Dopamine 40mg/ml Inj, 5ml
It is used to treat heart failure (weak heart).It is used to treat low blood pressure. It may be given to you for other reasons. Talk with the doctor.
Drug Class
Vasopressor; Inotropic agent
Pharmacologic Class
Adrenergic agonist; Dopaminergic agonist
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dopamine is a medication given by intravenous (IV) infusion to help improve blood pressure, heart function, and blood flow to vital organs like the kidneys, especially in emergency situations like shock. It works by stimulating different receptors in your body depending on the dose, helping your heart pump stronger and/or narrowing blood vessels to raise blood pressure.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all the information provided. Administration of this drug involves an infusion into a vein over a specified period of time.
For proper storage and disposal, consult with your doctor, nurse, or pharmacist to determine the best approach, as you may need to store this medication at home.
If you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
For proper storage and disposal, consult with your doctor, nurse, or pharmacist to determine the best approach, as you may need to store this medication at home.
If you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
Lifestyle & Tips
- This medication is administered in a hospital setting under close medical supervision.
- Patients should report any discomfort, pain at the IV site, or new symptoms immediately to their healthcare team.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Initial: 2-5 mcg/kg/min IV infusion, titrated to desired hemodynamic response. Max: 20-50 mcg/kg/min.
Dose Range:
2 - 50 mg
Condition-Specific Dosing:
renalDose:
1-5 mcg/kg/min (dopaminergic effects, increased renal perfusion)
cardiacDose:
5-10 mcg/kg/min (beta-1 adrenergic effects, increased cardiac contractility)
vasopressorDose:
10-20 mcg/kg/min (alpha-1 adrenergic effects, vasoconstriction)
Pediatric Dosing
Neonatal:
Initial: 1-5 mcg/kg/min IV infusion, titrated to desired hemodynamic response. Max: 20 mcg/kg/min (higher doses up to 50 mcg/kg/min reported in severe cases).
Infant:
Initial: 1-5 mcg/kg/min IV infusion, titrated to desired hemodynamic response. Max: 20 mcg/kg/min (higher doses up to 50 mcg/kg/min reported in severe cases).
Child:
Initial: 1-5 mcg/kg/min IV infusion, titrated to desired hemodynamic response. Max: 20 mcg/kg/min (higher doses up to 50 mcg/kg/min reported in severe cases).
Adolescent:
Initial: 2-5 mcg/kg/min IV infusion, titrated to desired hemodynamic response. Max: 20-50 mcg/kg/min.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended; monitor response.
Moderate:
No specific adjustment recommended; monitor response.
Severe:
No specific adjustment recommended; monitor response.
Dialysis:
Not significantly removed by dialysis; no specific adjustment needed, but monitor hemodynamic response closely.
Hepatic Impairment:
Mild:
No specific adjustment recommended; monitor response.
Moderate:
No specific adjustment recommended; monitor response.
Severe:
No specific adjustment recommended; monitor response.
Pharmacology
Mechanism of Action
Dopamine is a naturally occurring catecholamine that acts on dopaminergic, beta-1 adrenergic, and alpha-1 adrenergic receptors in a dose-dependent manner. At low doses (0.5-3 mcg/kg/min), it primarily stimulates D1 and D2 dopaminergic receptors, causing vasodilation in renal, mesenteric, coronary, and cerebral vascular beds, leading to increased renal blood flow and urine output. At moderate doses (3-10 mcg/kg/min), it primarily stimulates beta-1 adrenergic receptors, increasing myocardial contractility, heart rate, and cardiac output. At high doses (>10 mcg/kg/min), it primarily stimulates alpha-1 adrenergic receptors, causing generalized vasoconstriction, increasing systemic vascular resistance (SVR) and blood pressure.
Pharmacokinetics
Absorption:
Bioavailability:
Not applicable (IV administration)
Tmax:
Not applicable (continuous infusion)
FoodEffect:
Not applicable
Distribution:
Vd:
0.89 L/kg
ProteinBinding:
Not available (low)
CnssPenetration:
Limited
Elimination:
HalfLife:
Approximately 2 minutes (range 1-5 minutes)
Clearance:
Not available
ExcretionRoute:
Renal (primarily as inactive metabolites)
Unchanged:
Approximately 25% (excreted unchanged)
Pharmacodynamics
OnsetOfAction:
Within 5 minutes
PeakEffect:
Within 5-10 minutes
DurationOfAction:
Less than 10 minutes (due to rapid metabolism)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Shortness of breath
Chest pain or pressure
Abnormal heartbeat (fast, slow, or irregular)
Cool or pale arm or leg
Changes in skin color, such as turning black or purple
Difficulty urinating or changes in urine output
Additionally, if the medication leaks from the vein, it can cause tissue damage. Inform your nurse immediately if you experience:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. However, if you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Upset stomach or vomiting
Headache
Anxiety
* Goosebumps
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Shortness of breath
Chest pain or pressure
Abnormal heartbeat (fast, slow, or irregular)
Cool or pale arm or leg
Changes in skin color, such as turning black or purple
Difficulty urinating or changes in urine output
Additionally, if the medication leaks from the vein, it can cause tissue damage. Inform your nurse immediately if you experience:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. However, if you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Upset stomach or vomiting
Headache
Anxiety
* Goosebumps
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Chest pain or discomfort
- Palpitations or feeling of a racing heart
- Difficulty breathing
- Severe headache
- Numbness, tingling, or coldness in fingers or toes
- Pain or swelling at the IV injection site
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including any symptoms.
If you have been diagnosed with pheochromocytoma, a type of adrenal gland tumor.
If you have a history of abnormal or rapid heartbeat.
If you have low levels of potassium or magnesium in your blood.
* If you have low blood volume or a condition that causes acidic blood (acidosis).
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor. Be sure to tell your doctor and pharmacist about:
- All prescription and over-the-counter (OTC) medications you are taking
- Any natural products or vitamins you are using
- All your health problems
Your doctor needs this information to determine if it is safe for you to take this medication with your other drugs and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including any symptoms.
If you have been diagnosed with pheochromocytoma, a type of adrenal gland tumor.
If you have a history of abnormal or rapid heartbeat.
If you have low levels of potassium or magnesium in your blood.
* If you have low blood volume or a condition that causes acidic blood (acidosis).
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor. Be sure to tell your doctor and pharmacist about:
- All prescription and over-the-counter (OTC) medications you are taking
- Any natural products or vitamins you are using
- All your health problems
Your doctor needs this information to determine if it is safe for you to take this medication with your other drugs and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
Additionally, it is crucial to check your blood pressure as instructed by your doctor. Stopping this medication too quickly can lead to low blood pressure, which may cause severe dizziness or fainting. If you experience either of these symptoms, contact your doctor immediately.
If you have a known allergy to sulfites, consult with your doctor, as some formulations of this medication may contain sulfites.
Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or are breastfeeding. Your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
Additionally, it is crucial to check your blood pressure as instructed by your doctor. Stopping this medication too quickly can lead to low blood pressure, which may cause severe dizziness or fainting. If you experience either of these symptoms, contact your doctor immediately.
If you have a known allergy to sulfites, consult with your doctor, as some formulations of this medication may contain sulfites.
Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or are breastfeeding. Your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Excessive hypertension (very high blood pressure)
- Tachycardia (very fast heart rate)
- Arrhythmias (irregular heartbeats)
- Peripheral vasoconstriction (cold, pale extremities)
- Headache
- Nausea/vomiting
What to Do:
Management involves reducing the rate of infusion or temporarily discontinuing the infusion until the patient's condition stabilizes. If severe hypertension persists, an alpha-adrenergic blocking agent (e.g., phentolamine) may be administered. For extravasation, infiltrate the area with phentolamine. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Contraindicated Interactions
- MAO inhibitors (within 14 days)
Major Interactions
- Beta-blockers (may antagonize cardiac effects)
- Alpha-blockers (may antagonize vasoconstrictive effects)
- Tricyclic antidepressants (may potentiate pressor effect)
- General anesthetics (e.g., halothane, cyclopropane - may sensitize myocardium to arrhythmias)
- Ergot alkaloids (may cause severe peripheral vasoconstriction and gangrene)
Moderate Interactions
- Diuretics (may enhance diuresis, monitor for hypovolemia)
- Phenytoin (may cause hypotension and bradycardia)
- Oxytocic drugs (may cause severe persistent hypertension)
Minor Interactions
- Not available
Monitoring
Baseline Monitoring
Blood Pressure (BP)
Rationale: To establish baseline and guide titration.
Timing: Prior to initiation
Heart Rate (HR)
Rationale: To establish baseline and monitor for tachycardia/arrhythmias.
Timing: Prior to initiation
Electrocardiogram (ECG)
Rationale: To assess cardiac rhythm and identify pre-existing arrhythmias.
Timing: Prior to initiation
Urine Output
Rationale: To assess renal perfusion and function.
Timing: Prior to initiation
Peripheral Perfusion (skin color, temperature, capillary refill)
Rationale: To assess adequacy of circulation and detect signs of vasoconstriction/ischemia.
