Dopamine

Dosage Forms

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Concentrate for solution for IV infusion

40 mg/ml

Uses

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Management of vascular shock

Dose and Duration

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Management of vascular shock

Adult: 0.002–0.005 mg/kg/minute increased gradually by 0.005–0.01 mg/kg/minute increments, according to blood pressure, cardiac output and urine output. Dose can be increased up to 0.02–0.05 mg/kg/minute as required

Child 1 month–18 years: 0.005 mg/kg/minute adjust ed according to response (max 0.02 mg/kg/minute)

Neonate: 0.003 mg/kg/minute, adjusted according to response (max 0.02 mg/kg/minute)

Preparation

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Dilute with Glucose 5% or Sodium chloride 0.9% to a maximum concentration of 3.2 mg/ml.

Contraindications

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Uncorrected atrial or ventricular tachyarrhythmia
Ventricular fibrillation
Pheochromocytoma
Hyperthyroidism

Side Effects

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Nausea, vomiting
Anginal pain, ectopic heart beats, palpitations
Tachycardia, vasoconstriction, hypotension
Dyspnoea
Headache
Gangrene

Interactions

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MAOIs e.g. Selegiline (risk of hypertensive crisis)
Halogenated anaesthetics; halothane (sensitization of the myocardium)
Phenytoin (increased risk of hypotension and bradycardia)
Alpha-blockers (antagonize peripheral vasoconstriction caused by high doses of dopamine)
Beta-blockers (antagonize cardiac effects of dopamine)

Pregnancy

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Do not use

Breastfeeding

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Can be used

⚠️ Caution

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Do not use bicarbonate for dilution because dopamine concentrate is incompatible with bicarbonate
Reduce the dose or temporarily suspend dosage in case of decrease in established urine flow rate, increasing tachycardia or development of new dysrthythmias
Patients who have been treated with MAOI prior to dopamine should be given reduced doses (the starting dose should be 1/10th of the usual dose)
Avoid excess administration of potassium-free solutions since it may result in significant hypokalaemia
Withdraw gradually to avoid unnecessary hypotension
Only use in pregnancy if benefit outweighs risk