Corlopam (fenoldopam mesylate) Injection

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.

Common side effects of Corlopam include

• headache,
• flushing (warmth, redness, or tingly feeling, particularly in the face and neck),
• nausea,
• low blood pressure (hypotension),
• fast heartbeat, and
• low blood potassium.

Recommended Dosage

Adult Patients

• 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.

Pediatric Patients

• 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

Table 2: Dilution Instructions for Pediatric Patients

Rates of infusion in mL/hour for fenoldopam may be calculated using the following formula:

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:

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:

Beta-Blockers

• 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.

• 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.