Exosurf Neonatal
Classifications: lung surfactant
Prototype: Beractant
Pregnancy Category: Not applicable


108 mg powder for injection


Synthetic lung surfactant. Endogenous pulmonary surfactant lowers surface tension on alveolar surfaces during respiration and stabilizes the alveoli against collapse at resting pressures.

Therapeutic Effects

Deficiency of surfactant causes respiratory distress syndrome (RDS) in premature infants. Colfosceril lowers minimum surface tension on alveolar surfaces and restores pulmonary compliance and oxygenation in premature infants.


Prophylactic treatment of infants with birth weights <1350 g who are at risk of developing RDS. Prophylactic therapy of infants with birth weights >1350 g who show evidence of pulmonary immaturity.

Unlabeled Uses

Rescue treatment of infants with established RDS; RDS in adults.


Infants who have major congenital abnormalities or who are suspected of having congenital infections.

Route & Dosage

Infant: Intratracheal 3 doses of 5 mL/kg are recommended, with the first dose being given as soon as possible after birth and repeat doses 12 and 24 h later to infants who remain on mechanical ventilation

Rescue Therapy
Infant: Intratracheal 2 doses of 5 mL/kg are recommended, the first dose being initiated as soon as the diagnosis of RDS is confirmed and the second 12 h later in infants remaining on mechanical ventilation



INCOMPATIBILITIES Solution/additive: Do not mix any antibiotics with surfactant; this may inactivate surfactant.

Adverse Effects (1%)

CV: Bradycardia, tachycardia. Respiratory: Decreased oxygen saturation, mucous plugging, apnea, pulmonary hemorrhage.


Drug: No clinically significant interactions established.


Absorption: Absorbed from the alveolus into lung tissue, Duration: at least 7 d. Distribution: Distributes uniformly to all lobes of the lung, distal airways, and alveolar spaces; Metabolism: recycled and metabolized exclusively in the lungs. Half-Life: 20–36 h.

Nursing Implications

Assessment & Drug Effects

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug