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Dopamine: Drug information

Dopamine: Drug information
(For additional information see "Dopamine: Patient drug information" and see "Dopamine: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Antidote for peripheral ischemia:

To prevent sloughing and necrosis in ischemic areas, the area should be infiltrated as soon as possible with 10 to 15 mL of sodium chloride 0.9% injection containing phentolamine 5 to 10 mg, an adrenergic blocking agent. Pediatric dosage of phentolamine should be 0.1 to 0.2 mg/kg up to a maximum of 10 mg per dose. A syringe with a fine hypodermic needle should be used, and the solution liberally infiltrated throughout the ischemic area. Sympathetic blockade with phentolamine causes immediate and conspicuous local hyperemic changes if the area is infiltrated within 12 hours. Therefore, phentolamine should be given as soon as possible after the extravasation is noted.

Pharmacologic Category
  • Adrenergic Agonist Agent;
  • Inotrope
Dosing: Adult

Note: Hemodynamic effects of dopamine are dose dependent (however, this is relative and there is overlap of clinical effects between dosing ranges) (Hollenberg 2011; Rhodes 2017; Russell 2021).

Low dose: Augments renal dopamine receptors, which may increase renal blood flow and urine output. The use of low-dose dopamine to prevent or treat acute kidney injury is not recommended.

Intermediate dose: Dopamine and beta-adrenergic effects predominate, resulting in increased renal blood flow, heart rate, cardiac contractility, and cardiac output.

High dose: Alpha-adrenergic effects begin to predominate, resulting in vasoconstriction and increased blood pressure, in addition to increased heart rate, cardiac contractility, and cardiac output due to beta-adrenergic effects.

Bradycardia or atrioventricular block, symptomatic

Bradycardia or atrioventricular block, symptomatic (unresponsive to atropine) (off-label use):

Continuous infusion: IV: Initial: 5 mcg/kg/minute; increase by 5 mcg/kg/minute every 2 minutes until desired effect; maximum dose: 20 mcg/kg/minute (ACC [Kusumoto 2019]; AHA [Panchal 2020]; AHA/CPR 2020).

Hypotension or shock

Hypotension or shock:

Cardiogenic shock (alternative agent):

Note: Typically, not the preferred initial agent in cardiogenic shock; consider other inotropic and/or vasopressor options; caution with the use of dopamine due to increased arrhythmias and possibly mortality in this population (AHA [van Diepen 2017]; De Backer 2010). Optimal goal of therapy not well established, but typically titrate to maintain end-organ perfusion (AHA [van Diepen 2017]).

Continuous infusion: IV: Usual dosage range: 0.5 to 20 mcg/kg/minute; titrate based on clinical end point (eg, end-organ perfusion) (AHA [van Diepen 2017]).

Septic shock and other vasodilatory shock states (alternative agent):

Note: Not recommended for septic shock except as an alternative to norepinephrine in patients with bradycardia who have a low risk of tachyarrhythmias (SSC [Evans 2021]; SSC [Rhodes 2017]). Compared to norepinephrine, dopamine is associated with an increased risk of tachyarrhythmias and potentially worse outcomes (eg, increased mortality, kidney failure) (Avni 2015; De Backer 2012; SSC [Evans 2021]; SSC [Rhodes 2017]). In general, maintain goal mean arterial pressure (MAP) (eg, ~65 mm Hg); consider use if patient is in shock or has hypoperfusion during or after fluid resuscitation (SSC [Dellinger 2013]; SSC [Levy 2018]; SSC [Rhodes 2017]).

Continuous infusion: IV: Initial: 2 to 5 mcg/kg/minute; titrate to goal MAP up to a dose of 20 mcg/kg/minute (De Backer 2010; Manaker 2021).

Post–cardiac arrest shock (alternative agent):

Note: Typically, not the preferred initial agent in post–cardiac arrest shock due to risk of tachyarrhythmias; consider other inotropic and/or vasopressor options (De Backer 2010; Russell 2021). Optimal goal of therapy is not well established, but typically titrate to MAP >65 mm Hg and preferably >80 mm Hg to optimize cerebral and end-organ perfusion (AHA [Callaway 2015]; Russell 2021).

Continuous infusion: IV: Usual dosage range: 5 to 20 mcg/kg/minute; titrate based on clinical end points (eg, MAP, end-organ perfusion) (AHA [Peberdy 2010]; manufacturer's labeling).

Inotropic support

Inotropic support:

Note: May consider in patients with severe systolic dysfunction with decreased end-organ perfusion (AHA/ACC/HFSA [Heidenreich 2022]).

