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Inhaled Nitric Oxide (iNO) use
Inhaled nitric oxide is a vasodilator gas that selectively relaxes pulmonary vascular smooth muscle to reduce pulmonary hypertension and improve oxygenation.
Inhaled nitric oxide is a vasodilator gas that selectively relaxes pulmonary vascular smooth muscle to reduce pulmonary hypertension and improve oxygenation. Used for Persistent pulmonary hypertension of the newborn (PPHN), Acute respiratory distress syndrome (ARDS) with pulmonary hypertension, Pulmonary hypertension associated with left heart disease.
At a glance
| Generic name | Inhaled Nitric Oxide (iNO) use |
|---|---|
| Sponsor | The University of Texas Health Science Center, Houston |
| Drug class | Inhaled vasodilator |
| Target | Soluble guanylate cyclase |
| Modality | Small molecule |
| Therapeutic area | Pulmonary/Cardiovascular |
| Phase | FDA-approved |
Mechanism of action
Nitric oxide (NO) is an endogenous signaling molecule that activates guanylate cyclase in vascular smooth muscle cells, increasing cyclic GMP levels and causing vasodilation. When inhaled, NO preferentially dilates pulmonary vessels while being rapidly inactivated by hemoglobin in the systemic circulation, allowing selective pulmonary vasodilation without systemic hypotension. This reduces right ventricular afterload and improves ventilation-perfusion matching in the lungs.
Approved indications
- Persistent pulmonary hypertension of the newborn (PPHN)
- Acute respiratory distress syndrome (ARDS) with pulmonary hypertension
- Pulmonary hypertension associated with left heart disease
- Pulmonary hypertension associated with lung disease and hypoxemia
Common side effects
- Methemoglobinemia
- Rebound pulmonary hypertension upon withdrawal
- Hypotension
- Headache
- Tachycardia
Key clinical trials
- Effect of iNO in Patients With Submassive and Massive PE (PHASE2)
- De-implementing Inhaled Nitric Oxide for Congenital Diaphragmatic Hernia (PHASE4)
- Efficacy of Inhaled Nitric Oxide in Congenital Diaphragmatic Hernia (PHASE4)
- Nitric Oxide for Reduced Intensive Support in Cardiac Surgery With Cardiopulmonary Bypass (PHASE3)
- A Clinical Study of Inhaled Nitric Oxide in Moderate-to-Severe Chronic Obstructive Pulmonary Disease (NA)
- Inhaled Nitric Oxide for Cardiac Arrest in Pediatrics and Adults (iNOCAPA) (PHASE2)
- The Effects of Inhaled Nitric Oxide After Fontan Operation (PHASE2, PHASE3)
- Study of PAH Subjects With LTOT Use That Have Demonstrated Improved Exercise Tolerance With the Use of Inhaled Nitric (PHASE3)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
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