Doxapram Intravenous for Adults

Who can administer

Administration RESTRICTED - see Appendix 1

Important information

• Monitoring requirements - see below
• Doxapram infusion is listed as a licensed preparation - however, it is not marketed in Ireland. We are therefore suggesting preparing an infusion using the ampoules if an infusion is required

Available preparations

Doxapram 100mg per 5ml ampoule

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Infusion fluids

If infusion required: prepare using Glucose 5% (but see under Further Information re Sodium chloride 0.9%)

Methods of intravenous administration

Bolus intravenous injection

• Administer required dose over at least 30 seconds
• May be repeated at one hour intervals if needed

Continuous intravenous infusion ^(unlicensed)

• Prepare an infusion containing 2mg/ml as follows:
• Add 5 ampoules of 100mg/5ml (=500mg/25ml) to 225ml infusion fluid; (unlicensed method of preparation)
• Administer as per 'Dose below'
• Administer concurrently with oxygen

Dose in adults

Post-operative use (using intravenous injection)

• Administer 1 to 1.5mg/kg by intravenous bolus administration over at least 30 seconds
• May be repeated at one hour intervals if needed

Post-operative use (using intravenous infusion)

• Recommended dosage is 2 to 3 mg per minute (=60 to 90ml/hour of a 2mg/ml solution)
• Adjust dose according to the response of the patient
• Maximum dose 4mg/minute

Acute respiratory failure (using intravenous infusion)

• Administer 1.5 to 4mg per minute, depending on the condition and response of the patient
• Administer concurrently with oxygen

Liver impairment

• As doxapram is primarily metabolised by the liver, use with care in patients with hepatic dysfunction

Monitoring

• Frequent arterial blood gas measurements are necessary
• Blood pressure, and deep tendon reflexes should be monitored

Further information

• Respiratory stimulant effect of doxapram may not outlast the residual effects of the depressant drugs - patients will need to be closely monitored until fully alert for 30 to 60 minutes
• Do not use with mechanical ventilation
• The infusion may also be prepared in sodium chloride 0.9% if required - but consider sodium load in patients with impaired cardiac function ^{(ref 1)}
• Refer to SPC for other precautions

Storage

• Store below 25^oC
• Do not refrigerate

References

SPC Doxapram injection October 2022

1: Injectable Medicines guide, downloaded from Medusa 24/05/2025

Therapeutic classification

Repiratory stimulant