Dopamine injection

Yes

Common side effects of dopamine include

• disordered breathing,
• nausea,
• vomiting,
• headache, and
• increased blood urea nitrogen.

Serious side effects of dopamine include

• abnormal heart rhythm,
• increased or decreased blood pressure,
• increased pressure in the eye, and
• gangrene in the extremities.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

• chest pain;

• fast, slow, or pounding heartbeats;

• painful or difficult urination, blood in your urine;

• weakness, confusion, swelling in your feet or ankles, urinating less than usual or not at all;

• weak or shallow breathing;

• feeling like you might pass out, even while lying down;

• burning, pain, or swelling around the IV needle;

• cold feeling, numbness, or blue-colored appearance in your hands or feet; or

• darkening or skin changes in your hands or feet.

Less serious side effects may include:

• headache;

• feeling anxious;

• nausea, vomiting; or

• chills, goosebumps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Cardiothoracic Surgery:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Adult Dose for Myocardial Infarction:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Adult Dose for Renal Failure:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Adult Dose for Shock:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Adult Dose for Septicemia:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients should undergo circulatory volume restoration before starting this drug.
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Cardiothoracic Surgery:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Congestive Heart Failure:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Myocardial Infarction:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Renal Failure:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Shock:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Usual Pediatric Dose for Septicemia:

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Fliptop Vial

Pintop Vial

MUST BE DILUTED PRIOR TO ADMINISTRATION

Dopamine, a sympathomimetic amine vasopressor, is the naturally occurring immediate precursor of norepinephrine. Dopamine hydrochloride is a white to off-white crystalline powder, which may have a slight odor of hydrochloric acid. It is freely soluble in water and soluble in alcohol. Dopamine HCl is sensitive to alkalies, iron salts, and oxidizing agents. Chemically it is designated as 4-(2-aminoethyl) pyrocatechol hydrochloride, and its molecular formula is C8H11NO2•HCl.

Dopamine hydrochloride injection is a clear, practically colorless, sterile, pyrogen-free, aqueous solution of dopamine HCl for intravenous infusion after dilution. Each milliliter of the 40 mg/mL preparation contains 40 mg of dopamine hydrochloride (equivalent to 32.31 mg of dopamine base). Each milliliter of the 80 mg/mL preparation contains 80 mg of dopamine hydrochloride (equivalent to 64.62 mg of dopamine base). Each milliliter of both preparations contains the following: Sodium metabisulfite 9 mg added as an antioxidant; citric acid, anhydrous 10 mg; and sodium citrate, dihydrate 5 mg added as a buffer. May contain additional citric acid and/or sodiumcitrate for pH adjustment pH is 3.3 (2.5 to 5.0).

Dopamine must be diluted in an appropriate sterile parenteral solution before intravenous administration. (See DOSAGE AND ADMINISTRATION)

Dopamine HCl is indicated for the correction of hemodynamic imbalances present in the shock syndrome due to myocardial infarction, trauma, endotoxic septicemia, open-heart surgery, renal failure, and chronic cardiac decompensation as in congestive failure.

Patients most likely to respond adequately to dopamine HCl are those in whom physiological parameters, such as urine flow, myocardial function, and blood pressure, have not undergone profound deterioration. Multiclinic trials indicate that the shorter the time interval between onset of signs and symptoms and initiation of therapy with blood volume correction and dopamine HCl, the better the prognosis. Where appropriate, blood volume restoration with a suitable plasma expander or whole blood should be accomplished prior to administration of dopamine HCl.

Peer Perfusion of Vital Organs- Urine flow appears to be one of the better diagnostic signs by which adequacy of vital organ perfusion can be monitored. Nevertheless, the physician should also observe the patient for signs of reversal of confusion or reversal of comatose condition. Loss of pallor, increase in two temperature, and/or frequency of nail bed capillary filling may also be used as indices of adequate dosage. Clinical studies have shown that when dopamine HCl is administered before urine flow has diminished to levels of approximately 0.3 mL/minute, prognosis is more favorable. Nevertheless, in a number of oliguric or anuric patients, administration of dopamine HCl has resulted in an increase in urine flow, which in some cases reached normal levels. Dopamine HCl may also increase urine flow in patients whose output is within normal limits and thus may be of value in reducing the degree of pre-existing fluid accumulation. It should be noted that at doses above those optimal for the individual patient, urine flow may decrease, necessitating reduction of dosage.

Low Cardiac Output - Increased cardiac output is related to dopamine's direct inotropic effect on the myocardium. Increased cardiac output at low or moderate doses appears to be related to a favorable prognosis. Increase in cardiac output has been associated with either static or decreased systemic vascular resistance (SVR). Static or decreased SVR associated with low or moderate movements in cardiac output is believed to be a reflection of differential effects on specific vascular beds with increased resistance in peripheral beds (e.g., femoral) and concomitant decreases in mesenteric and renal vascular beds.

Redistribution of blood flow parallels these changes so that an increase in cardiac output is accompanied by an increase in mesenteric and renal blood flow. In many instances the renal fraction of the total cardiac output has been found to increase. Increase in cardiac output produced by dopamine is not associated with substantial decreases in systemic vascular resistance as may occur with isoproterenol.

Hypotension - Hypotension due to indequate cardiac output can be managed by administration of low to moderate doses of dopamine HCl which have little effect on SVR. At high therapeutic doses, dopamine's alpha-adrenergic activity becomes more prominent and thus may correct hypotension due to diminished SVR. As in the case of other circulatory decompensation states, prognosis is better in patients whose blood pressure and urine flow have not undergone profound deterioration. Therefore, it is suggested that the physician administer dopamine HCl as soon as a definite trend toward decreased systolic and diastolic prressure becomes evident.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Tell your doctor about all other medicines you use, especially:

• droperidol (Inapsine);

• epinephrine (EpiPen, Adrenaclick, Twinject, and others);

• haloperidol (Haldol);

• midodrine (ProAmatine);

• phenytoin (dilantin);

• vasopressin (Pitressin);

• a diuretic (water pill);

• an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), nortriptyline (Pamelor), and others;

• a beta blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

• cough or cold medicine that contains an antihistamine or decongestant;

• ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), or methylergonovine (Methergine);

• a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine);

There may be other drugs that can interact with dopamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure

Initial dose: 2 to 10 mcg/kg/min IV by continuous infusion
Maintenance dose: 2 to 50 mcg/kg/min IV by continuous infusion

Comments:
-Patients with advanced circulatory decompression states have been given rates greater than 50 mcg/kg/min.
-Urinary flow should be monitored in patients given rates over 50 mcg/kg/min.
-Patients should undergo circulatory volume restoration before starting this drug.
-Maintenance doses should be titrated to desired response.

Use: Correction of hemodynamic imbalances present in shock due to myocardial infection, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation/refractory congestive heart failure