Dobutamine Hydrochloride Inj

Dobutamine Information

Dobutamine is indicated in the treatment of adults with cardiac decompensation due to depressed contractility resulting from organic heart disease or following cardiac surgical procedures in which parenteral therapy is necessary for inotropic support.

Dobutamine Warnings

During the administration of dobutamine, ECG, heart rate and blood pressure should be continuously monitored, as with any adrenergic agent. In addition, monitoring of cardiac output and pulmonary wedge pressure should be performed whenever possible to aid in the safe and effective infusion of dobutamine injection. Dobutamine may cause a marked increase in blood pressure, especially systolic pressure or in heart rate. There appears to be an increased risk in patients with pre-existing hypertension of developing an exaggerated pressor response. A reduction of dosage usually results in a prompt reversal of these effects. Dobutamine may exacerbate or precipitate ventricular ectopic activity but has rarely caused ventricular tachycardia. There are contra indications in patients with idiopathic hypertrophic subaortic stenosis, in patients with Pheochromocytoma, and in those patients with hypersensitivity to dobutamine. Following the administration of dobutamine, reactions suggestive of hypersensitivity including skin rash, fever, eosinophilia, and bronchospasm have been reported occasionally. Dobutamine injection contains sodium bisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms, in certain susceptible people. Dobutamine should not be used in the presence of ventricular fibrillation or uncorrected tachycardia. Minimal vasoconstriction has occasionally been observed, most notably in patients recently treated with a b-blocking drug. Hypovolemia should be corrected with suitable volume expanders prior to the initiation of treatment with dobutamine. Caution should be exercised when using dobutamine in patients with hyperthyroidism. Dobutamine should be used with caution in patients receiving anesthetic agents such as halogenated hydrocarbons, or cyclopropane. Dobutamine can produce a mild reduction in serum potassium concentration, like other b2-agonists, but rarely to hypokalemic levels. Accordingly serum potassium levels should be considered for monitoring. Clinical studies indicate that the concomitant use of dobutamine and nitroprusside results in a higher cardiac output and, usually, a lower pulmonary wedge pressure than when either drug is used alone. Dobutamine has not been administered to pregnant women to date and should be used in such patients only when the expected benefits clearly outweigh the potential risks to the mother and fetus.

Dobutamine Side Effects

The most common side effects relate to the effect of dobutamine on the cardiovascular system. An increase in heart rate of 5 to 15 beats/minute and a 10 to 20 mmHg increase in systolic blood pressure have been noted in most patients. There have been reports of precipitous decreases in blood pressure associated with dobutamine therapy. A reduction in dose or discontinuation of the drug is necessary to return the blood pressure to baseline levels. In some cases pressor support may be required. Gastrointestinal side effects like nausea, vomiting and bad taste; CNS: headache, fatigue, anxiety, and paresthesia; rash, fever, eosinophilia and bronchospasm have been reported occasionally. Other side effects like dyspnea, thrombocytopenia, pruritus, chill, and sweating were observed rarely. Phlebitis has been occasionally reported. Local inflammatory changes following inadvertent infiltration have also been reported. Infusions of up to 72 hours have revealed no adverse effects

Dobutamine Overdose

In case of overdosage, as evidenced by tachycardia or excessive blood pressure alteration, reduce the rate of administration, or temporarily discontinue dobutamine until the patient's condition stabilizes. No additional remedial measures are usually necesssary because the duration of action of dobutamine is short.

Dobutamine Usage guidelines

Dobutamine is a potent drug and is not for direct injection. It must be diluted exactly as directed before administration to patients as an i.v. infusion. Dobutamine is incompatible with alkaline solutions and should not be mixed with products such as 5% Sodium Bicarbonate Injection. Dobutamine injection must be further diluted at the time of administration to at least 50 mL prior to administration in an i.v. container with one of the following i.v. solutions: 5% Dextrose Injection, 0.9% Sodium Chloride Injection, or Sodium Lactate Injection. I.V. solutions should be used within 24 hours of preparation. The rate of administration and duration of therapy should be adjusted according to the patient's response as determined by heart rate, presence of ectopic activity, blood pressure, urine flow and, whenever possible, measurement of central venous or pulmonary wedge pressure and cardiac output. Store at room temperature (15 to 30°C).

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