Continuous infusion: IV: 5 to 15 mcg/kg/minute; doses at lower end of this range are preferred as inotropic actions predominate at lower doses and vasoconstrictive actions predominate at higher doses (AHA/ACC/HFSA [Heidenreich 2022]; Hollenberg 2011).

Dosing: Pediatric

(For additional information see "Dopamine: Pediatric drug information")

Hemodynamic support

Hemodynamic support: Infants, Children, and Adolescents: Continuous IV or intraosseous infusion: 2 to 20 mcg/kg/minute; titrate gradually by 5 to 10 mcg/kg/minute increments until optimal response is obtained (PALS [Kleinman 2010]; manufacturer's labeling). Note: Dopamine has a dose-dependent effect; doses at lower end of this range are preferred, as inotropic actions predominate at lower doses and vasoconstrictive actions predominate at higher doses (ACCM/SCCM [Davis 2017]; PALS [Kleinman 2010]).

Dosing: Older Adult

Refer to adult dosing.

Dosing: Obesity: Adult

The recommendations for dosing in patients with obesity are based upon the best available evidence and clinical expertise. Senior Editorial Team: Jeffrey F. Barletta, PharmD, FCCM; Manjunath P. Pai, PharmD, FCP; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC.

Class 1, 2, and 3 obesity (BMI ≥30 kg/m2):

Continuous infusion: IV: Use ideal body weight for initial dose calculations, then titrate to hemodynamic effect and clinical response (Erstad 2021; expert opinion). During therapy, clinicians should not change dosing weight from one weight metric to another (ie, ideal body weight to/from actual body weight) (Erstad 2021; expert opinion). Refer to adult dosing for indication specific doses.

Rationale for recommendations:

There is a paucity of studies evaluating the influence of obesity on dopamine dosing or pharmacokinetics. One observational study evaluating patients with obesity and overall mortality showed a trend in lower dopamine doses at 6 hours with increasing obesity (Arabi 2013). Other observational studies, including phenylephrine, epinephrine and norepinephrine, suggest non–weight-based dosing strategies may result in lower overall cumulative dose requirements and increased drug exposure to second line agents in some patients and may not be advantageous in time to achieving hemodynamic stability (Adams 2017; Radosevich 2016; Vadiei 2017). However, it is difficult to show outcome differences between weight-based and non–weight-based dosing because of dose titration to target BP, particularly in the context of retrospective studies. Furthermore, there is substantial variability in response in critically ill patients, irrespective of weight. Due to the short onset of action and small volume of distribution, rapid titration to clinical effect after initial dosing is possible (Erstad 2021).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Intravenous, as hydrochloride:

Generic: 0.8 mg/mL (250 mL, 500 mL); 1.6 mg/mL (250 mL, 500 mL); 3.2 mg/mL (250 mL); 40 mg/mL (5 mL, 10 mL); 80 mg/mL (5 mL [DSC]); 160 mg/mL (5 mL [DSC])

Solution, Intravenous, as hydrochloride [preservative free]:

Generic: 40 mg/mL (5 mL, 10 mL)

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous:

Generic: 0.8-5 MG/ML-% (250 mL); 1.6-5 MG/ML-% (250 mL, 500 mL); 3.2-5 MG/ML-% (250 mL, 500 mL)

Administration: Adult

IV: Administer as a continuous infusion via an infusion pump. Central line administration is preferred; extravasation may cause severe ischemic necrosis. If central line is not available, may administer for a short duration (<72 hours) through a peripheral IV catheter placed in a large vein at a proximal site (eg, in or proximal to antecubital fossa). Frequent monitoring of the IV catheter site is recommended to rapidly identify extravasation (Cardenas-Garcia 2015; Evans 2021; Lewis 2019; Medlej 2018; Tian 2020). Refer to institutional policies and procedures; catheter placement/size and vasopressor concentration may vary depending on institution.

Vesicant; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation.

Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); remove needle/cannula; elevate extremity. Initiate phentolamine (or alternative) antidote. Apply dry warm compresses (Hurst 2004; Reynolds 2014).

Phentolamine: Dilute 5 to 10 mg in 10 to 20 mL NS and administer into extravasation site as soon as possible after extravasation; may readminister if patient remains symptomatic (Reynolds 2014)

Alternatives to phentolamine:

Nitroglycerin topical 2% ointment (based on limited data): Apply a 1-inch strip to the site of ischemia; may repeat every 8 hours as necessary (Reynolds 2014).

