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dopamine
generic
Black Box Warnings .
Extravasation
to prevent sloughing/necrosis in peripheral ischemic areas promptly use syringe with fine hypodermic needle to liberally infiltrate area with 10-15 mL saline solution containing 5-10 mg phentolamine; sympathetic blockade causes immediate conspicuous local hyperemic changes if area infiltrated within 12h
Adult Dosing .
Dosage forms: INJ
shock, adjunct tx
- [2-20 mcg/kg/min IV]
- Start: 2-5 mcg/kg/min IV, then titrate to effect in 5-10 mcg/kg/min increments; Max: 50 mcg/kg/min
heart failure, acute decompensated
- [5-15 mcg/kg/min IV]
- Info: use lowest effective dose, shortest effective tx duration
ACLS, bradycardia (off-label)
- [5-20 mcg/kg/min IV]
- Info: for patients unresponsive to atropine or if atropine use inappropriate; see ACLS: Bradycardia table
post-resuscitation stabilization (off-label)
- [5-10 mcg/kg/min IV]
- Info: refer to ACLS guidelines
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
shock, adjunct tx
- [2-20 mcg/kg/min IV]
- Start: 2-5 mcg/kg/min IV, then titrate to effect in 5-10 mcg/kg/min increments; Max: 50 mcg/kg/min
post-resuscitation stabilization (off-label)
- [2-20 mcg/kg/min IV/IO]
- Info: refer to PALS guidelines
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- tachyarrhythmia
- ventricular fibrillation
- pheochromocytoma
- caution: hypersensitivity to sulfites
- caution: MAO inhibitor use within 14 days
- caution: hypovolemia
- caution: respiratory acidosis
- caution: vascular disease, occlusive
Drug Interactions .
Overview
dopamine
alpha/beta/dopamine agonist
- COMT substrate
- MAO substrate
- hypertensive effects
- tachycardia
Contraindicated
- dihydroergotamine
- ergotamine
- phenelzine
Avoid/Use Alternative
- clomipramine
- cocaine
- dronabinol
- ephedra
- esmolol
- fosphenytoin
- imipramine
- landiolol
- methylergonovine
- midodrine
- phenytoin
- procarbazine
- protriptyline
- trimipramine
Monitor/Modify Tx
- abiraterone acetate
- acebutolol
- albuterol
- albuterol inhaled
- almotriptan
- amitriptyline
- amoxapine
- amphetamine
- angiotensin II
- arformoterol inhaled
- armodafinil
- asciminib
- atenolol
- atogepant
- atomoxetine
- atropine ophthalmic
- axitinib
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bisoprolol
- brigatinib
- bromocriptine
- budesonide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- cannabis
- carfilzomib
- carvedilol
- celecoxib
- ceritinib
- copanlisib
- corticotropin
- cyclosporine
- danazol
- darbepoetin alfa
- deflazacort
- desflurane
- desipramine
- desmopressin
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- doxapram
- doxazosin
- doxepin
- droxidopa
- eletriptan
- entacapone
- ephedrine injection
- ephedrine oral
- epinephrine
- epoetin alfa
- eptinezumab
- erenumab
- esketamine
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethanol (alcoholic beverage)
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- everolimus
- fenfluramine
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galcanezumab
- glycopyrrolate
- hoodia
- hydrocortisone
- hydroxocobalamin IV
- hyoscyamine
- ibrutinib
- ibuprofen
- indomethacin
- isocarboxazid
- isoflurane
- isoniazid
- ketamine
- ketoprofen
- ketorolac
- labetalol
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levothyroxine
- licorice
- lifileucel
- linezolid
- liothyronine
- liraglutide
- lisdexamfetamine
- lorlatinib
- lumacaftor/ivacaftor
- luspatercept
- lutetium Lu 177 dotatate
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methylene blue injection
- methylene blue oral
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- metoprolol
- milnacipran
- mirabegron
- modafinil
- nabumetone
- nadolol
- naproxen
- naratriptan
- naxitamab
- nebivolol
- niraparib
- obinutuzumab
- olodaterol inhaled
- opicapone
- orphenadrine
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pazopanib
- pexidartinib
- phendimetrazine
- phentermine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- piroxicam
- ponatinib
- ponesimod
- pralsetinib
- prednisolone
- prednisone
- propranolol
- pseudoephedrine
- quetiapine
- ramucirumab
- rasagiline
- regorafenib
- rimegepant
- ripretinib
- rizatriptan
- ropinirole
- safinamide
- salmeterol inhaled
- selegiline
- selegiline transdermal
- selpercatinib
- sevoflurane
- siponimod
- solriamfetol
- sorafenib
- sotalol
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- terazosin
- terbutaline
- teriflunomide
- testosterone
- thyroid
- timolol
- tivozanib
- tolcapone
- tolmetin
- trametinib
- tranylcypromine
- triamcinolone
- trospium
- ubrogepant
- vadadustat
- vamorolone
- vandetanib
- vasopressin
- venlafaxine
- vilanterol inhaled
- viloxazine
- voclosporin
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
Caution Advised
- digoxin
Adverse Reactions .
Serious Reactions
- anaphylaxis
- hypotension
- ventricular arrhythmia
- atrial fibrillation
- bronchospasm
- extravasation necrosis
- gangrene
Common Reactions
- tachycardia
- headache
- nausea
- vomiting
- anxiety
- HTN
- cardiac conduction disturbance
- vasoconstriction
- angina
- palpitations
- azotemia
- dyspnea
Safety/Monitoring .
Monitoring Parameters
fluid status, acid-base balance at baseline; K; BP; ECG
Look/Sound-Alike Drug Names
DOPamine confused with: DOBUTamine; Dobutrex
Pregnancy/Lactation .
Pregnancy
Clinical Summary
benefits outweigh risks during pregnancy; risk of fetal harm not expected based on limited human data; no known risk of fetal harm based on animal data at up to 6 mg/kg/day
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available, though low risk of infant harm based on drug properties; no human data available to assess effects on milk production, though possible decr. milk production based on decr. prolactin levels
Pharmacology .
Metabolism: for dopamine: liver, kidney, plasma; CYP450: unknown; Info: 25% metabolized to norepinephrine within adrenergic nerve terminals
Excretion: for dopamine: urine 80%; Half-life: 2min
Subclass: Advanced Life Support (ACLS/PALS/NALS) ; Inotropes/Pressors
Mechanism of Action
for dopamine: stimulates alpha and beta-1 adrenergic and dopaminergic receptors; produces inotropic, chronotropic, renal/splanchnic vasodilatory (at low doses), and pressor (at high doses) effects
Formulary .
No Formulary Selected
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