Nitric Oxide
Nitric oxide is an inhaled gas medication used primarily to treat persistent pulmonary hypertension of the newborn (PPHN), a condition where blood flow is restricted through the lungs. It works by dilating pulmonary blood vessels, improving oxygenation and reducing the need for extracorporeal membrane oxygenation (ECMO) in some cases. The medication is administered in hospital settings, typically in neonatal intensive care units, and requires specialized monitoring during therapy.
Inhaled nitric oxide is used to treat severe pulmonary hypertension in newborns by dilating blood vessels in the lungs to improve oxygenation.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- R07AX01
- RxNorm
- 314325
- Generic
- Nitric Oxide
- Class
- atc-r07
- Brands
- Ulspira, Noxivent, INOmax
- Availability
- otc
- Pregnancy
- C
- Lactation
- unknown
- Half-life (h)
- 0.002
- Onset (min)
- 5
- Duration (h)
- 0
- Routes
- inhalation
- Forms
- inhalation gas, compressed medical gas
- Regions
- United States, European Union, Canada, Australia, Japan
- Monitoring
- methemoglobin levels, nitrogen dioxide concentrations, arterial oxygenation, pulmonary artery pressure
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Nitric oxide is primarily indicated for the treatment of persistent pulmonary hypertension of the newborn (PPHN), a life-threatening condition where blood pressure remains elevated in the lungs after birth. It is used in term or near-term infants who require mechanical ventilation and have not responded adequately to other treatments. Occasionally used in adult cardiac surgery or acute respiratory distress syndrome in specialized settings.
Inhaled nitric oxide acts as a selective pulmonary vasodilator by activating guanylate cyclase in vascular smooth muscle cells, increasing cyclic guanosine monophosphate (cGMP) levels. This causes relaxation of smooth muscle in the pulmonary arteries, reducing pulmonary vascular resistance and improving blood flow to the lungs for better oxygen exchange. Because it is inhaled, it primarily affects ventilated areas of the lung with minimal systemic effects.
Nitric oxide must be administered in a monitored hospital environment with trained personnel due to risks of methemoglobinemia and NO2 formation. Abrupt discontinuation should be avoided as rebound pulmonary hypertension may occur; weaning must be gradual. Close monitoring of methemoglobin levels, oxygen saturation, and blood pressure is required throughout treatment. May interact with other vasodilators or agents affecting cGMP pathways.
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 26, 2026. · Read our editorial policy