Terbutaline (based on limited case reports): Infiltrate extravasation area using a solution of terbutaline 1 mg diluted in 10 mL NS (large extravasation site; administration volume varied from 3 to 10 mL) or 1 mg diluted in 1 mL NS (small/distal extravasation site; administration volume varied from 0.5 to 1 mL) (Reynolds 2014; Stier 1999)

Administration: Pediatric

Parenteral: Continuous IV infusion: Vials (concentrated solution) must be diluted prior to administration; premixed IV solutions (800 mcg/mL, 1,600 mcg/mL, 3,200 mcg/mL) are available. Administer as a continuous IV infusion with the use of an infusion pump or an intraosseous infusion until IV access can be obtained in pediatric patients (PALS [Kleinman 2010]). Administer into large vein to minimize the possibility of extravasation (central line administration); administration into an umbilical arterial catheter is not recommended (Domonoske 2017). If central line is not available, may administer for a short duration through a peripheral IV catheter placed in a large vein or via intraosseous access using a more dilute solution or with a second carrier fluid; once central access is available, begin central line infusion and wait for pharmacologic effect prior to stopping peripheral administration (AAP [Shenoi 2020]; ACCM/SCCM [Davis 2017]; SCCM/ESICM [Weiss 2020]). Frequent monitoring of the IV catheter site is recommended to rapidly identify extravasation (Reynolds 2014). Refer to institutional policies and procedures; catheter placement/size and vasopressor concentration may vary depending on institution. Do not administer sodium bicarbonate (or any alkaline solution) through an IV line containing dopamine; inactivation of dopamine may occur (AAP [Shenoi 2020]). Avoid abrupt discontinuation; reduce infusion flow rate slowly.

Rate of infusion (mL/hour) = [dose (mcg/kg/minute) × weight (kg) × 60 minutes/hour] divided by concentration (mcg/mL)

Vesicant; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation. If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); remove needle/cannula; elevate extremity. Initiate phentolamine (or alternative) antidote (see Management of Drug Extravasations for more details). Apply dry warm compresses (Hurst 2004; Reynolds 2014).

Usual Infusion Concentrations: Adult

Note: Premixed solutions available.

IV infusion: 400 mg in 250 mL (concentration: 1600 mcg/mL) or 800 mg in 250 mL (concentration: 3200 mcg/mL) of D5W or NS

Usual Infusion Concentrations: Pediatric

Note: Premixed solutions available.

IV infusion: 800 mcg/mL, 1,600 mcg/mL, or 3,200 mcg/mL.

Use: Labeled Indications

Hypotension or shock: Treatment of severe hypotension or shock (eg, septic shock and other vasodilatory shock states, cardiogenic shock, decompensated heart failure, post–cardiac arrest) that persists during and after adequate fluid volume replacement.

Use: Off-Label: Adult

Bradycardia or atrioventricular block, symptomatic (unresponsive to atropine)

Medication Safety Issues
Sound-alike/look-alike issues:

DOPamine may be confused with DOBUTamine, Dopram

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

Adverse Reactions

The following adverse drug reactions are derived from product labeling unless otherwise specified.

Postmarketing:

Cardiovascular: Angina pectoris, atrial fibrillation, bradycardia, cardiac conduction disorder, ectopic beats, hypertension, hypotension, palpitations, tachycardia, vasoconstriction, ventricular arrhythmia, widened QRS complex on ECG

Dermatologic: Peripheral gangrene (with prolonged or high dose, can occur with low doses with concomitant occlusive vascular disease), piloerection

Gastrointestinal: Nausea, vomiting

Genitourinary: Azotemia

Nervous system: Anxiety, headache

Respiratory: Dyspnea

Contraindications

Hypersensitivity to sulfites (commercial preparation contains sodium bisulfite); pheochromocytoma; uncorrected tachyarrhythmias; ventricular fibrillation

Warnings/Precautions

Concerns related to adverse effects:

• Arrhythmias: May cause increases in heart rate, increasing the risk of tachycardia and other tachyarrhythmias including ventricular arrhythmias (Tisdale 1995). In heart transplant candidates, institute appropriate measures to protect patient against risks of sudden cardiac death (Young 2000).

• Extravasation: Vesicant; ensure proper needle or catheter placement prior to and during infusion. Avoid extravasation; infuse into a large vein if possible. Avoid infusion into leg veins. Watch IV site closely. [US Boxed Warning]: If extravasation occurs, infiltrate the area with diluted phentolamine (5 to 10 mg in 10 to 15 mL of saline) with a fine hypodermic needle. Phentolamine should be administered as soon as possible after extravasation is noted to prevent sloughing/necrosis.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular disease, cardiac arrhythmias and/or occlusive vascular disease.

• Active myocardial ischemia/post-myocardial infarction: Use with caution in patients with active myocardial ischemia or recent myocardial infarction; may increase myocardial oxygen consumption.

