Indications
Nikethamide is a breathing and circulation stimulant (an analeptic). It has been used to stimulate breathing in cases of breathing depression, such as after overdose of sedative drugs or during recovery from anaesthesia, and to support circulation in collapse. In human medicine it has largely been replaced by safer treatments such as assisted breathing and specific antidotes, and today it is used mainly in veterinary practice for newborn and collapsed animals. It should be used only under the direction of a doctor or veterinarian.
How It Works
Nikethamide stimulates the breathing centre in the brainstem, both directly and through sensors in the large blood vessels (chemoreceptors). This increases the rate and depth of breathing. At higher doses it stimulates the whole nervous system, which is why its safety margin is narrow.
Dosage and Administration
Nikethamide is given by injection by a doctor, nurse or veterinarian, or as drops placed in the mouth of newborn animals, as prescribed. The dose depends on the species, body weight and response, and repeated doses are given only under close observation. It must not be used for self-treatment.
Interactions
- Other stimulant drugs (such as Caffeine, Theophylline or sympathomimetics) may add to the risk of restlessness, fast heartbeat and seizures.
- It does not reverse the effects of opioids or sedatives in a reliable way, so specific antidotes and breathing support remain the main treatment.
Contraindications
- Seizure disorders or a history of convulsions.
- Breathing problems caused by blocked airways or by muscle weakness, where stimulation will not help.
- Severe high blood pressure, fast heart rhythm disorders or overactive thyroid.
- Allergy to nikethamide.
Side Effects
Possible effects include sweating, flushing, nausea, vomiting, itching, coughing or sneezing, restlessness, muscle twitching, fast heartbeat and raised blood pressure.
Urgent medical (or veterinary) help is needed if there are muscle spasms, seizures, irregular heartbeat or worsening breathing after a dose.
Pregnancy and Lactation
Safety in pregnancy and breastfeeding has not been established. It should be used only in an emergency when the treating doctor or veterinarian considers it essential.
Precautions and Warnings
- The gap between an effective dose and a dose causing seizures is small; the patient must be watched closely.
- Breathing support and oxygen should be available.
- Effects are short-lived, so breathing may slow again after the dose wears off.
- For veterinary products: follow the label withdrawal period before meat or milk from treated animals is used for human food.
Overdose
Overdose causes high blood pressure, fast heartbeat, irregular heart rhythm, muscle rigidity, seizures and, after the stimulation, breathing depression. It is a medical emergency and needs hospital or veterinary treatment, which may include seizure control and breathing support.
Therapeutic Class
Respiratory stimulant (analeptic).
Storage
Store below 30°C, away from light, as directed on the pack, out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.