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Pharmacology · Special Pharmacology

Nikethamide

*Nikethamidum*

Nikethamide (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.

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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
2 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Mechanism of pharmacological action

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

  • Central component: caused by a direct activating effect on the vasomotor center located in the brain.
  • Peripheral component: consists in the excitation of chemoreceptors located in the carotid sinus area.

As a result of this combined action, the drug significantly increases the rate and depth of respiration. At the same time, the substance has no direct agent effect on the cardiovascular system (CVS) itself.

Indications for medical use

The clinical use of nikethamide is associated with the need for emergency stimulation of vital body functions in critical conditions.

Main indications:

  1. Various systemic circulation disorders.
  2. Arterial hypotension.
  3. States of collapse and shock.
  4. Asphyxia of various etiologies.
  5. Acute poisoning with narcotic analgesics, as well as hypnotics.
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Routes of administration and dosages

The choice of administration route for cordiamine is determined by the severity of the patient's condition:

  • Oral administration: the drug is prescribed orally as 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.

Briefly: answers to topical questions

What are the absolute contraindications to prescribing nikethamide?

The provided study guides contain no information on absolute contraindications for prescribing 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 worsening hypoxia.

What side effects are characteristic of nikethamide overdose?

The study guide texts contain no specific information on side effects and symptoms of overdose directly from nikethamide (cordiamine). At the same time, other stimulating agents are noted to have specific toxic manifestations: 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 study guide materials do not specify numerical values for the maximum single and daily doses of cordiamine (nikethamide) for parenteral administration in adults. Only parenteral use in collapse, asphyxia, shock, and poisoning is mentioned — 3–5 ml of the drug.

How to memorize

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

Class and exam questions

What is the main 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 associated with the stimulation of the vasomotor center and chemoreceptors.

In what emergency cases is nikethamide used parenterally?

The drug is used by injection in collapse, shock, asphyxia, as well as in poisoning with hypnotic agents and narcotic analgesics.

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What else to study on this topic

  • Pharmacology of Bemegride and features of barbiturate poisoning
  • Strychnine: mechanism of glycine blockade and tetanic seizures
  • Caffeine: pharmacological properties and effects on blood vessels of various organs
  • Comparative analysis of direct and reflex analeptic agents
  • Toxicology and symptoms of psychostimulant overdose

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Other topics in the "Special Pharmacology" section

AnalepticsAnaleptic mixturePhysiological regulation of respirationRespiratory stimulants
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