• Electrolyte imbalance: Correct electrolyte disturbances, especially hypokalemia or hypomagnesemia, prior to use and throughout therapy to minimize the risk of arrhythmias (ACC/AHA/ESC [Zipes 2006]; Tisdale 1995).

• Shock: The use of dopamine in adult patients with shock (majority of patients had septic shock) demonstrated a higher incidence of adverse events (eg, tachyarrhythmias) (De Backer 2010). Higher 28-day mortality was also seen in patients with septic shock with the use of dopamine as compared to norepinephrine (De Backer 2012; Vasu 2012).

Concurrent drug therapy issues:

• Monoamine oxidase inhibitors (MAO-I): Use with extreme caution in patients taking MAO inhibitors; prolong hypertension may result from concurrent use.

Dosage form specific issues:

• Sodium metabisulfite: Product may contain sodium metabisulfite.

Other warnings/precautions:

• Appropriate use: Assure adequate circulatory volume to minimize need for vasoconstrictors when used in hemodynamic support. Avoid hypertension; monitor blood pressure closely and adjust infusion rate.

Metabolism/Transport Effects

Substrate of COMT, OCT1, OCT2

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha-/Beta-Agonists. Similarly, Alpha-/Beta-Agonists may antagonize Alpha1-Blocker vasodilation. Risk C: Monitor therapy

Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Benzylpenicilloyl Polylysine: Alpha-/Beta-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Risk D: Consider therapy modification

Bretylium: May enhance the therapeutic effect of Alpha-/Beta-Agonists (Direct-Acting). Risk C: Monitor therapy

Bromocriptine: May enhance the hypertensive effect of Alpha-/Beta-Agonists. Management: Consider alternatives to this combination when possible. If combined, monitor for hypertension and tachycardia, and do not coadminister these agents for more than 10 days. Risk D: Consider therapy modification

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Chloroprocaine (Systemic): May enhance the hypertensive effect of Alpha-/Beta-Agonists. Risk C: Monitor therapy

CloZAPine: May diminish the therapeutic effect of Alpha-/Beta-Agonists. Risk C: Monitor therapy

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider therapy modification

COMT Inhibitors: May increase the serum concentration of COMT Substrates. Risk C: Monitor therapy

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Risk C: Monitor therapy

Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): May enhance the vasoconstricting effect of Alpha-/Beta-Agonists. Risk X: Avoid combination

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Hyaluronidase: May enhance the adverse/toxic effect of DOPamine. Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of dopamine. Use of hyaluronidase for other purposes in patients receiving dopamine may be considered as clinically indicated. Risk D: Consider therapy modification

Inhalational Anesthetics: May enhance the arrhythmogenic effect of DOPamine. Risk C: Monitor therapy

Kratom: May enhance the adverse/toxic effect of Sympathomimetics. Risk X: Avoid combination

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Risk D: Consider therapy modification

Lisuride: May enhance the hypertensive effect of Alpha-/Beta-Agonists. Risk X: Avoid combination

Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of DOPamine. Management: Initiate dopamine at no greater than one-tenth (1/10) of the usual dose in patients who are taking (or have taken within the last 2 to 3 weeks) monoamine oxidase inhibitors. Monitor for an exaggerated hypertensive response to dopamine. Risk D: Consider therapy modification

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Pergolide: May enhance the hypertensive effect of Alpha-/Beta-Agonists. Risk C: Monitor therapy

Serotonin/Norepinephrine Reuptake Inhibitors: May enhance the tachycardic effect of Alpha-/Beta-Agonists. Serotonin/Norepinephrine Reuptake Inhibitors may enhance the vasopressor effect of Alpha-/Beta-Agonists. Management: If possible, avoid coadministration of direct-acting alpha-/beta-agonists and serotonin/norepinephrine reuptake inhibitors. If coadministered, monitor for increased sympathomimetic effects (eg, increased blood pressure, chest pain, headache). Risk D: Consider therapy modification

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy

Spironolactone: May diminish the vasoconstricting effect of Alpha-/Beta-Agonists. Risk C: Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha-/Beta-Agonists. Management: Avoid, if possible, the use of alpha-/beta-agonists in patients receiving tricyclic antidepressants. If combined, monitor for evidence of increased pressor effects and consider reductions in initial dosages of the alpha-/beta-agonist. Risk D: Consider therapy modification

Vasopressin: Alpha-/Beta-Agonists (Direct-Acting) may enhance the hypertensive effect of Vasopressin. The effect of other hemodynamic parameters may also be enhanced. Risk C: Monitor therapy

Pregnancy Considerations

Medications required for the treatment of critically ill pregnant patients should not be withheld due to concerns of fetal teratogenicity (ACOG 2019; AHA [Jeejeebhoy 2015]). Medications used for the treatment of cardiac arrest in pregnancy are the same as in the nonpregnant patients. Dopamine use during the postresuscitation phase may be considered; however, the effects of vasoactive medications on the fetus should also be considered. Doses and indications should follow current Advanced Cardiovascular Life Support guidelines (AHA [Jeejeebhoy 2015]).

