DOPAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: safe
MAOIs can cause severe hypertension Extravasation can cause tissue necrosis and sloughing.
Dopamine hydrochloride stimulates both dopaminergic (D1 and D2) and adrenergic (β1 and α1) receptors. At low doses, it primarily activates D1 receptors in renal and mesenteric vessels causing vasodilation. At moderate doses, it stimulates β1 receptors increasing cardiac contractility and heart rate. At high doses, it activates α1 receptors causing vasoconstriction.
| Metabolism | Dopamine is metabolized by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) in the liver, kidney, and plasma to homovanillic acid and other inactive metabolites. |
| Excretion | Renal: 75-80% as metabolites (homovanillic acid, dihydroxyphenylacetic acid) and ~25% as unchanged drug; biliary: <5%. |
| Half-life | Terminal half-life approximately 2 minutes. Clinical context: requires continuous intravenous infusion; abrupt cessation may cause hypotension. |
| Protein binding | 25% bound, primarily to albumin. |
| Volume of Distribution | Vd: 0.89 L/kg; distributes extensively into tissues including heart, brain, and kidneys. |
| Bioavailability | Intravenous: 100%; oral: <1% due to extensive first-pass metabolism; not administered orally. |
| Onset of Action | Intravenous: 2-5 minutes. |
| Duration of Action | Intravenous: 5-10 minutes; effects cease shortly after infusion stops due to rapid metabolism. |
Intravenous infusion: 2-20 mcg/kg/min. Titrate to desired hemodynamic response; typical range 5-10 mcg/kg/min.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for renal impairment; monitor for arrhythmias and ischemia in severe renal dysfunction. |
| Liver impairment | No specific dose adjustment; use with caution due to altered metabolism in severe hepatic impairment. |
| Pediatric use | Intravenous infusion: 2-20 mcg/kg/min; titrate to effect. Start at low end and increase gradually. |
| Geriatric use | Start at low end of dosing range (2-5 mcg/kg/min); titrate slowly due to increased risk of arrhythmias and ischemia. |
| 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 has a high molecular weight and is poorly lipid soluble, making it unlikely to transfer into breast milk in significant amounts. M/P ratio is unknown; systemic levels after IV infusion may be minimal. However, due to its potent vasoactive effects, use during breastfeeding should be cautious and only if clearly needed. |
| Teratogenic Risk |
■ FDA Black Box Warning
None
| Common Effects | hypotension |
| Serious Effects |
["Hypersensitivity to dopamine or any component","Pheochromocytoma","Ventricular fibrillation or tachyarrhythmias","Uncorrected hypovolemia"]
| Precautions | ["Hypovolemia should be corrected prior to administration.","Extravasation may cause tissue necrosis; administer via large vein.","Use with caution in patients with occlusive vascular disease.","Monitor cardiac function, blood pressure, and urine output.","May increase myocardial oxygen demand; risk of arrhythmias.","Do not add to alkaline solutions (e.g., sodium bicarbonate).","Use with caution in patients taking MAO inhibitors."] |
Loading safety data…
| Dopamine is a catecholamine used for hemodynamic support. There is limited data on use in pregnancy. Animal studies have not been conclusive. In the first trimester, theoretical risk of reduced uteroplacental blood flow due to alpha-adrenergic effects. In the second and third trimesters, dopamine can cause uterine contractions and placental vasoconstriction, potentially leading to fetal hypoxia. Risk cannot be excluded. |
| Fetal Monitoring | Continuous maternal blood pressure, heart rate, ECG, and urine output monitoring. Fetal heart rate monitoring should be considered during infusion, especially in the third trimester, due to possible uteroplacental insufficiency. Assess for signs of tissue ischemia and extravasation at infusion site. |
| Fertility Effects | No specific studies on human fertility. Dopamine infusion may alter hypothalamic-pituitary function and inhibit prolactin secretion, potentially affecting ovulation in women. In males, dopamine can affect gonadotropin release. Clinical relevance is uncertain; effects likely reverse after discontinuation. |