dopamine

Dopamine is a medication form of a substance that occurs naturally in the body. It works by improving the pumping strength of the heart and improves blood flow to the kidneys.

Dopamine injection (Intropin) is used to treat certain conditions, such as low pressure, that occur when you are in shock, which may be caused by heart attack, trauma, surgery, heart failure, kidney failure, and other serious medical conditions.

Dopamine may also be used for purposes not listed in this medication guide.

Important information

If possible before you receive dopamine, tell your caregivers if you have pheochromocytoma (tumor of the adrenal gland).

Also tell your caregivers if you have hardened arteries, circulation problems, diabetes, frostbite, Buergers disease, asthma, sulfite allergy, or a history of blood clots.

Tell your doctor about all the prescription and over-the-counter medications you use, especially if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 21 days.

In an emergency situation it may not be possible before you are treated with dopamine to tell your caregivers about your health conditions or if you are pregnant or breast feeding. Make sure any doctor caring for you afterward knows that you have received dopamine.

Before receiving dopamine?

If possible before you receive dopamine, tell your caregivers if you have pheochromocytoma (tumor of the adrenal gland).

To make sure you can safely receive dopamine injection, tell your caregivers if you have any of these other conditions:

• coronary artery disease (hardened arteries);

• circulation problems such as Raynaud"s syndrome;

• a history of blood clots;

• diabetes;

• frostbite;

• Buergers disease;

• asthma;

• sulfite allergy; or

• if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 21 days.

FDA pregnancy category C. It is not known whether dopamine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether dopamine passes into breast milk or if it could harm a nursing baby. Do not use dopamine without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before you are treated with dopamine to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received dopamine.

Dopamine side effects

Get emergency medical help if you have any of these signs of an allergic reaction to dopamine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you suffer a serious side effect from dopamine such as:

• chest pain;

• fast, slow, or pounding heartbeats;

• painful or difficult urination, blood in your urine;

• weakness, confusion, swelling in your feet or ankles, urinating less than usual or not at all;

• weak or shallow breathing;

• feeling like you might pass out, even while lying down;

• burning, pain, or swelling around the IV needle;

• cold feeling, numbness, or blue-colored appearance in your hands or feet; or

• darkening or skin changes in your hands or feet.

Less serious dopamine side effects may include:

• headache;

• feeling anxious;

• nausea, vomiting; or

• chills, goosebumps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Dopamine dosing information

Usual Adult Dose of Dopamine for Nonobstructive Oliguria:

Initial dose: 1 to 5 mcg/kg/min by continuous IV infusion.
Titrate to desired response. Administration at rates greater than 50 mcg per kg per minute have been used safely in serious situations.

Usual Adult Dose of Dopamine for Shock:

Initial dose: 1 to 5 mcg/kg/min by continuous IV infusion.
Titrate to desired response. Administration at rates greater than 50 mcg per kg per minute have been used safely in serious situations.

Usual Pediatric Dose for Nonobstructive Oliguria:

less than 1 month: 1 to 20 mcg/kg/min by continuous IV infusion, titrated to desired response.

1 month or older: 1 to 20 mcg/kg/min by continuous IV infusion, titrated to desired response. Maximum of 50 mcg/kg/min.

The hemodynamic effects of dopamine are dose dependent:
Low dosage: 1 to 5 mcg/kg/minute, increased renal blood flow and urine output
Intermediate dosage: 5 to 15 mcg/kg/minute, increased renal blood flow, heart rate, cardiac contractility, cardiac output, and blood pressure
High dosage: greater than 15 mcg/kg/minute, alpha-adrenergic effects begin to predominate, vasoconstriction, increased blood pressure

Usual Pediatric Dose for Shock:

less than 1 month: 1 to 20 mcg/kg/min by continuous IV infusion, titrated to desired response.

1 month or older: 1 to 20 mcg/kg/min by continuous IV infusion, titrated to desired response. Maximum of 50 mcg/kg/min.

The hemodynamic effects of dopamine are dose dependent:
Low dosage: 1 to 5 mcg/kg/minute, increased renal blood flow and urine output
Intermediate dosage: 5 to 15 mcg/kg/minute, increased renal blood flow, heart rate, cardiac contractility, cardiac output, and blood pressure
High dosage: greater than 15 mcg/kg/minute, alpha-adrenergic effects begin to predominate, vasoconstriction, increased blood pressure

What other drugs will affect dopamine?

Tell your doctor about all other medicines you use, especially:

• droperidol (Inapsine);

• epinephrine (EpiPen, Adrenaclick, Twinject, and others);

• haloperidol (Haldol);

• midodrine (ProAmatine);

• phenytoin (dilantin);

• vasopressin (Pitressin);

• a diuretic (water pill);

• an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), nortriptyline (Pamelor), and others;

• a beta blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

• cough or cold medicine that contains an antihistamine or decongestant;

• ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), or methylergonovine (Methergine);

• a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine);

There may be other drugs that can interact with dopamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.