Breastfeeding Considerations

It is not known if dopamine is present in breast milk.

Monitoring Parameters

Note: General monitoring parameters are below; individualize monitoring and consult institutional policies and procedures.

BP, heart rate, ECG; hemodynamic parameters as appropriate (eg, CVP, RAP, CI, PCWP, SVR, ScvO2 or SvO2); end-organ perfusion (eg, urine output, mental status); infusion site for blanching/extravasation; intravascular volume status.

Mechanism of Action

Stimulates both adrenergic and dopaminergic receptors, lower doses are mainly dopaminergic stimulating and produce renal and mesenteric vasodilation, higher doses also are both dopaminergic and beta1-adrenergic stimulating and produce cardiac stimulation and renal vasodilation; large doses stimulate alpha-adrenergic receptors

Pharmacokinetics

Note: Children: Dopamine has exhibited nonlinear kinetics in children; with dose changes, may not achieve steady-state for ~1 hour rather than 20 minutes.

Onset of action: Adults: Within 5 minutes.

Duration: Adults: <10 minutes.

Metabolism: Renal, hepatic, plasma; 75% to inactive metabolites by monoamine oxidase and 25% to norepinephrine (active).

Half-life elimination: ~2 minutes.

Excretion: Urine (as metabolites).

Clearance: Neonates: Varies and appears to be age related; clearance is more prolonged with combined hepatic and kidney dysfunction.

Pricing: US

Solution (DOPamine HCl Intravenous)

40 mg/mL (per mL): $0.70 - $0.71

Solution (DOPamine in D5W Intravenous)

0.8 mg/mL 5% (per mL): $0.06

1.6 mg/mL 5% (per mL): $0.06 - $0.07

3.2 mg/mL 5% (per mL): $0.09

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • A Si Ke Ding (CN);
  • Admeda (HU);
  • Bagotropin (UY);
  • Cardiofast (PH);
  • Cardopa (BD);
  • Catabon (JP);
  • Cetadop (ID);
  • Cordodopa Forte (PT);
  • Domin (IN);
  • Dopacard (IN);
  • Dopacin (TZ);
  • Dopacris (BR);
  • Dopamax (PH);
  • Dopamex (TH);
  • Dopamin (BG, CH, DE, NO);
  • Dopamin AWD (HN);
  • Dopamin Giulini (HU, LU);
  • Dopamina (ES);
  • Dopamine (FR);
  • Dopamine Pierre Fabre (LU);
  • Dopaminex (BD);
  • Dopaminum (PL);
  • Dopamix (KR);
  • Dopar (IN, TW);
  • Dopasin (KR);
  • Dopasol (LK);
  • Dopasunny (EG);
  • Dopatropin (AR);
  • Dopavate (TW);
  • Dopazef (PH);
  • Dopina (VE);
  • Dopinga (IN);
  • Dopmin (DK, EE, FI, MY, RU, TR);
  • Dopnax (PH);
  • Dopress (IN);
  • Dopuramin (KR);
  • Drinalken (MX);
  • Dynatra (LU);
  • Emodopan (PE);
  • Giludop (AT, GR, SE, TR);
  • Glomin (ID);
  • Inopan (VN);
  • Inopin (TH);
  • Inotropisa (CO);
  • Inovan (JP);
  • Intropin (IE, PK);
  • Intropin IV (MY);
  • Limdopa (VN);
  • Medopa (MT, PT);
  • Megadose (AR, UY);
  • Myocard (PH);
  • Myotil (HK, LB);
  • Pamin (BD);
  • Pre Dopa (JP);
  • Proinfark (ID);
  • Revivan (IT);
  • Tensamin (CZ, SK);
  • Tropin (KR, PK, SG);
  • Udopa (KR);
  • Uramin (TW);
  • Zetarina (MX)


