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Overdosage with INOmax (nitric oxide) will be manifest by elevations in methemoglobin and NO₂. Elevated NO₂ may cause acute lung injury. Elevations in methemoglobinemia reduce the oxygen delivery capacity of the circulation. In clinical studies, NO₂ levels > 3 ppm or methemoglobin levels > 7% were treated by reducing the dose of, or discontinuing, INOmax (nitric oxide) .

Methemoglobinemia that does not resolve after reduction or discontinuation of therapy can be treated with intravenous vitamin C, intravenous methylene blue, or blood transfusion, based upon the clinical situation.

Post - Marketing Experience

The following adverse events have been reported as part of the post-marketing surveillance. These events have not been reported above. Given the nature of spontaneously reported post-marketing surveillance data, it is impossible to determine the actual incidence of the events or definitively establish their causal relationship to the drug. The listing is alphabetical: dose errors associated with the delivery system; headaches associated with environmental exposure of INOmax (nitric oxide) in hospital staff; hypotension associated with acute withdrawal of the drug; hypoxemia associated with acute withdrawal of the drug; pulmonary edema in patients with CREST syndrome.

INOmax (nitric oxide) should not be used in the treatment of neonates known to be dependent on right-to-left shunting of blood.

Last reviewed on RxList: 7/29/2008
This monograph has been modified to include the generic and brand name in many instances.