Inomax (Nitric Oxide)

Nitric oxide diffuses from the inhaled gas into the smooth muscle of the pulmonary vasculature, where it binds to the heme moiety of soluble guanylate cyclase. This activation raises intracellular cyclic guanosine monophosphate (cGMP) levels, leading to relaxation of smooth‑muscle cells and a reduction in pulmonary arterial pressure while sparing systemic circulation.

The dose of Inomax is individualized by the treating physician based on the patient’s age, weight, severity of pulmonary hypertension, and response to therapy. Clinicians typically titrate the inhaled nitric oxide concentration in parts per million (ppm) and adjust the duration of treatment according to clinical monitoring.

Safety data for inhaled nitric oxide in pregnant or lactating individuals are limited. Because the drug is administered directly to the lungs and systemic exposure is minimal, it is generally considered low risk, but the prescriber should evaluate the benefit‑risk balance and follow local regulatory guidance before use.

To order Inomax, submit an enquiry on the product page at gnhindia.com specifying the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details (including any cold‑chain requirements) and necessary import documentation.

Inomax delivers nitric oxide directly to the pulmonary circulation, offering rapid and reversible vasodilation, whereas systemic agents such as sildenafil act orally and affect both pulmonary and systemic vessels. Compared with inhaled prostacyclin analogues, nitric oxide has a shorter half‑life and allows precise titration, but requires specialized delivery equipment and monitoring.

Inomax cylinders should be stored at ambient temperature, away from direct sunlight and heat sources. Keep the gas in its original, sealed container, protect the regulator from moisture, and ensure cylinders are secured upright to prevent damage. Follow local regulations for medical gas storage and handle with trained personnel.

Inomax is supplied as a medical gas and is administered through an endotracheopulmonary delivery system, typically a ventilator circuit or specialized inhalation device. The gas is mixed with the patient’s inspiratory flow, allowing precise control of nitric oxide concentration in parts per million. Administration requires continuous monitoring of oxygenation, methemoglobin levels, and nitrogen dioxide concentrations.

The most serious risks include the development of methemoglobinemia, which can impair oxygen delivery, and severe hypotension due to excessive pulmonary vasodilation. Elevated nitrogen dioxide levels may cause airway irritation, and rare cases of pulmonary edema have been reported. Continuous clinical monitoring and adherence to recommended concentration limits help mitigate these hazards.

Inomax is contraindicated in patients with known hypersensitivity to nitric oxide or its delivery system components. It should be used with caution, or avoided, in individuals with severe left‑heart dysfunction, methemoglobin‑forming disorders, or those receiving other potent vasodilators such as phosphodiesterase inhibitors. Clinical judgment is required to determine suitability for each patient.