For country code abbreviations (show table)
  1. Adams C, Tucker C, Allen B, et al. Disparities in hemodynamic resuscitation of the obese critically ill septic shock patient. J Crit Care. 2017;37:219-223. doi:10.1016/j.jcrc.2016.10.004 [PubMed 27969574]
  2. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 211: Critical care in pregnancy. Obstet Gynecol. 2019;133(5):e303-e319. doi:10.1097/AOG.0000000000003241 [PubMed 31022122]
  3. American Heart Association (AHA). CPR & First Aid: Emergency Cardiovascular Care. Adult Bradycardia Algorithm. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms. Published 2020. Accessed January 29, 2021.
  4. American Society of Health-System Pharmacists (ASHP). Pediatric continuous infusion standards. Available at https://www.ashp.org/-/media/assets/pharmacy-practice/s4s/docs/Pediatric-Infusion-Standards.ashx. Updated January 2021. Accessed April 4, 2022.
  5. Arabi YM, Dara SI, Tamim HM, et al; Cooperative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group. Clinical characteristics, sepsis interventions and outcomes in the obese patients with septic shock: an international multicenter cohort study. Crit Care. 2013;17(2):R72. doi:10.1186/cc12680 [PubMed 23594407]
  6. Argalious M, Motta P, Khandwala F, et al. "Renal dose" dopamine is associated with the risk of new-onset atrial fibrillation after cardiac surgery. Crit Care Med. 2005;33(6):1327-1332. [PubMed 15942351]
  7. Avni T, Lador A, Lev S, Leibovici L, Paul M, Grossman A. Vasopressors for the treatment of septic shock: systematic review and meta-analysis. PLoS One. 2015;10(8):e0129305. doi:10.1371/journal.pone.0129305 [PubMed 26237037]
  8. Bellomo R, Chapman M, Finfer S, et al. Low-dose Dopamine in Patients With Early Renal Dysfunction: A Placebo-Controlled Randomised Trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet. 2000;356(9248):2139-2143. [PubMed 11191541]
  9. Cardenas-Garcia J, Schaub KF, Belchikov YG, Narasimhan M, Koenig SJ, Mayo PH. Safety of peripheral intravenous administration of vasoactive medication. J Hosp Med. 2015;10(9):581-5. doi:10.1002/jhm.2394 [PubMed 26014852]
  10. Chan TY. Low-Dose Dopamine in Severe Right Heart Failure and Chronic Obstructive Pulmonary Disease. Ann Pharmacother. 1995;29(5):493-496. [PubMed 7655133]
  11. Chen HH, Anstrom KJ, Givertz MM, et al. Low-dose dopamine or low-dose nesiritide in acute heart failure with renal dysfunction: the ROSE acute heart failure randomized trial. JAMA. 2013;310(23):2533-2543. [PubMed 24247300]
  12. Davis AL, Carcillo JA, Aneja RK, et al. American College of Critical Care Medicine (ACCM) clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Crit Care Med. 2017;45(6):1061-1093. doi:10.1097/CCM.0000000000002425 [PubMed 28509730]
  13. De Backer D, Aldecoa C, Njimi H, et al. Dopamine versus Norepinephrine in the Treatment of Septic Shock: A Meta-Analysis. Crit Care Med. 2012;40(3):725-730. [PubMed 22036860]
  14. De Backer D, Biston P, Devriendt J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362(9):779-789. [PubMed 20200382]
  15. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637. doi:10.1097/CCM.0b013e31827e83af [PubMed 23353941]
  16. Dempsey E, Rabe H. The use of cardiotonic drugs in neonates. Clin Perinatol. 2019;46(2):273-290. doi:10.1016/j.clp.2019.02.010 [PubMed 31010560]
  17. Denkler KA, Cohen BE. Reversal of dopamine extravasation injury with topical nitroglycerin ointment. Plast Reconstr Surg. 1989;84(5):811-813. [PubMed 2510208]
  18. Domonoske C. Appendix A: Common neonatal intensive care unit (NICU) medication guidelines. In: Eichenwald EC, Hansen AR, Martin CR, Stark AR. Cloherty and Stark's Manual of Neonatal Care. 8th ed. Lippincott Williams & Wilkins; 2017.
  19. Dopamine HCL injection solution [prescribing information]. Shirley, NY: American Regent Inc; March 2014.
  20. Dopamine Hydrochloride Injection (Fliptop, Pintop, LifeShield Fliptop Vials) [prescribing information]. Lake Forest, IL: Hospira; February 2019.
  21. Dopamine Hydrochloride in 5% Dextrose Injection [prescribing information]. Lake Forest, IL: Hospira; April 2021.
  22. Elkayam U, Ng TM, Hatamizadeh P, Janmohamed M, Mehra A. Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action. Circulation. 2008;117(2):200-205. J Card Fail. 2010;16(12):922-930. [PubMed 18172028]
