Inomax (Nitric Oxide)

Nitric oxide activates soluble guanylate cyclase in vascular smooth muscle cells, increasing cyclic GMP levels. Elevated cGMP leads to relaxation of pulmonary vascular smooth muscle, causing selective vasodilation of the pulmonary circulation without systemic effects, thereby lowering pulmonary artery pressure and enhancing gas exchange.

The dosing regimen for Inomax is determined by the treating physician based on the patient’s age, weight, severity of pulmonary hypertension, and response to therapy. Clinicians titrate the inhaled nitric oxide concentration, typically starting at low ppm levels and adjusting as needed while monitoring clinical parameters.

The safety of inhaled nitric oxide in pregnant or breastfeeding individuals has not been conclusively established, and the product is classified with an unknown pregnancy category. Use during pregnancy or lactation should only occur when the potential benefits outweigh any potential risks, and under close medical supervision.

To request Inomax, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India supplies hospitals, pharmacies, and procurement teams worldwide, and will verify trade or institutional credentials before providing pricing, availability, shipping details (including any cold‑chain requirements), and necessary import documentation.

Inomax delivers nitric oxide directly to the lungs, providing rapid and selective pulmonary vasodilation, whereas agents such as sildenafil act systemically and may have broader vascular effects. Compared with inhaled prostacyclin analogues, nitric oxide has a shorter half‑life, allowing more precise titration but requires specialized delivery equipment and monitoring.

Inomax is supplied as a medical gas cylinder and should be stored at ambient temperature, away from direct sunlight and heat sources. Keep the cylinder in its original packaging, secure it upright, and ensure the regulator is compatible. Do not expose the gas to temperatures above 30 °C or allow the cylinder to be dropped.

Inomax is administered via an endotracheopulmonary inhalation system, typically connected to a mechanical ventilator or a specialized delivery circuit. The gas is blended with the patient’s inspiratory flow at a prescribed concentration, and continuous monitoring of oxygenation, methemoglobin levels, and nitrogen dioxide is performed throughout therapy.

The most serious risks include severe methemoglobinemia, which can impair oxygen delivery, and rebound pulmonary hypertension that may occur after abrupt discontinuation. Additionally, high concentrations of nitrogen dioxide formed from nitric oxide can cause lung injury, and profound systemic hypotension may develop if dosing is not carefully titrated.

Inomax should be avoided in patients with known hypersensitivity to nitric oxide or its delivery system components, and in individuals with severe left‑heart dysfunction where pulmonary vasodilation could worsen pulmonary edema. Caution is also advised for patients with methemoglobin‑forming enzyme deficiencies or those receiving concurrent therapies that may cause additive hypotension.