Respiratory stimulant
Doxapram hydrochloride
Brand names: Dopram
Adult dose
Dose: Post-anaesthetic respiratory depression: 1–1.5mg/kg IV; Acute on chronic respiratory failure: 1.5–4mg/min IV infusion (max 4mg/min)
Route: IV
Frequency: Bolus or infusion
Clinical pearls
- BTS / NICE NG115: NIV preferred for type 2 respiratory failure; doxapram is rarely used now
- ICU last-line in selected post-extubation hypoventilation
Contraindications
- Severe hypertension
- Status asthmaticus
- Coronary artery disease
- Severe hyperthyroidism
- Phaeochromocytoma
- Epilepsy
- Mechanical ventilation indicated
- Hypersensitivity
Side effects
- Hypertension
- Tachycardia/arrhythmia
- Hyperventilation
- Restlessness
- Nausea
- Cough
- Convulsions
Interactions
- MAOIs / sympathomimetics (additive HTN)
- Volatile anaesthetics (arrhythmia)
- Theophylline (additive CNS stimulation)
Monitoring
- Continuous ECG
- BP
- SpO₂
- ABG
- Conscious level
Reference: BNF; BTS NIV guideline; NICE NG115; SmPC; https://bnf.nice.org.uk/drugs/doxapram-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- P/F Ratio (Horowitz Index) · Respiratory Assessment
- Murray Score for Acute Lung Injury (ALI/ARDS) · Respiratory Failure
- CURB-65 Score for Pneumonia · Infection
- Lower Respiratory Tract Infection (LRTI) Severity Score · Pneumonia / LRTI
- Silverman-Andersen Retraction Score · Respiratory Distress
- CPAP Initiation Criteria (Neonatal) · Respiratory Support
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Malignant Hyperthermia · AAGBI 2011; MHAUS
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Postoperative Nausea & Vomiting · Society for Ambulatory Anesthesia 2020; AAGBI