  23. Erstad BL, Barletta JF. Drug dosing in the critically ill obese patient: a focus on medications for hemodynamic support and prophylaxis. Crit Care. 2021;25(1):77. doi:10.1186/s13054-021-03495-8 [PubMed 33622380]
  24. Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):e1063-e1143. doi:10.1097/CCM.0000000000005337 [PubMed 34605781]
  25. Field JM, Hazinski MF, Sayre MR, et al. Part 1: Executive Summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):640-656. [PubMed 20956217]
  26. Friedrich JO, Adhikari N, Herridge MS, Beyene J. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med. 2005;142(7):510-524. [PubMed 15809463]
  27. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
  28. Hollenberg SM, Ahrens TS, Annane D, et al. Practice Parameters for Hemodynamic Support of Sepsis in Adult Patients: 2004 Update. Crit Care Med. 2004;32(9):1928-1948. [PubMed 15343024]
  29. Hollenberg SM. Vasoactive drugs in circulatory shock. Am J Respir Crit Care Med. 2011;183(7):847-855. doi:10.1164/rccm.201006-0972CI [PubMed 21097695]
  30. Hurst S, McMillan M. Innovative Solutions in Critical Care Units: Extravasation Guidelines. Dimens Crit Care Nurs. 2004;23(3):125-128. [PubMed 15192356]
  31. Institute for Safe Medication Practice (ISMP) and Vermont Oxford Network. Standard Concentrations of Neonatal Drug Infusions. 2011. https://www.ismp.org/Tools/PediatricConcentrations.pdf
  32. Jeejeebhoy FM, Zelop CM, Lipman S, et al; American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Diseases in the Young, Council on Clinical Cardiology. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132(18):1747-1773. doi:10.1161/CIR.0000000000000300 [PubMed 26443610]
  33. Johnson RL Jr. Low-Dose Dopamine and Oxygen Transport by the Lung. Circulation. 1998;98(2):97-99. [PubMed 9679713]
  34. Kellum JA, Decker J. Use of Dopamine in Acute Renal Failure: A Meta-Analysis. Crit Care Med. 2001;29(8):1526-1531. [PubMed 11505120]
  35. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012;2(suppl 1):1-138. http://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO%20AKI%20Guideline.pdf.
  36. Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):S876-S908. [PubMed 20956230]
  37. Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(7):e51-e156. doi:10.1016/j.jacc.2018.10.044 [PubMed 30412709]
  38. Lamontagne F, Richards-Belle A, Thomas K, et al; 65 trial investigators. Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA. 2020;323(10):938–49. doi:10.1001/jama.2020.0930 [PubMed 32049269]
  39. Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 Update. Crit Care Med. 2018;46(6):997-1000. doi: 10.1097/CCM.0000000000003119 [PubMed 29767636]
  40. Lewis T, Merchan C, Altshuler D, Papadopoulos J. Safety of the peripheral administration of vasopressor agents. J Intensive Care Med. 2019;34(1):26-33. doi:10.1177/0885066616686035 [PubMed 28073314]
  41. Manaker S. Use of vasopressors and inotropes. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed November 22, 2021.
  42. Martin C, Papazian L, Perrin G, et al. Norepinephrine or Dopamine for the Treatment of Hyperdynamic Septic Shock? Chest. 1993;103(6):1826-1831. [PubMed 8404107]
  43. Medlej K, Kazzi AA, El Hajj Chehade A, et al. Complications from administration of vasopressors through peripheral venous catheters: an observational study. J Emerg Med. 2018;54(1):47-53. doi:10.1016/j.jemermed.2017.09.007 [PubMed 29110979]
  44. Murray KL, Wright D, Laxton B, Miller KM, Meyers J, Englebright J. Implementation of standardized pediatric i.v. medication concentrations. Am J Health Syst Pharm. 2014;71(17):1500-1508. [PubMed 25147175]
  45. Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):S729-S767. [PubMed 20956224]
  46. Panchal AR, Bartos JA, Cabañas JG, et al; Adult Basic and Advanced Life Support Writing Group. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16)(suppl 2):S366-S468. doi:10.1161/CIR.0000000000000916 [PubMed 33081529]
  47. Patel GP, Grahe JS, Sperry M, et al. Efficacy and Safety of Dopamine versus Norepinephrine in the Management of Septic Shock. Shock. 2010;33(4):375-380. [PubMed 19851126]
  48. Peberdy MA, Callaway CW, Neumar RW, et al. Part 9: Post Cardiac Arrest Care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):768-786. [PubMed 20956225]
