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Is Oxygen a Medication?

Oxygen is something we breathe in each and every day, but is oxygen a medication, too? It might be hard to adjust to the idea, but medical oxygen is indeed a medication. However, medical-grade oxygen can also be used incorrectly like any medicine, which can trigger negative side effects. As such, it is important to respect medical-grade oxygen as a controlled substance and to use it carefully and under the guidance of a doctor at all times.

Why is Oxygen a Medication?

Various forms of oxygen seem to be available in all kinds of places these days. You can easily buy oxygen canisters over the internet, or pop into an oxygen bar on the street. So, if oxygen is so easy to come by, why is medical grade oxygen considered a medication?

The Food and Drug Administration (FDA) carefully regulates all prescription drugs and medical devices, including compressed medical gasses and medical oxygen concentrators.[1][2] Medical oxygen is considered a drug and is different from what you would find in a scuba tank or at an oxygen bar. The distribution, dosing and use of medical-grade oxygen must be carefully monitored to ensure that it works as intended. When medical oxygen is used incorrectly, or at higher doses than intended, there can be adverse health effects.[3]

Patients using medical oxygen are typically medically dependent upon that oxygen to maintain healthy oxygen levels. These patients require precise dosing to ensure that they get the oxygen they need without getting too much. Because of this, a doctor must be closely involved both in determining whether a person requires oxygen therapy and ascertaining how much medical oxygen they will need. The doctor will also need to closely monitor the patient after they begin using medical-grade oxygen to ensure that the dosing is correct.

Use Carefully: Medical Oxygen is a Prescription Drug

Medical grade oxygen is very different from the oxygen you might buy in cans or use at a spa. While the oxygen provided at an oxygen bar may claim to be 95% oxygen, it is not regulated, so it’s hard to be sure exactly what you will get. The methods of administering oxygen in these forms are also unregulated.

Medical-grade oxygen, on the other hand, is administered in increasing percentages, and the dosing depends on the liters per minute administered to the patient. Because the liters per minute need to be precise to ensure that the patient receives the correct amount of oxygen, medical oxygen is highly regulated by the FDA. It should also be prescribed and monitored by a health care professional to ensure that the dosing is right for that patient and their medical needs.

Also keep in mind that even if a patient is receiving medical-grade oxygen with 99% purity, they may not actually inhale that same purity. This is because with nasal cannulas and some oxygen masks, some room air will mix in during the inhalation.[4] Medical professionals know this and understand how changes in liters per minute impact the amount of oxygen the patient receives. The patient’s lung function will also play a part in the amount of oxygen they require.

As such, using medical-grade oxygen is much more complex than it may appear. The margin of safety between effective doses and potentially toxic doses of oxygen is actually quite small.3 This is why it is essential that a knowledgeable professional prescribes, doses and monitors the use of medical oxygen. Whether a patient uses a compressed oxygen tank, liquid oxygen tank or medical oxygen concentrator, the fact remains that medical-grade oxygen is a prescription drug.

How Too Much Medical Oxygen Could Affect You

Because we breathe in oxygen every day, people often think that if they are struggling to breathe, more oxygen is better. However, as with all prescription medications, increased intake is not always better. It is possible to take too much of a good medicine, in which case it can evolve into a hazard to your health.

As surprising as it may be, this is still the case with medical oxygen. When more oxygen is administered to a patient than they need, it can cause hyperoxia, or too much oxygen in the body. This can cause oxygen toxicity, which can cause seizures and negatively impact your respiratory system and central nervous system.

Some studies indicate that the use of too much high-flow oxygen in COPD patients, asthma patients, stroke patients and cardiac arrest patients can have negative to downright dangerous effects. The studies found that when high-flow oxygen was given to these patients, it tended to cause increased mortality rates, longer hospital stays, higher admission rates to the ICU and slower recovery rates.[5]

While this should not dissuade you from using medical-grade oxygen if your doctor prescribes it, it should make the consequences of misusing medical oxygen quite clear. The FDA even recently issued a consumer update about using a medical oxygen concentrator incorrectly or without a prescription.[6] They warn that breathing too much oxygen can damage your lungs, and could lead to oxygen toxicity.6 As with all medications, oxygen should only be used as directed.

Ask the Right Questions About Medical Grade Oxygen

If you are prescribed oxygen therapy, it is important to ask the right questions about your oxygen prescription. You should know why you are receiving medical oxygen, as well as what the intended therapeutic benefit should be.

Make sure you know your liters per minute flow rate, as well as any variations in flow rate that you might need throughout the day. Ensure that you are clear on the frequency and duration of your medical oxygen therapy treatments so you don’t use more than prescribed. Also make sure that you know exactly how to use your oxygen delivery system, whether you are using an oxygen tank or a medical oxygen concentrator. Most importantly, never adjust your flow rate or frequency or duration of use without your doctor’s guidance.

Medical-grade oxygen is a medication, and it should not be used without a doctor’s prescription and oversight. However, when used as directed, medical-grade oxygen can provide significant benefits. With medical guidance from your doctor, and careful monitoring of your oxygen levels and overall health, you can safely enjoy improved oxygen saturation and better breathing with medical oxygen. If you are prescribed oxygen therapy, feel confident in following your doctor’s directions and safely using medical-grade oxygen as prescribed.

Sources cited:

[1] “Food and Drug Administration Compliance Program Guidance Manual: Compressed Medical Gasses.” Fda.gov, U.S. Department of Health and Human Services, 15 Mar. 2015, www.fda.gov/media/75194/download.

[2] “Product Classification.” fda.gov, U.S. Department of Health and Human Services, 17 May 2021, www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=91.

[3] Bitterman, Haim. “Bench-to-Bedside Review: Oxygen as a Drug.” Critical Care (London, England), BioMed Central, 24 Feb. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2688103/#:~:text=Oxygen%20is%20one%20of%20the%20most%20widely%20used%20therapeutic%20agents,adverse%20effects%20at%20high%20doses.

[4] Goodman, John. “Oxygen Purity versus Oxygen Concentration.” Pulmonary Paper, Main Clinic Supply, 7 Nov. 2019, www.pulmonarypaper.org/oxygen-purity-versus-oxygen-concentration-march-2014/.

[5] “Oxygen Is a Drug – Act Accordingly: Emergency Physicians Monthly.” Emergency Physicians Monthly, EPMonthly, 8 July 2014, epmonthly.com/article/oxygen-is-a-drug-act-accordingly/.

[6] Commissioner, Office of the. “Pulse Oximeters and Oxygen Concentrators: What to Know.” U.S. Food and Drug Administration, FDA, 19 Feb. 2021, www.fda.gov/consumers/consumer-updates/pulse-oximeters-and-oxygen-concentrators-what-know-about-home-oxygen-therapy.


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