Nitric oxide
INOmax · ATC code R07AX
Brand names: INOmax, Neophyr, Stickstoffmonoxid Messer, Vasokinox, Inoxgen, Noxap, Respadur A
- Key facts
- Active substance
- Nitric oxide
- ATC code
- R07AX
- Authorisation
- centrally authorised across the EU (EMA)
- Dosage forms
- INOmax 400 ppm mol/mol medicinal gas, compressed · INOmax 800 ppm mol/mol medicinal gas, compressed
- Marketing authorisation holder
- Linde Healthcare AB
- Information as of
- 2026-10-27
Key facts
Nitric oxide (INOmax) is an inhaled medicinal gas that selectively dilates the pulmonary vessels. It is used with ventilatory support for pulmonary hypertension in newborns and in connection with heart surgery.
What it is used for
- Newborn infants of 34 weeks gestation or more with hypoxic respiratory failure and evidence of pulmonary hypertension, to improve oxygenation and reduce the need for ECMO
- Peri- and post-operative pulmonary hypertension with heart surgery in adults and children of all ages (0-17 years)
Dosing
- Newborns (PPHN): maximum dose 20 ppm, not to be exceeded; start at 20 ppm and wean to 5 ppm within 4-24 hours if oxygenation is adequate
- Heart surgery, children: starting dose 10 ppm, up to 20 ppm if insufficient; use the lowest effective dose
- Adult dosing and the weaning scheme are in the full text
- Measure methaemoglobin within one hour of starting; monitor NO, NO2 and FiO2 continuously
- Only in specialised, trained neonatal or cardiothoracic units
Contraindications
- Hypersensitivity to the active substance or excipients
- Neonates dependent on right-to-left or significant left-to-right shunting of blood
Important warnings
- Abrupt discontinuation may cause a rebound reaction with falling oxygenation and blood pressure; wean gradually
- Methaemoglobinaemia, especially in neonates; reduce the dose if levels rise
- May aggravate cardiac insufficiency with left-to-right shunting
- If response is inadequate consider rescue such as ECMO; no efficacy shown in congenital diaphragmatic hernia
Side effects
- Most common: rebound reaction on discontinuation
- Methaemoglobinaemia, thrombocytopenia and hypotension (details in the full text)
Interactions
- No interaction studies; nitric oxide donors (e.g. sodium nitroprusside, nitroglycerin) may add to methaemoglobinaemia risk
- Other vasodilators (e.g. sildenafil): possible additive effects, use with caution
Pregnancy and breastfeeding
- Should not be used during pregnancy or breastfeeding; no adequate data
Summary of the official product information, written with AI (Claude, Anthropic) on 2026-10-28. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.
Common questions – ask Medelix
For patients
Package leaflet, verbatim
Authorisation and brand names by country
Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.
EU – centrally authorised (all member states)
- INOmaxLinde Healthcare AB · EMEA/H/C/000337
Source: European Medicines Agency (EMA), product information
Austria
- NeophyrSol Spa · 1 register entry
- Stickstoffmonoxid MesserMesser Austria Gmbh · 1 register entry
- VasokinoxAir Liquide Sante International · 1 register entry
Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-28
Germany
- InoxgenNippon Sanso Deutschland Gmbh · 2 register entries
- NeophyrSol Spa · 1 register entry
- NoxapAir Products Gmbh · 1 register entry
- Respadur AWestfalen Ag & Co. Kg · 1 register entry
- Stickstoffmonoxid MesserMesser Industriegase Gmbh · 1 register entry
- VasokinoxAir Liquide Sante International · 1 register entry
Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-28
Brand names in 27 more European countries
- Belgium
- Monoxyde D`azote Messer, Neophyr, Noxap, Stikstofmonoxide Messer, Vasokinox
- Bulgaria
- Неофир
- Croatia
- Du¨ikov (Ii) Oksid Messer, Neophyr
- Cyprus
- Neophyr
- Czechia
- Iasophyr, Noxap, Oxid Dusnatý Messer
- Denmark
- Vasokinox
- Estonia
- Lämmastikoksiid Messer
- Finland
- Pulmonox
- France
- Kinox, Monoxyde D`azote Messer, Monoxyde D’azote Sol France, Noxap
- Greece
- Neophyr
- Hungary
- Inhanimon, Nitrogén Monoxid Messer, Noxphyr
- Iceland
- Inomax
- Ireland
- Neophyr
- Italy
- Inalossin, Neophyr, Noxap, Rivonox, Vasokinox
- Latvia
- Slapekla (Ii) Oksids (Nitric Oxide) (No)
- Liechtenstein
- Inomax
- Lithuania
- Azoto Oksidas Messer
- Luxembourg
- Neophyr, Vasokinox
- Netherlands
- Neophyr, Noxap, Vasokinox
- Norway
- Inomax, Inoxgen, Vasokinox
- Poland
- Noxap, Tlenek Azotu
- Portugal
- Inoxgen, Noxap, Vasokinox
- Romania
- Monoxid De Azot Messer, Neophyr
- Slovakia
- Neophyr, Oxid Dusnatý Messer
- Slovenia
- Dusikov Oksid (No), Neophyr
- Spain
- Inoxgen, Neophyr, Noxap, Vasokinox, Óxido Nítrico Messer
- Sweden
- Vasokinox
EMA – Article 57 product data (EU/EEA), 2026-10-28
Medelix receives no money from pharmaceutical companies. Brand names are listed alphabetically and without ranking.
Other substances in the same group
Another question about this substance?
Medelix answers clinical questions from guidelines, studies and product information – every claim with its source.
Sources
- European Medicines Agency. INOmax – EPAR, Product Information. 2026-10-27. https://www.ema.europa.eu/en/documents/product-information/inomax-epar-product-information_en.pdf
- EMA – Article 57 product data (EU/EEA), 2026-10-28. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
- EMA – Article 57 product data (EU/EEA), 2026-10-28. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
Editorial: Medelix editorial team · last updated 2026-10-27 · How these pages are made · Report an error
Source: European Medicines Agency (EMA), product information. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.