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Respiratory stimulant

Doxapram hydrochloride

Brand names: Dopram

Doxapram is an intravenous respiratory stimulant (analeptic) used in specialist and critical-care settings for acute respiratory failure or post-operative respiratory depression. It has a narrow role and is short-acting.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE & ADMINISTRATION NOTE: CONTAINS BENZYL ALCOHOL (see PRECAUTIONS ) In Postanesthetic Use Table I. Dosage for postanesthetic use-I.V. and infusion. * Dose not to exceed 3 grams/24 hours. BY I.V. INJECTION (See Table I. Dosage for postanesthetic use—I.V.) The recommended dose for I.V. administration is 0.5 – 1 mg/kg for a single injection and at 5-minute intervals. Careful observation of the patient during administration and for some time subsequently are advisable. The maximum total dosage by I.V. injection is 2 mg/kg. BY INFUSION The solution is prepared by adding 250 mg of doxapram (12.5 mL) to 250 mL of dextrose 5% or 10% in water or normal saline solution. The infusion is initiated …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-01-08. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

At low doses it stimulates respiration through peripheral chemoreceptors, and at higher doses acts on the central respiratory centres in the brainstem, increasing respiratory rate and tidal volume.

Prescribing in practice

  • It is contraindicated in severe hypertension, epilepsy and severe asthma, and requires close monitoring in a setting equipped to support ventilation.
  • It can cause agitation, tachycardia and hypertension, and may provoke arrhythmias or convulsions.
  • Its short duration of action means it is a temporising measure and not a substitute for assisted ventilation where that is indicated.

Monitoring

Continuous monitoring of respiratory rate, oxygenation, blood pressure, heart rate and conscious level is required during administration, with arterial blood gas measurement to guide therapy and avoid worsening carbon dioxide retention.

Counselling the patient

  • This medicine is given under close supervision in hospital; staff will monitor you continuously.
  • Tell staff if you feel agitated, develop palpitations or have any unusual sensations.

Evidence & guidelines

A specialist respiratory stimulant with a limited, closely monitored role in acute respiratory failure and post-operative respiratory depression.

Reference: BTS NIV guideline; NICE NG115; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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