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RESPIRATORY SYSTEM › OTHER RESPIRATORY SYSTEM PRODUCTS › OTHER RESPIRATORY SYSTEM PRODUCTS › Respiratory stimulants
nikethamide
R07AB02
Forms & Strengths
- Oral solution: 25%
- Injectable solution: 25% (250 mg/mL)
Adult Dosing
- Respiratory stimulant: 250 mg to 500 mg IV or IM as a single dose, repeated as necessary
- Oral: 25% solution, 1 to 2 mL up to 3 times daily
Pediatric Dosing
- Safety and efficacy in pediatric patients not well established; generally avoided due to narrow therapeutic index and risk of toxicity
Indications
- Historically used as a respiratory and central nervous system stimulant
- Obsolete or withdrawn in many countries due to severe toxicity and availability of safer alternatives
Mechanism of Action
- Stimulates the respiratory center in the medulla oblongata, increasing sensitivity to carbon dioxide
- Acts as a central nervous system stimulant primarily via action on the brainstem and carotid/aortic chemoreceptors
Contraindications
- Hypersensitivity to nikethamide
- Severe hypertension
- Epilepsy or history of convulsive disorders
- Severe cardiovascular disease
Adverse Reactions
- Convulsions and muscle twitching
- Tachycardia and hypertension
- Nausea and vomiting
- Sweating and pruritus
- Anxiety and agitation
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs): potential for severe hypertensive crisis
- Central nervous system stimulants: additive risk of neurotoxicity and seizures
- Anesthetics: increased risk of cardiac arrhythmias and CNS excitation
Curated Content: Needs Vetting Before Put to Clinical Use