DOPAMINE HYDROCHLORIDE AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: safe
MAOIs can cause severe hypertension Extravasation can cause tissue necrosis and sloughing.
Dopamine is a catecholamine neurotransmitter that acts on D1-like (D1, D5) and D2-like (D2, D3, D4) dopamine receptors, as well as β1-adrenergic and α1-adrenergic receptors. At low doses, it primarily stimulates D1 receptors in renal and mesenteric beds causing vasodilation; at moderate doses, it stimulates β1 receptors increasing cardiac contractility and heart rate; at high doses, it stimulates α1 receptors causing vasoconstriction and increased systemic vascular resistance.
| Metabolism | Metabolized primarily in the liver, kidneys, and plasma by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) to inactive metabolites (homovanillic acid [HVA] and 3,4-dihydroxyphenylacetic acid [DOPAC]). Approximately 25% is metabolized to norepinephrine via dopamine β-hydroxylase. |
| Excretion | Renal elimination of metabolites (homovanillic acid and other conjugates): ~80-85% within 24 hours; less than 10% excreted unchanged; minor biliary/fecal elimination (<5%). |
| Half-life | Terminal elimination half-life: approximately 2 minutes (dopamine itself); clinical context: due to rapid metabolism, continuous IV infusion is required for sustained effect. |
| Protein binding | ~75% bound to albumin; also binds to alpha-1 acid glycoprotein. |
| Volume of Distribution | 0.89 L/kg; indicates extensive distribution into total body water and tissues. |
| Bioavailability | Oral: negligible (<5%) due to extensive first-pass metabolism; IV: 100%. |
| Onset of Action | IV infusion: within 2-5 minutes for increased cardiac contractility and blood pressure; immediate for renal vasodilation. |
| Duration of Action | Duration: 5-10 minutes after infusion cessation; dose-dependent; clinical note: short duration necessitates continuous infusion for hemodynamic support. |
IV infusion: 2-20 mcg/kg/min, titrated to desired hemodynamic response. For adults, typical starting dose is 2-5 mcg/kg/min, with increments of 1-4 mcg/kg/min every 10-30 minutes until goal blood pressure or urine output achieved.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for GFR. Dopamine is primarily metabolized in the liver and kidney; however, in severe renal impairment (eGFR <15 mL/min), consider alternative vasopressors due to potential accumulation of active metabolites? Actually, dopamine dose is titrated to effect regardless of renal function, but caution in oliguric patients. |
| Liver impairment | No specific Child-Pugh based dose adjustment. Liver failure may reduce clearance, but titration to clinical response remains standard. Monitor for excessive effects. |
| Pediatric use | IV infusion: 2-20 mcg/kg/min starting at 2-5 mcg/kg/min, titrated to effect. Maximum 20 mcg/kg/min in most guidelines. Use dextrose 5% as diluent, but caution in neonates due to risk of hyperglycemia. |
| Geriatric use | Lower initial doses (1-2 mcg/kg/min) and slower titration recommended due to increased sensitivity and higher risk of arrhythmias and excessive vasoconstriction. Monitor cardiac function and hemodynamic parameters closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
MAOIs can cause severe hypertension Extravasation can cause tissue necrosis and sloughing.
| FDA category | Animal |
| Breastfeeding | Dopamine is likely excreted into human milk in low amounts due to its molecular weight and short half-life. No specific M/P ratio available. Intravenous dopamine has poor oral bioavailability, so infant ingestion via milk is minimal. However, consider discontinuing breastfeeding during infusion due to potential adverse effects (e.g., tachycardia) if infant absorbs. No data on long-term effects. |
| Teratogenic Risk |
■ FDA Black Box Warning
None.
| Common Effects | hypotension |
| Serious Effects |
["Hypersensitivity to dopamine or any component","Pheochromocytoma","Ventricular fibrillation or tachycardia","Uncorrected tachyarrhythmias","Concurrent use of MAO inhibitors (may cause hypertensive crisis)"]
| Precautions | ["May cause ventricular arrhythmias, especially in patients with preexisting arrhythmias or myocardial ischemia","Hypotension may occur at low infusion rates due to D1-mediated vasodilation","Extravasation can cause tissue necrosis and sloughing; administer via central line or large vein","Use with caution in patients with occlusive vascular disease (e.g., atherosclerosis, Raynaud's) as it may exacerbate vasoconstriction","Avoid alkaline solutions (dopamine is inactivated in alkaline pH)"] |
Loading safety data…
| Dopamine is a sympathomimetic amine. No adequate and well-controlled studies in pregnant women. In animal studies, dopamine has not been shown to be teratogenic. However, uteroplacental blood flow may decrease due to alpha-adrenergic effects. Use only if potential benefit justifies risk. First trimester: limited data, theoretical risk of vasoconstriction affecting placental perfusion. Second and third trimesters: risk of reduced uterine blood flow and potential fetal hypoxia. Avoid if possible; monitor fetal heart rate. |
| Fetal Monitoring | Monitor maternal blood pressure, heart rate, ECG, urine output, and peripheral perfusion. Fetal monitoring: continuous fetal heart rate and uterine contraction monitoring during labor; assess for signs of fetal distress (late decelerations, tachycardia). Monitor for maternal arrhythmias and hypertensive episodes. |
| Fertility Effects | Dopamine modulates prolactin secretion; elevated prolactin can impair fertility. Exogenous dopamine may suppress prolactin via D2 receptor agonism, potentially improving fertility in hyperprolactinemic states. In normoprolactinemic individuals, impact on fertility is minimal. No specific studies on fertility with intravenous dopamine. |