dobutamine

Dobutamine is a synthetic catecholamine prescribed to help increase cardiac output in a failing heart due to heart disease or cardiac surgery. Dobutamine injection is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.

In patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine hydrochloride.

The most frequent adverse reactions include

• increased heart rate,
• increased blood pressure,
• irregular ventricular beats, and
• chest pain.

Other important side effects include

• fever,
• headache,
• nausea, and
• shortness of breath.

Serious side effects of dobutamine include

• abnormal heart beats,
• increased heart rate,
• low blood pressure,
• chest pain,
• fainting , and
• eosinophilic myocarditis.

• 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.

• 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.

• Available evidence suggests that dobutamine may be safely used in pregnancy.
• Dobutamine should be used cautiously by nursing mothers as it is unknown whether it is excreted in breast milk.

What preparations of dobutamine-injection are available?

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

How should I keep dobutamine-injection stored?

• 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.