Side Effects of Dopamine Injection

Dopamine is prescribed to correct hemodynamic status in patients with shock syndrome due to

• heart attack (myocardial infarction),
• trauma,
• open-heart surgery,
• renal failure,
• congestive heart failure, and
• other causes of shock syndrome. 

This means dopamine may be capable of improving urine flow, blood pressure, blood flow to vital organs, and improving heart function in patients with shock syndrome.

Common side effects of dopamine include

• disordered breathing,
• nausea,
• vomiting,
• headache, and
• increased blood urea nitrogen (BUN).

Serious side effects of dopamine include

• abnormal heart rhythm,
• increased or decreased blood pressure,
• increased pressure in the eye, and
• gangrene in the extremities.

Drug interactions of dopamine include selegiline, linezolid, and MAO inhibitors due to increased risk of a hypertensive episode. Dopamine should not be used with tricyclic antidepressants that increase dopamine and norepinephrine due to increased risk of hypertension and abnormal heart rate and rhythm. 

There are no adequate studies done on dopamine to determine its safe and effective use in pregnant women. It is unknown if dopamine enters breast milk; therefore, it is best to be cautious before using it in breastfeeding mothers.

Common side effects of dopamine include

• disordered breathing,
• nausea,
• vomiting,
• headache, and
• increased blood urea nitrogen.

Serious side effects of dopamine include

• abnormal heart rhythm,
• increased or decreased blood pressure,
• increased pressure in the eye, and
• gangrene in the extremities.

The following adverse reactions have been observed, but there are not enough data to support an estimate of their frequency.

Cardiovascular System

• ventricular arrhythmia (at very high doses),
• atrial fibrillation,
• ectopic beats,
• tachycardia,
• anginal pain,
• palpitation,
• cardiac conduction abnormalities,
• widened QRS complex,
• bradycardia,
• hypotension,
• hypertension,
• vasoconstriction

Respiratory System

• dyspnea

Gastrointestinal System

• nausea,
• vomiting

Metabolic/Nutritional System

• azotemia

Central Nervous System

• headache,
• anxiety

Dermatological System

• piloerection

Other

Gangrene of the extremities has occurred when high doses were administered for prolonged periods or in patients with occlusive vascular disease receiving low doses of dopamine HCl.

1. Because dopamine is metabolized by monoamine oxidase (MAO), inhibition of this enzyme prolongs and potentiates the effect of dopamine. Patients who have been treated with MAO inhibitors within two to three weeks prior to the administration of dopamine HCl should receive initial doses of dopamine HCl no greater than one-tenth (1/10) of the usual dose.
2. Concurrent administration of dopamine HCl and diuretic agents may produce an additive or potentiating effect on urine flow.
3. Tricyclic antidepressants may potentiate the pressor response to adrenergic agents.
4. Cardiac effects of dopamine are antagonized by beta-adrenergic blocking agents, such as propranolol and metroprolol. The peripheral vasoconstriction caused by high doses of dopamine HCl is antagonized by alpha-adrenergic blocking agents. Dopamine-induced renal and mesenteric vasodilation is not antagonized by either alpha- or beta-adrenergic blocking agents.
5. Haloperidol appears to have strong central antidopaminergic properties. Haloperidol and haloperidol-like drugs suppress the dopaminergic renal and mesenteric vasodilation induced at low rates of dopamine infusion.
6. Cyclopropane or halogenated hydrocarbon anesthetics increase cardiac autonomic irritability and may sensitize the myocardium to the action of certain intravenously administered catecholamines, such as dopamine. The interaction appears to be related both to pressor activity and to the beta-adrenergic stimulating properties of these catecholamines, and may produce ventricular arrhythmias. Therefore, EXTREME CAUTION should be exercised when administering dopamine HCl to patients receiving cyclopropane or halogenated hydrocarbon anesthetics. It has been reported that results of studies in animals indicated that dopamine-induced ventricular arrhythmias during anesthesia can be reversed by propranolol.
7. The concomitant use of vasopressors, vasoconstricting agents and some oxytocic drugs may result in severe persistent hypertension. See Labor and Delivery below.
8. Administration of phenytoin to patients receiving dopamine HCl has been reported to lead to hypotension and bradycardia. It is suggested that in patients receiving dopamine HCl, alternatives to phenytoin should be used if anticonvulsant therapy is needed.