What is Corlopam, and how does it work?
Corlopam (fenoldopam mesylate) Injection is a dopamine receptor agonist (vasodilator) used for in-hospital, short-term (up to 48 hours) management of severe high blood pressure (hypertension) when rapid, but quickly reversible, emergency reduction of blood pressure is indicated. Corlopam is available in generic form.
What is the dosage for Corlopam?
- Initiate dosing at 0.01 to 0.3 mcg/kg/min as a continuous intravenous infusion.
- Dosing may be increased in increments of 0.05 to 0.1 mcg/kg/minute every 15 minutes or longer, until target blood pressure is reached; the maximal infusion rate reported in clinical studies was 1.6 mcg/kg/minute.
- Doses lower than 0.1 mcg/kg/min and slow up-titration have been associated with less reflex tachycardia.
- Maintenance infusions may be continued for up to 48 hours.
- Oral antihypertensive agents can be added during fenoldopam infusion or after discontinuation.
- Initiate dosing at 0.2 mcg/kg/minute and titrate dose by 0.3 to 0.5 mcg/kg/min every 20-30 minutes to a maximum dose of 0.8 mcg/kg/minute.
- Higher doses generally produced no further decreases in MAP but did worsen tachycardia.
Preparation And Administration
- Dilute contents of ampules or vials with 0.9% Sodium Chloride Injection or 5% Dextrose in Water before infusion.
- Each ampule or vial is for single use only. Discard diluted solution if not being administered to a patient after 4 hours at room temperature or 24 hours at refrigerated temperature.
- Inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit.
- If particulate matter or cloudiness is observed, discard the drug.
Table 1: Dilution Instructions for Adults
|mL of Concentrate (mg of drug)||Added to||Final Concentration|
|4 mL (40 mg)||1000 mL||40 mcg/mL|
|2 mL (20 mg)||500 mL||40 mcg/mL|
|1 mL (10 mg)||250 mL||40 mcg/mL|
Table 2: Dilution Instructions for Pediatric Patients
|mL of Concentrate (mg of drug)||Added to||Final Concentration|
|3 mL (30 mg)||500 mL||60 mcg/mL|
|1.5 mL (15 mg)||250 mL||60 mcg/mL|
|0.6 mL (6 mg)||100 mL||60 mcg/mL|
Rates of infusion in mL/hour for fenoldopam may be calculated using the following formula:
|Infusion Rate (mL/h) =||[Dose (mcg/kg/min) x Weight (kg) x 60 min/h]|
Example 1: for a 60 kg patient at an initial dose of 0.01 mcg/kg/min using a 40 mcg/mL concentration, the infusion rate would be as follows:
|Infusion Rate (mL/h) =||[0.01 (mcg/kg/min) x 60 (kg) x 60 (min/h)] = 0.9 (mL/h)|
Example 2: for a 10 kg patient at a dose of 0.2 mcg/kg/min using a 60 mcg/mL concentration, the infusion rate would be as follows:
|Infusion Rate (mL/h) =||[0.2 (mcg/kg/min) x 10 (kg) x 60 (min/h)] = 2.0 (mL/h)|
What drugs interact with Corlopam?
- Avoid concomitant use of fenoldopam with beta-blockers.
- If the drugs are used together, blood pressure should be monitored frequently because hypotension could result from beta-blocker inhibition of the sympathetic reflex response to fenoldopam.
Is Corlopam safe to use while pregnant or breastfeeding?
- Studies have revealed maternal toxicity at the highest doses tested but no evidence of impaired fertility or harm to the fetus due to fenoldopam.
- There are, however, no adequate and well-controlled studies in pregnant women.
- Fenoldopam is excreted in milk in rats. It is not known whether this drug is excreted in human milk.
- Because many drugs are excreted in human milk, discontinue nursing or fenoldopam.
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Corlopam (fenoldopam mesylate) Injection is a dopamine receptor agonist (vasodilator) used for in-hospital, short-term (up to 48 hours) management of severe high blood pressure (hypertension) when rapid, but quickly reversible, emergency reduction of blood pressure is indicated.
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High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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Things to Know About High Blood Pressure Treatment
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Pulmonary hypertension is elevated pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur. As pulmonary hypertension worsens, some people with the condition have difficulty performing any activities that require physical exertion. While there is no cure for pulmonary hypertension, it can be managed and treated with medications and supplemental oxygen to increase blood oxygen levels.
Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
What Is High Blood Pressure (Hypertension)?
High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Blood pressure readings above 180/120 mmHg are dangerously high and require immediate medical attention.
High Blood Pressure Symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. In some patients, symptoms may include fatigue, headaches, dizziness, confusion, sweating, chest pain and vision problems.
Treatment & Diagnosis
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