Timing: Prior to initiation
Routine Monitoring
Blood Pressure (BP)
Frequency: Continuously (arterial line preferred)
Target: Titrate to desired mean arterial pressure (MAP) or systolic BP
Action Threshold: MAP < 65 mmHg or SBP < 90 mmHg (or as clinically indicated); excessive hypertension
Heart Rate (HR)
Frequency: Continuously
Target: Maintain within physiological limits, avoid excessive tachycardia
Action Threshold: HR > 120-140 bpm or significant arrhythmias
Electrocardiogram (ECG)
Frequency: Continuously
Target: Normal sinus rhythm, absence of significant arrhythmias
Action Threshold: Development of new arrhythmias (e.g., ventricular tachycardia, frequent PVCs)
Urine Output
Frequency: Hourly
Target: > 0.5 mL/kg/hr in adults
Action Threshold: < 0.5 mL/kg/hr for 2 consecutive hours
Peripheral Perfusion
Frequency: Every 1-4 hours (or more frequently as needed)
Target: Warm, dry skin, good capillary refill
Action Threshold: Cool, clammy extremities, mottling, prolonged capillary refill
IV Site
Frequency: Hourly (or more frequently)
Target: No signs of extravasation
Action Threshold: Swelling, pallor, pain, or coolness at injection site
Symptom Monitoring
- Chest pain
- Palpitations
- Headache
- Nausea/vomiting
- Dyspnea
- Anxiety
- Extremity pain or discoloration (signs of ischemia)
Special Patient Groups
Pregnancy
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects at high doses. Limited human data.
Trimester-Specific Risks:
First Trimester:
Potential for fetal harm, but human data are limited. Use only if clearly needed.
Second Trimester:
Potential for fetal harm, but human data are limited. Use only if clearly needed.
Third Trimester:
Potential for fetal harm, but human data are limited. Use only if clearly needed. May reduce uterine blood flow.
Lactation
Dopamine is rapidly metabolized and has low oral bioavailability, making infant exposure through breast milk unlikely to be significant. However, caution is advised, and the decision to breastfeed should consider the mother's clinical condition and the potential risks to the infant.
Infant Risk:
Low risk due to rapid maternal metabolism and poor oral absorption by infant, but monitor infant for signs of adrenergic effects (e.g., irritability, feeding difficulties, changes in heart rate).
Pediatric Use
Dopamine is commonly used in pediatric patients for similar indications as adults (e.g., shock, hypotension). Dosing is weight-based (mcg/kg/min) and titrated to effect. Close monitoring of vital signs, urine output, and peripheral perfusion is crucial. Neonates and infants may be more sensitive to its effects.
Geriatric Use
Elderly patients may be more sensitive to the effects of dopamine, particularly regarding cardiovascular effects (e.g., arrhythmias, hypertension). Start with lower doses and titrate carefully. Monitor closely for adverse effects and hemodynamic response. Renal and hepatic function may be impaired, though dopamine's metabolism is rapid and not heavily reliant on these organs for dose adjustment.
Clinical Information
Clinical Pearls
- Dopamine's effects are highly dose-dependent: low doses (renal vasodilation), moderate doses (cardiac inotropy), high doses (vasoconstriction).
- Always administer via continuous IV infusion, preferably through a central venous catheter. If a peripheral line is used, ensure it is a large vein and monitor closely for extravasation.
- Extravasation is a significant risk; if it occurs, immediately infiltrate the area with phentolamine (5-10 mg diluted in 10-15 mL saline) to prevent tissue necrosis.
- Correct hypovolemia prior to initiating dopamine, unless it's a severe emergency, as dopamine is less effective in hypovolemic states.
- Monitor vital signs (BP, HR, CVP if available), urine output, and peripheral perfusion continuously.
- Dopamine can increase myocardial oxygen demand, which may be detrimental in patients with severe coronary artery disease.
- Avoid abrupt discontinuation; taper gradually if possible to prevent rebound hypotension.
Alternative Therapies
- Norepinephrine (Levophed) - primarily alpha-1 agonist, strong vasoconstrictor, some beta-1 effects.
- Epinephrine (Adrenalin) - alpha and beta agonist, strong inotrope and vasopressor.
- Phenylephrine (Neo-Synephrine) - pure alpha-1 agonist, vasoconstrictor.
- Dobutamine (Dobutrex) - primarily beta-1 agonist, inotropic agent, less effect on SVR.
- Vasopressin (Pitressin) - non-adrenergic vasopressor, acts on V1 receptors.
- Milrinone (Primacor) - phosphodiesterase inhibitor, inotropic and vasodilatory effects.
Cost & Coverage
Average Cost:
Not available Not available
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the proper disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the quantity, and the time of ingestion.