric oxide and nitrogen (0.08% and 99.92%, respectively for 800 ppm). INOmax is supplied in aluminum cylinders as a compressed gas under high pressure (2000 pounds per square inch gauge [psig]).

The structural formula of nitric oxide (NO) is shown below:



What does INOmax look like?



What are the available doses of INOmax?

INOmax (nitric oxide) is a gas available in a 800 ppm concentration ().

What should I talk to my health care provider before I take INOmax?

How should I use INOmax?

INOmax is 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.

Use only with an INOmax DS operated by trained personnel ()

Avoid abrupt discontinuation (, ).


What interacts with INOmax?

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What are the warnings of INOmax?

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What are the precautions of INOmax?

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What are the side effects of INOmax?

Sorry No records found


What should I look out for while using INOmax?

INOmax is contraindicated in neonates dependent on right-to-left shunting of blood.


What might happen if I take too much INOmax?

Overdosage with INOmax is manifest by elevations in methemoglobin and pulmonary toxicities associated with inspired NO. Elevated NO may cause acute lung injury. Elevations in methemoglobin reduce the oxygen delivery capacity of the circulation. In clinical studies, NO levels >3 ppm or methemoglobin levels >7% were treated by reducing the dose of, or discontinuing, INOmax.

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.


How should I store and handle INOmax?

Store at 25°C (77°F) with excursions permitted between 15–30°C (59–86°F) [see USP Controlled Room Temperature].All regulations concerning handling of pressure vessels must be followed.Protect the cylinders from shocks, falls, oxidizing and flammable materials, moisture, and sources of heat or ignition.Store at 25°C (77°F) with excursions permitted between 15–30°C (59–86°F) [see USP Controlled Room Temperature].All regulations concerning handling of pressure vessels must be followed.Protect the cylinders from shocks, falls, oxidizing and flammable materials, moisture, and sources of heat or ignition.Store at 25°C (77°F) with excursions permitted between 15–30°C (59–86°F) [see USP Controlled Room Temperature].All regulations concerning handling of pressure vessels must be followed.Protect the cylinders from shocks, falls, oxidizing and flammable materials, moisture, and sources of heat or ignition.INOmax (nitric oxide) is available in the following sizes:


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Clinical Information

Chemical Structure

No Image found
Clinical Pharmacology

Nitric oxide relaxes vascular smooth muscle by binding to the heme moiety of cytosolic guanylate cyclase, activating guanylate cyclase and increasing intracellular levels of cyclic guanosine 3',5'-monophosphate, which then leads to vasodilation. When inhaled, nitric oxide selectively dilates the pulmonary vasculature, and because of efficient scavenging by hemoglobin, has minimal effect on the systemic vasculature.

INOmax appears to increase the partial pressure of arterial oxygen (PaO) by dilating pulmonary vessels in better ventilated areas of the lung, redistributing pulmonary blood flow away from lung regions with low ventilation/perfusion (V/Q) ratios toward regions with normal ratios.

Non-Clinical Toxicology
INOmax is contraindicated in neonates dependent on right-to-left shunting of blood.

Androgens may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may require reduction in order to maintain satisfactory therapeutic hypoprothrombinemia.

Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.

In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.

Wean from INOmax Abrupt discontinuation of INOmax may lead to worsening oxygenation and increasing pulmonary artery pressure, i.e., Rebound Pulmonary Hypertension Syndrome. Signs and symptoms of Rebound Pulmonary Hypertension Syndrome include hypoxemia, systemic hypotension, bradycardia, and decreased cardiac output. If Rebound Pulmonary Hypertension occurs, reinstate INOmax therapy immediately.

The following adverse reactions are discussed elsewhere in the label;

Hypoxemia

Worsening Heart Failure

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Interactions

Interactions

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