Dobutamine

Indications
Intravenous
Acute heart failure
Adult: 2.5-10 mcg/kg, up to 0.5-40 mcg/kg according to patient's heart rate, cardiac output, BP and urine output.
Intravenous
Cardiac stress test
Adult: 5 mcg/kg/min for 8 min using a 1 mg/ml solution, dose is then increased at 5 mcg/kg/min until 20 mcg/kg/min, with each dose being infused for 8 min before the next increase. Monitor ECG and stop infusion if arrhythmias, marked ST segment depression or other adverse effects occur.
Contraindications
Hypersensitivity; idiopathic hypertrophic subaortic stenosis (IHSS).
Warnings / Precautions
Correct hypovolaemia prior to treatment. Increased risk of rapid ventricular response in patients with atrial fibrillation. Insufficient data to determine the safety and efficacy of dobutamine use after acute MI. Elderly. Neonates. Pregnancy.
Adverse Reactions
Increased heart rate and BP, ectopic beats, palpitation. Nausea, headache, chest pain, palpitation, dyspnoea, paraesthesia, leg cramps. Tissue necrosis at site of extravasation.
Potentially Fatal: Cardiac arrhythmias, allergy (rare), MI and hypotension.
Overdose Reactions
Symptoms may include anorexia, nausea, vomiting, tremor, anxiety, palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. Treatment includes discontinuing drug admin, establishing an airway, ensuring oxygenation and ventilation. Initiate resuscitative measures immediately. Severe ventricular tachyarrhythmias may be treated with propranolol or lidocaine. Hypertension usually responds to dose reduction or therapy discontinuation.
Drug Interactions
Increased cardiac output when used with nitroprusside. Increased vasopressor effect of dobutamine when used with bretylium, guanethidine, oxytocic drugs or TCAs.
See Below for More dobutamine Drug Interactions
Mechanism of Actions
Dobutamine increases contractility and heart rate by stimulating β-adrenergic receptors in the cardiac tissues.
Absorption: Inactivated in the GI tract (oral).
Metabolism: Converted to 3-O-methyldobutamine.
Excretion: Mainly via urine, via faeces (small amounts); 2 min (elimination half-life).
Storage Conditions
Intravenous: Store at 15-30°C.
ATC Classification
C01CA07 - dobutamine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.
Storage
Intravenous: Store at 15-30°C.
Available As
  • Dobutamine 12.5 mg
  • Dobutamine 40 mg
  • Dobutamine 50 mg
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