Pressor therapy is not a substitute for replacement of blood, plasma, fluids and/or electrolytes. Blood volume depletion should be corrected as fully as possible before dopamine therapy is instituted. If excessive vasoconstriction, decreased urine output, increased heart rate or an arrhythmia occurs, the rate of infusion of dopamine should be decreased or temporarily suspended and the patient should be observed closedly. Patients with a history of occlusive vascular disease (e.g., atherosclerosis, arterial embolism, Raynaud's disease, cold injury, diabetic endarteritis, or buerger's disease) should be carefully monitored during dopamine therapy for decreased circulation to the extremities indicated by changes in color or temperwise of the skin or pain in the extremities. Dopamine should be used with caution in patients with ischemic heart disease. The drug is contraindicated in patients with pheochromocytoma and in patients with uncorrected tachyarrhythmias or ventricular fibrillation.
Pediatric Precautions: Safety and efficacy of dopamine in children have not been established. The drug has been used in a limited number of pediatric patients but data are insufficient to define optimum dosage requirements and criteria for usage in this patient population.