  49. Phillips MS. Standardizing I.V. Infusion Concentrations: National Survey Results. Am J Health Syst Pharm. 2011;68(22):2176-2182. [PubMed 22058104]
  50. Prasanna N, Yamane D, Haridasa N, Davison D, Sparks A, Hawkins K. Safety and efficacy of vasopressor administration through midline catheters. J Crit Care. 2021;61:1-4. doi:10.1016/j.jcrc.2020.09.024 [PubMed 33049486]
  51. Radosevich JJ, Patanwala AE, Erstad BL. Norepinephrine dosing in obese and nonobese patients with septic shock. Am J Crit Care. 2016;25(1):27-32. doi:10.4037/ajcc2016667 [PubMed 26724290]
  52. Reynolds PM, Maclaren R, Mueller SW, Fish DN, Kiser TH. Management of extravasation injuries: a focused evaluation of noncytotoxic medications. Pharmacotherapy. 2014;34(6):617-632. [PubMed 24420913]
  53. Rhodes A, Evans LE, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(3):304-377. doi:10.1007/s00134-017-4683-6 [PubMed 28101605]
  54. Russell JA, Gordon AC, Williams MD, Boyd JH, Walley KR, Kissoon N. Vasopressor therapy in the intensive care unit. Semin Respir Crit Care Med. 2021;42(1):59-77. doi:10.1055/s-0040-1710320 [PubMed 32820475]
  55. Sakr Y, Reinhart K, Vincent JL, et al. Does Dopamine Administration in Shock Influence Outcome? Results of the Sepsis Occurrence in Acutely Ill Patients (SOAP) Study. Crit Care Med. 2006;34(3):589-597. [PubMed 16505643]
  56. Shenoi RP, Timm N; Committee on Drugs; Committee on Pediatric Emergency Medicine. Drugs used to treat pediatric emergencies. Pediatrics. 2020;145(1):e20193450. [PubMed 31871244]
  57. Stier PA, Bogner MP, Webster K, et al. Use of Subcutaneous Terbutaline to Reverse Peripheral Ischemia. Am J Emerg Med. 1999;17(1):91-94. [PubMed 9928712]
  58. Tian DH, Smyth C, Keijzers G, et al. Safety of peripheral administration of vasopressor medications: a systematic review. Emerg Med Australas. 2020;32(2):220-227. doi:10.1111/1742-6723.13406 [PubMed 31698544]
  59. Tisdale JE, Patel R, Webb CR, Borzak S, Zarowitz BJ. Electrophysiologic and proarrhythmic effects of intravenous inotropic agents. Prog Cardiovasc Dis. 1995;38(2):167-180. [PubMed 7568905]
  60. Triposkiadis FK, Butler J, Karayannis G, et al. Efficacy and safety of high dose versus low dose furosemide with or without dopamine infusion: The Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) trial. Int J Cardiol. 2014;172(1):115-121. [PubMed 24485633]
  61. Vadiei N, Daley MJ, Murthy MS, Shuman CS. Impact of norepinephrine weight-based dosing compared with non-weight-based dosing in achieving time to goal mean arterial pressure in obese patients with septic shock. Ann Pharmacother. 2017;51(3):194-202. doi:10.1177/1060028016682030 [PubMed 27886982]
  62. van de Borne P, Oren R, Somers VK. Dopamine Depresses Minute Ventilation in Patients With Heart Failure. Circulation. 1998;98(2):126-131. [PubMed 9679718]
  63. van Diepen S, Katz JN, Albert NM, et al; American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; Mission: Lifeline. Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation. 2017;136(16):e232-e268. doi:10.1161/CIR.0000000000000525 [PubMed 28923988]
  64. Vanden Hoek TL, Morrison LJ, Shuster M, et al. Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18)(suppl 3):S836. [PubMed 20956228]
  65. Vasu TS, Cavallazzi R, Hirani A, et al. Norepinephrine or Dopamine for Septic Shock: Systematic Review of Randomized Clinical Trials. J Intensive Care Med. 2012;27(3):172-178. [PubMed 21436167]
  66. Weiss SL, Peters MJ, Alhazzani W, et al. Surviving Sepsis Campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Pediatr Crit Care Med. 2020;21(2):e52-e106. doi:10.1097/PCC.0000000000002198 [PubMed 32032273]
  67. Wong AF, McCulloch LM, Sola A. Treatment of Peripheral Tissue Ischemia With Topical Nitroglycerin Ointment in Neonates. J Pediatr. 1992;121(6):980-983. [PubMed 1447671]
  68. Young JB, Moen EK. Outpatient parenteral inotropic therapy for advanced heart failure. J Heart Lung Transplant. 2000;19(8)(suppl):s49-s57. [PubMed 11016488]
  69. Zipes DP, Camm AJ, Borggrefe M, et al; American College of Cardiology/American Heart Association Task Force; European Society of Cardiology Committee for Practice Guidelines; European Heart Rhythm Association; Heart Rhythm Society. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(10):e385-e484. [PubMed 16935995]
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