dobutamine (injection; Dobutrex)

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GENERIC NAME: dobutamine injection

BRAND NAMES: Dobutrex (Brand name is no longer available in the US)

DRUG CLASS AND MECHANISM: Dobutamine is a synthetic drug that stimulates receptors (beta-1 receptors) on the heart. It is classified as a catecholamine. Other catecholamines include epinephrine, dopamine, and isoproterenol. Stimulating beta-1 receptors receptor causes an increase in the force of the heart's contraction, therefore increasing cardiac output which is the amount of blood pumped by the heart. Unlike other catecholamines, dobutamine has minimal effects on heart rate, which helps to decrease the chance of irregular heartbeats. Dobutamine does not have significant effects on blood pressure. The FDA approved dobutamine in July 1978.



PREPARATIONS: Intravenous solution: 250, 500, 1000 mg in 250 mL, 250 mg in 20 mL, 500 mg in 40 mL

STORAGE: Vials should be stored at room temperature, between 15 C to 30 C (59 F to 86 F). Once diluted, dobutamine may be stored in the refrigerator (4 C) for 7 days or up to 48 hours at room temperature.

PRESCRIBED FOR: Dobutamine is prescribed to help increase cardiac output in a failing heart due to heart disease or cardiac surgery.

DOSING: The initial dose for adults is based on the indication and severity of heart failure. Dosing is 0.5 to 1 micrograms per kilogram body weight per minute followed by an intravenous infusion of 2 to 20 micrograms per kilogram body weight per minute. Maximum dose is 40 micrograms per kilogram per minute.

DRUG INTERACTIONS: Use caution when combining dobutamine with other agents that increase heart rate or blood pressure (sympathomimetics), such as atomoxetine (Strattera), dopamine, and epinephrine. Use lower doses of dobutamine initially if the patient is also on linezolid (Zyvox) as there is a risk of significant increase in blood pressure. Calcium salts may decrease the effect of dobutamine, so monitor closely.

PREGNANCY: Available evidence suggests that dobutamine may be safely used in pregnancy.

NURSING MOTHERS: Dobutamine should be used cautiously by nursing mothers as it is unknown whether it is excreted in breast milk.

SIDE EFFECTS: The most frequent adverse reactions include increased heart rate, increased blood pressure, irregular ventricular beats, and chest pain. Fever, headache, nausea, low blood pressure, and shortness of breath have also been reported.

REFERENCE: FDA Prescribing Information.

Medically Reviewed by a Doctor on 6/26/2014

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