What is INOmax (Nitric Oxide) used for?
INOmax is indicated to improve oxygenation in term and near-term (> 34 weeks gestation) neonates, who have hypoxic respiratory failure associated with clinical or echocardiographic evidence of pulmonary hypertension in conjunction with ventilatory support and other appropriate agents.
How should I take INOmax (Nitric Oxide)?
Nitric oxide is inhaled into the baby’s lungs through the mouth or nose. Your baby will receive this medication in a neonatal intensive care unit (NICU) or similar hospital setting.
Your baby may also be using a breathing tube connected to a ventilator (a machine that moves air in and out of the lungs to help your baby breathe easier and get enough oxygen).
Nitric oxide is usually given for up to 14 days. You baby may need to be weaned off this medication slowly, using less and less before treatment is stopped completely.
Your baby’s breathing, blood pressure, oxygen levels, and other vital signs will be watched closely during treatment with nitric oxide.
How do I store INOmax (Nitric Oxide)?
- Store at 25°C with excursions permitted between 15–30°C.
- 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.
Precautions & warnings
What should I know before using INOmax (Nitric Oxide)?
To best participate in the care of your baby while he or she is in the NICU, carefully follow all instructions provided by your baby’s caregivers.
INOmax is contraindicated in neonates dependent on right-to-left shunting of blood.
Is it safe during pregnancy or breastfeeding?
Animal reproduction studies have not been conducted with INOmax. It is not known if INOmax can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. INOmax is not indicated for use in adults.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
What side effects can occur from INOmax (Nitric Oxide)?
Check with your doctor or nurse immediately if any of the following side effects occur:
More common side effects are:
- Blurred vision;
- Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position;
- Unusual tiredness or weakness.
Incidence not known
- Chest discomfort;
- Difficult or labored breathing;
- Tightness in the chest;
- Trouble breathing.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Incidence not known;
- Dry throat;
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
What drugs may interact with INOmax (Nitric Oxide)?
Using nitric oxide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using nitric oxide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Does food or alcohol interact with INOmax (Nitric Oxide)?
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
What health conditions may interact with INOmax (Nitric Oxide)?
The presence of other health conditions may affect the use of nitric oxide. Make sure you tell your doctor if you have any other medical problems, especially:
- Heart failure;
- Lung or breathing problems: use with caution because it may increase risk for more serious side effects.
- Heart problem (e.g., babies dependent on right-to-left shunt) should not be given to patients with this condition.
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using INOmax (Nitric Oxide).
What is the dose of INOmax (Nitric Oxide) for an adult?
Nitric oxide is not indicated for use in the adult.
What is the dose of INOmax (Nitric Oxide) for a child?
Term and near-term neonates with hypoxic respiratory failure
The recommended dose of INOmax is 20 ppm. Maintain treatment up to 14 days or until the underlying oxygen desaturation has resolved and the neonate is ready to be weaned from INOmax (Nitric Oxide) therapy.
Doses greater than 20 ppm are not recommended.
How is INOmax (Nitric Oxide) available?
INOmax is available in the following dosage forms and strengths:
- INOmax gas is available in a 800 ppm concentration.
What should I do in case of an emergency or overdose?
Since nitric oxide is given in a controlled medical setting by a healthcare professional, an overdose is not likely to occur. However, an overdose of nitric oxide is not expected to produce life-threatening symptoms.
Overdose with INOmax is manifest by elevations in methemoglobin and pulmonary toxicities associated with inspired NO2. Elevated NO2 may cause acute lung injury. Elevations in methemoglobin reduce the oxygen delivery capacity of the circulation. In clinical studies, NO2 levels >3 ppm or methemoglobin levels >7% were treated by reducing the dose of, or discontinuing, INOmax (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.
What should I do if I miss a dose?
Since nitric oxide is given as needed by a healthcare professional, it is not likely that your baby will miss a dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Nitric oxide (inhalation gas). http://www.emedicinehealth.com/drug-nitric_oxide_inhalation_gas/page2_em.htm. Accessed October 18, 2016.
INOmax (Nitric Oxide). https://www.drugs.com/pro/inomax.html. Accessed October 18, 2016.
Nitric oxide (inhalation gas). https://www.drugs.com/mtm/nitric-oxide-inhalation-gas.html. Accessed October 18, 2016.
INOmax (Nitric Oxide). http://www.rxlist.com/inomax-drug/indications-dosage.htm. Accessed October 18, 2016.
Nitric oxide (Inhalation route). https://www.drugs.com/cons/nitric-oxide-inhalation.html. Accessed October 18, 2016.
Review Date: December 7, 2016 | Last Modified: September 12, 2019