Dobutamin

Dobutamine is a catecholamine indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.

Dosages of Dobutamin:

Infusion solution, in D5W

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

Injectable solution

• 12.5mg/mL

Dosage Considerations – Should be Given as Follows:

Cardiac Decompensation

• Adult and pediatric: 0.5-1 mcg/kg/minute intravenous (IV) continuous infusion initially, then 2-20 mcg/kg/minute; not to exceed 40 mcg/kg/minute

Low Cardiac Output (Off-label)

• 2-20 mcg/kg/min intravenously (IV) or intraosseously (IO); titrate to desired effect; not to exceed 40 mcg/kg/minute

Common side effects of Dobutamin include:

• Fast, irregular heartbeat
• High blood pressure (hypertension)
• Eosinophilic myocarditis
• Premature ventricular beats (dose-related)
• Chest pain (angina)
• Shortness of breath
• Fever
• Headache
• Nausea
• Palpations
• Nervousness
• Vomiting
• Swelling at the injection site

Other side effects of Dobutamin include:

• Cardiac dysrhythmia
• Exacerbation of coronary arteriosclerosis
• Low blood potassium (hypokalemia)
• Injection-site reactions
• Fainting
• 10- to 20-mm Hg increase in systolic blood pressure and increase in heart rate of 5 to 15 beats/minute

Serious side effects of dobutamine include:

• low blood pressure
• fast or slow heartbeat
• trouble breathing

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Severe interactions of dobutamine include:
  • isocarboxazid
  • linezolid
  • phenelzine
  • selegiline transdermal
  • tranylcypromine
• Dobutamine has serious interactions with at least 29 different drugs.
• Dobutamine has moderate interactions with at least 256 different drugs.
• Mild interactions of dobutamine include:
  • bendroflumethiazide
  • bumetanide
  • chlorothiazide
  • chlorthalidone
  • cyclopenthiazide
  • desmopressin
  • ethacrynic acid
  • eucalyptus
  • furosemide
  • hydrochlorothiazide
  • indapamide
  • methyclothiazide
  • metolazone
  • noni juice
  • sage
  • torsemide

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains dobutamine. Do not take dobutamine if you are allergic to dobutamine or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity to drug or components
• Idiopathic hypertrophic subaortic stenosis

Effects of Drug Abuse

• No information is available

Short-Term Effects

• See "What Are Side Effects Associated with Using Dobutamin?”

Long-Term Effects

• See "What Are Side Effects Associated with Using Dobutamin?”

Cautions

• To optimize hemodynamics, correct hypovolemia if needed.
• Clinical experience with dobutamine following a heart attack (myocardial infarction) has been insufficient to establish the safety of the drug for this use; there is concern that any agent that increases contractile force and heart rate may increase the size of infarction by intensifying ischemia, but not known whether dobutamine does so.
• Severe coronary artery disease (CAD).
• High blood pressure (hypertension) is common; low blood pressure (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 the rapid ventricular response, a digitalis preparation should be used before the institution of therapy with dobutamine; patients with pre-existing hypertension appear to face an increased risk of developing an exaggerated pressure response.
• During the 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 and Lactation

• Dobutamine may be acceptable for use during pregnancy. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risk.
• It is unknown whether dobutamine is excreted into breast milk; avoid use if breastfeeding.