Nikethamide is indicated in

• acute respiratory failure,
• respiratory depression following anesthesia,
• and central nervous system (CNS) depression.

Nikethamide, also known as nicotinic acid diethylamide, is a central and respiratory stimulant. It has a direct stimulatory effect on the central nervous system and increases both the frequency and depth of respiration. It does not have any immediate effect on the cardiovascular system. The drug is extensively metabolized in the liver, and both its metabolites and a small amount of unchanged drug are excreted in urine.

2 to 10 mL by slow IV injection of the usual 25% solution every 20 to 30 minutes if necessary. Infants and children are particularly susceptible to toxic effects of nikethamide.

May interact with anesthetic agents, sympathomimetics, monoamine oxidase inhibitors (MAOIs), neuromuscular blocking agents, and bupropion.

Contraindicated in porphyria, epilepsy or other convulsive disorders, cerebral edema, airway obstruction, cerebrovascular accident, severe hypertension, and ischemic heart disease.

May cause dyspnea and respiratory problems such as coughing and bronchospasm. CNS effects include convulsions, headache, and dizziness. Cardiovascular effects include fluctuations in blood pressure and cardiac arrhythmias. Overdose may lead to nausea, vomiting, and diarrhea.

There are not enough adequate and well-controlled studies in pregnant women and nursing mothers.

Should not be used in mild hypertension, impaired cardiac reserve, or hepatic dysfunction.

Respiratory stimulant (Analeptics)

Store below 25°C in a dry place, protected from light.