What are the absolute contraindications to prescribing nikethamide?

The reference materials do not provide information on absolute contraindications for nikethamide. Available data concern only restrictions and contraindications for other analeptics, such as bemegride, which is contraindicated in severe hypnotic poisoning due to increased neuronal oxygen demand and exacerbation of hypoxia.

What side effects are characteristic of nikethamide overdose?

The texts do not contain specific information regarding side effects and overdose symptoms of nikethamide (Cordiamine) directly. However, for other stimulant agents, specific toxic manifestations are noted: caffeine overdose causes clonic seizures, while strychnine overdose leads to tetanic seizures.

What are the maximum single and daily doses of Cordiamine for parenteral administration in adults?

The provided instructional materials do not specify numerical values for the maximum single and daily doses of Cordiamine (nikethamide) for parenteral use in adults. Only parenteral use at 3–5 mL of the drug for collapse, asphyxia, shock, and poisoning is mentioned.

What is the primary mechanism of action of nikethamide on the respiratory system?

The drug stimulates respiration through central and peripheral mechanisms, leading to an increase in the rate and depth of respiratory movements.

Does nikethamide have a direct effect on the cardiovascular system?

No, the drug has no direct effect on the cardiovascular system; its vascular effect is related to the stimulation of the vasomotor center and chemoreceptors.

In what emergency cases is nikethamide used parenterally?

It is used by injection in collapse, shock, asphyxia, as well as in poisoning with hypnotics and opioid analgesics.

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Nikethamide

*Nikethamidum*

For medical students2 min readUpdated 2026-10-10

Nikethamide (commonly known as Cordiamine) is an analeptic agent that stimulates the respiratory and cardiovascular systems. The drug activates the respiratory center and increases vascular tone through a combined mechanism.

RespirationIncreases the rate and depth of respiratory movements

MechanismDirect effect on the vasomotor center of the medulla oblongata

AdministrationPrescribed orally and parenterally for collapse and shock

IndicationsAsphyxia, hypotension, and hypnotic poisoning

Mechanism of Pharmacological Action

The pharmacological effects of nikethamide are achieved through two main pathways:

Central component: mediated by a direct stimulating effect on the vasomotor center located in the brain.
Peripheral component: involves the excitation of chemoreceptors located in the carotid sinus area.

As a result of this combined action, the drug significantly increases the respiratory rate and depth. However, it does not exert a direct primary action on the cardiovascular system (CVS) itself.

Indications for Medical Use

The clinical application of nikethamide involves the urgent stimulation of vital body functions during critical conditions.

Main indications:

Various systemic circulatory disorders.
Arterial hypotension.
Collapse and shock states.
Asphyxia of various etiologies.
Acute poisoning with opioid analgesics and hypnotics.

Routes of Administration and Dosage

The choice of administration route for Cordiamine depends on the severity of the patient's condition:

Oral administration: the drug is prescribed orally in drops (30–40 drops per dose), repeated several times a day.
Parenteral administration: in life-threatening conditions (asphyxia, collapse, shock episodes, drug or hypnotic intoxication), the solution is administered by injection at a dosage of 3–5 mL.

Mnemonic

Cordiamine — drops (30–40) for hypotension, cubes (3–5 mL) for shock and collapse.

Frequently asked questions

What are the absolute contraindications to prescribing nikethamide?: The reference materials do not provide information on absolute contraindications for nikethamide. Available data concern only restrictions and contraindications for other analeptics, such as bemegride, which is contraindicated in severe hypnotic poisoning due to increased neuronal oxygen demand and exacerbation of hypoxia.
What side effects are characteristic of nikethamide overdose?: The texts do not contain specific information regarding side effects and overdose symptoms of nikethamide (Cordiamine) directly. However, for other stimulant agents, specific toxic manifestations are noted: caffeine overdose causes clonic seizures, while strychnine overdose leads to tetanic seizures.
What are the maximum single and daily doses of Cordiamine for parenteral administration in adults?: The provided instructional materials do not specify numerical values for the maximum single and daily doses of Cordiamine (nikethamide) for parenteral use in adults. Only parenteral use at 3–5 mL of the drug for collapse, asphyxia, shock, and poisoning is mentioned.
What is the primary mechanism of action of nikethamide on the respiratory system?: The drug stimulates respiration through central and peripheral mechanisms, leading to an increase in the rate and depth of respiratory movements.
Does nikethamide have a direct effect on the cardiovascular system?: No, the drug has no direct effect on the cardiovascular system; its vascular effect is related to the stimulation of the vasomotor center and chemoreceptors.
In what emergency cases is nikethamide used parenterally?: It is used by injection in collapse, shock, asphyxia, as well as in poisoning with hypnotics and opioid analgesics.

Go deeper

Pharmacology of Bemegride and Characteristics of Barbiturate Poisoning
Strychnine: Glycine Blockade Mechanism and Tetanic Seizures
Caffeine: Pharmacological Properties and Effects on Regional Blood Flow
Comparative Analysis of Direct and Reflex Analeptic Agents
Toxicology and Symptoms of Psychostimulant Overdose