Dobutamine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Acute heart failure 2.5-10 mcg/kg/min, adjust according to response. Dose range of 0.5-40 mcg/kg/min may be given. Cardiac stress test 5 mcg/kg/min for 8 min via infusion pump. Increase dose by increments of 5 mcg/kg/min up to max 20 mcg/kg/min, w/ each dose being infused for 8 min before the next increase.
Dosage Details
Intravenous
Acute heart failure
Adult: 2.5-10 mcg/kg/min. Dose range of 0.5-40 mcg/kg/min may be given. Adjust according to patient's BP, heart rate, cardiac and urine output.
Child: Neonates to 18 yr Initially, 5 mcg/kg/min, adjust to 2-20 mcg/kg/min according to response.

Intravenous
Cardiac stress test
Adult: 5 mcg/kg/min for 8 min via infusion pump using a soln containing 1 mg/mL. Increase dose by increments of 5 mcg/kg/min up to max 20 mcg/kg/min, w/ each dose being infused for 8 min before the next increase.
Child:
Reconstitution
Dilute to a concentration of 0.5-1 mg/mL (max 5 mg/mL, if fluid restricted) w/ glucose 5% or NaCl 0.9%.
Incompatibility
Incompatible w/ alkaline soln (e.g. Na bicarbonate), heparin, penicillin, cefazolin. Y-site: Aciclovir, alteplase, aminophylline, amphotericin B cholesteryl sulfate complex, foscarnet, indometacin, micafungin, pantoprazole, pemetrexed, phytonadione, piperacillin/tazobactam, thiopental, warfarin. Syringe: Doxapram, pantoprazole.
Contraindications
Idiopathic hypertrophic subaortic stenosis (IHSS), phaeochromocytoma.
Special Precautions
Patient w/ hyperthyroidism, active myocardial ischaemia or recent MI, cardiogenic shock complicated by severe hypotension, DM, closed angle glaucoma. Correct hypovolaemia prior to treatment. Childn, including neonates. Pregnancy and lactation.
Adverse Reactions
Increased heart rate, ectopic heartbeats, angina, chest pain, palpitation, elevations in BP, skin rash, fever, eosinophilia, bronchospasm, paraesthesia, nausea, vomiting, tingling sensation, dyspnoea, fever, headache, mild leg cramps; pruritus of the scalp; phlebitis at the inj site. Rarely, ventricular tachycardia, hypokalaemia.
IV/Parenteral: B
MonitoringParameters
Monitor BP, ECG, cardiac output and pulmonary wedge pressure.
Overdosage
Symptoms: Nausea, vomiting, anorexia, headache, shortness of breath, anginal and non-specific chest pain, palpitations, anxiety, tremor, urinary incontinence, HTN, tachyarrhythmias, myocardial ischaemia, ventricular fibrillation, hypotension. Management: Protect patient’s airway and support ventilation and perfusion. May admin metoprolol, esmolol or other β-adrenergic blocking agents.
Drug Interactions
Risk of hypotension and tachycardia w/ α-blockers (e.g. phenoxybenzamine). May produce ventricular arrhythmias w/ cyclopropane, halothane and other halogenated anaesth. Increased risk of arrhythmias w/ quinidine and cardiac glycosides. Risk of HTN and arrhythmias w/ TCAs. May increase BP w/ antihypertensives. Risk of severe HTN and bradycardia w/ β-blocker esp non-selective β-blockers. Reduced cardiotonic effects w/ CaCl infusion. Increased risk of HTN w/ doxapram. Enhanced effects w/ entacapone. Risk of ergotism w/ ergotamine or ergometrine (ergonovine) or methysergide. Oxytocin may possibly enhance the pressor effect of dobutamine w/ or w/o HTN.
Action
Description: Dobutamine exerts positive inotropic effect on the myocardium by stimulating β1-adrenergic receptors, thereby increasing myocardial contractility, stroke vol and cardiac output.
Onset: Approx 2 min.
Duration: <10 min.
Pharmacokinetics:
Absorption: Inactivated when given orally.
Metabolism: Hepatically metabolised; converted to 3-O-methyldobutamine by COMT and via conjugation by glucuronic acid.
Excretion: Mainly via urine; via faeces (small amounts). Elimination half-life: Approx 2 min.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 15-30°C.
MIMS Class
ATC Classification
C01CA07 - dobutamine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of hypotension.
Disclaimer: This information is independently developed by MIMS based on Dobutamine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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