doxapram, dopram in the NICU

[janda381]

Hello, would be interested to hear if your NICU administers dopram in the treatment of apnea in very premature infants? From what I can gather this medication is contraindicated in neonates because of the presence of benzyl alcohol AND that it is no longer used in standard NICU practice because it has not been shown to be effective and moreover having quite nasty adverse effects.

Thanks for your input. Janda

[NicuGal, MSN, RN]

We only use caffeine citrate or base. I haven't seen those meds used in over 25 years in the hospital I work at.

[janda381]

Hi there. Thanks for your answer. I should say that I am still a student. My cousin ask me about this med. She is living outside of the country and has had some difficulties getting information about treatment. Her baby, a girl, was born at 25 weeks, was ventilated at birth for about 2 days, and then on CPAP. About one week later the doctors gave her doxapram after giving her caffeine. My cousin asked the doctors about this med, didn’t really get an answer, and then checked the internet. She read that it is contraindicated in neonates because of the presence of benzyl alcohol. Her husband called the doctor to get more information and again got the brush off, so he told the doctor that they did not want them to administer doxapram again. The doctor said he would give it to her regardless because she would die if she didn’t get it. Two hours later she was back on the ventilator. A week later the doctors gave my cousin a consent form for a study they are conducting on this med – after the fact. They are investigating the possible adverse neurological outcomes. My cousin is now beside herself because they did not inform them of this study in advance and they ignored their requests for more information and to stop treatment with this med.

I couldn’t really find much information on this med for neonates (actually just discovered this fantastic website when searching the internet for more info :-). Asked a doctor who worked in the the NICU several years ago, but he couldn’t give any information. Seems that very few or no studies have been conducted in the past 5 years, presumably because this med was never or is no longer used for neonates!

Thanks again, Janda

[SteveNNP, MSN, NP]

It's an old drug that is used really only as a last resort in treating apnea. Here where I work we use cycled cpap and/or caffeine.