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4-dimethylaminophenol
V03AB27
Forms & Strengths
- Intravenous solution: 250 mg/10 mL ampoules
Adult Dosing
- Cyanide poisoning: 3 to 4 mg/kg IV once, administered slowly over 1 minute
- May repeat once if clinical symptoms persist and methemoglobin levels remain below safe threshold
Pediatric Dosing
- Cyanide poisoning: 3 to 4 mg/kg IV once, administered slowly over 1 minute
- Safety and efficacy in neonates and infants not well established
Indications
- Emergency treatment of acute cyanide poisoning
Mechanism of Action
- Induces rapid formation of methemoglobin by oxidizing hemoglobin
- Cyanide ions exhibit high affinity for methemoglobin, forming cyanomethemoglobin and freeing cytochrome c oxidase
Contraindications
- Known hypersensitivity to 4-dimethylaminophenol or its excipients
- Pre-existing severe methemoglobinemia
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency due to high hemolysis risk
Adverse Reactions
- Severe methemoglobinemia leading to cyanosis and potential tissue hypoxia
- Hypotension and transient hemodynamic instability
- Injection site pain and local phlebitis
- Hemolysis in susceptible individuals
Drug Interactions
- Additive methemoglobin-inducing agents (e.g., sodium nitrite, nitrates) increase risk of dangerous methemoglobinemia
- Other cytochrome c oxidase inhibitors may exacerbate cellular hypoxia
Curated Content: Needs Vetting Before Put to Clinical Use