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Dobutamine

    Brands

    DEA Class;  Rx

    Common Brand Names; Dobutamine

    • Inotropic Agents

    Parenteral direct-acting inotrope
    Used for short-term treatment of patients with cardiac decompensation due to depressed contractility from organic heart disease or cardiac surgical procedures
    Comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects

    Indicated for the short-term inotropic treatment of low output states caused by congestive heart failure, cardiogenic shock, septic shock, or after cardiac surgery.

    For use in coronary artery disease diagnosis† (i.e., dobutamine stress echocardiography).

    Hypersensitivity to drug or components

    Idiopathic hypertrophic subaortic stenosis

    • Tachyarrhythmia (~10%)
    • Hypertension (7.5%)
    • Eosinophilic myocarditis (≤7%)
    • Premature ventricular beats (5%; dose related)
    • Angina (1-3%)
    • Dyspnea (1-3%)
    • Fever (1-3%)
    • Headache (1-3%)
    • Nausea (1-3%)
    • Palpation (1-3%)
    • Cardiac dysrhythmia
    • Exacerbation of coronary arteriosclerosis
    • Hypokalemia
    • Injection-site reactions
    • Syncope

    To optimize hemodynamics, correct hypovolemia if needed

    Clinical experience with dobutamine following myocardial infarction has been insufficient to establish safety of drug for this use; there is concern that any agent that increases contractile force and heart rate may increase size of infarction by intensifying ischemia, but not known whether dobutamine does so

    Severe coronary artery disease (CAD)

    Hypertension common; hypotension may also occur

    May cause a marked increase in heart rate or blood pressure,especially systolic pressure; because dobutamine facilitates atrioventricular conduction, patients with atrial fibrillation are at risk of developing rapid ventricular response; in patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine; patients with pre-existing hypertension appear to face an increased risk of developing an exaggerated pressure response

    During administration of dobutamine, monitor blood pressure continuously; pulmonary wedge pressure and cardiac output should be monitored whenever possible to aid safe and effective infusion of dobutamine in 5% dextrose Injection, USP

    Ventricular ectopy exacerbation may occur

    Pregnancy category: B

    Lactation: Unknown whether drug is excreted into breast milk; avoid use

    Adults

    20 mcg/kg/minute IV infusion; rarely, up to 40 mcg/kg/minute IV per manufacturer.

    Geriatric

    20 mcg/kg/minute IV infusion; rarely, up to 40 mcg/kg/minute IV per manufacturer.

    Adolescents

    20 mcg/kg/minute IV infusion; rarely, up to 40 mcg/kg/minute IV per manufacturer.

    Children

    20 mcg/kg/minute IV infusion; rarely, up to 40 mcg/kg/minute IV per manufacturer.

    Infants

    20 mcg/kg/minute IV infusion; rarely, up to 40 mcg/kg/minute IV per manufacturer.

    Neonates

    20 mcg/kg/minute IV infusion is the usual maximum dosage; however, higher doses may be required in some clinical situations.

    Dobutamine hydrochloride

    infusion solution, in D5W

    • 100mg/100mL
    • 200mg/100mL
    • 400mg/100mL

    injectable solution

    • 12.5mg/mL