Dopamine
Dopamine: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Dopamine
ATX code: C01CA04
Active ingredient: Dopamine (Dopamine)
Manufacturer: Ozon Pharm LLC, Russia
Description and photo update: 2019-12-08
Prices in pharmacies: from 54 rubles.
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Dopamine is a cardiotonic and hypertensive drug.
Release form and composition
Dosage form - concentrate for the preparation of a solution for infusion: transparent, slightly colored or colorless liquid (5 ml each in glass colorless ampoules, in a blister strip or cardboard tray, 5 ampoules each, in a cardboard box 1 or 2 packages or trays; 5 or 10 ampoules in a cardboard box or bundle).
The active ingredient of Dopamine is dopamine hydrochloride, in 1 ml - 5 mg, 10 mg, 20 mg or 40 mg.
Auxiliary components: hydrochloric acid solution 0.1 M (up to pH 3.5-4.0), sodium disulfite, water for injection.
Pharmacological properties
Pharmacodynamics
Dopamine has diuretic, hypertensive and cardiotonic effects. When administered in therapeutic doses, it promotes the stimulation of dopamine receptors, in large doses it leads to the excitation of beta-adrenergic receptors, and in high doses, to the activation of both alpha and beta adrenergic receptors. Dopamine mediates the release of norepinephrine at adrenergic synapses. The substance has a favorable inotropic effect, improves peripheral blood flow (especially in shock conditions), slightly increases heart rate, selectively dilates the renal arteries, increases myocardial oxygen demand, increases blood pressure and total peripheral vascular resistance. Stimulation of renal blood flow causes an intensification of renal filtration, promotes natriuresis and diuresis.
Pharmacokinetics
Dopamine is poorly absorbed from the gastrointestinal tract, therefore it is used only for intravenous administration. After parenteral administration, the substance is widely distributed throughout the body, but does not penetrate the blood-brain barrier at significant concentrations. Dopamine is metabolized at a high rate in blood plasma, kidneys and liver by catechol-O-methyltransferase and monoamine oxidase to inactive metabolites.
Approximately 25% of the dose is absorbed by neurosecretory vesicles (adrenergic nerve terminals), where hydroxylation occurs and norepinephrine is formed. The plasma half-life is 2 minutes. Dopamine is excreted through the kidneys: 80% of the administered dose - as metabolites (over 24 hours), in small concentrations - unchanged. The therapeutic effect is observed 5 minutes after the infusion, the duration of action is less than 10 minutes after administration.
Indications for use
- Acute form of cardiovascular insufficiency of various etiologies;
- Cardiogenic, anaphylactic, infectious toxic, hypovolemic (after restoration of the circulating blood volume), postoperative shock;
- Arterial hypotension;
- Low cardiac output syndrome in cardiac surgery patients;
- Increased urine output in case of poisoning.
Contraindications
- Hypertrophic obstructive cardiomyopathy;
- Pheochromocytoma;
- Ventricular fibrillation;
- Individual intolerance to dopamine.
It is recommended to prescribe Dopamine with caution in patients with cardiac arrhythmias (tachyarrhythmia, ventricular arrhythmia, atrial fibrillation), hypovolemia, metabolic acidosis, myocardial infarction, hypercapnia, hypertension in the pulmonary circulation, hypoxia, thyrotoxicosis, prostatic hyperplasia, hyperplasia occlusive vascular diseases (including frostbite, thromboembolism, atherosclerosis, thromboangiitis obliterans, diabetic endarteritis, obliterating endarteritis, Raynaud's disease), bronchial asthma (with a history of hypersensitivity to disulfite); during pregnancy and breastfeeding; under the age of 18.
Instructions for the use of Dopamine: method and dosage
Ready dopamine solution is administered intravenously.
The dosage regimen and the period of use are prescribed by the doctor on the basis of clinical indications individually, taking into account the value of blood pressure (BP), the patient's response to the drug, the severity of shock.
To increase myocardial contractility and diuresis, the recommended dose of Dopamine is 0.1-0.25 mg / min, if necessary, the effect on blood pressure is increased to 0.3-0.5-0.7 mg / min. For adult patients, the maximum dose should not exceed 1.5 mg / min.
For children, the appointment is made taking into account the weight of the child - 0.004-0.006 mg per 1 kg per minute.
The use of Dopamine can last up to 28 days.
Side effects
- Cardiovascular system: decrease or increase in blood pressure, bradycardia or tachycardia, chest pain, conduction disturbances, expansion of the QRS complex, increased end diastolic pressure in the left ventricle, vasospasm; at high doses - supraventricular or ventricular arrhythmia;
- Nervous system: more often - headache; less often - motor restlessness, anxiety, tremor of the fingers;
- Digestive system: nausea, vomiting, bleeding from the gastrointestinal tract;
- Allergic reactions: in patients with bronchial asthma - bronchospasm, shock;
- Metabolism: polyuria;
- Local reactions: necrosis of the skin and subcutaneous tissue when the solution gets under the skin;
- Others: less often - azotemia, shortness of breath, piloerection; rarely - polyuria (with therapy in low doses).
Overdose
The range of therapeutic doses of Dopamine used is quite wide (2–20 μg per 1 kg of body weight per minute, the maximum dose can reach 50 μg per 1 kg of body weight per minute), therefore, to make an unequivocal conclusion about what the toxic dose should be for the onset of symptoms overdose is impossible. Signs of an overdose are: nausea, vomiting, abdominal pain, chest pain, significant arterial hypertension, heart rhythm disturbances, in isolated cases - acute myocardial infarction, cyanosis or pallor of the palms or feet, insomnia, anxiety.
In this case, Dopamine is immediately canceled and symptomatic therapy is performed.
special instructions
The use of Dopamine for hypovolemia can be started only after compensation of the circulating blood volume.
The introduction of the solution must be accompanied by careful monitoring of heart rate, blood pressure, electrocardiography, urine output, pulmonary artery pressure, stroke volume of the heart, ventricular filling pressure, and central venous pressure.
With a decrease in urine output, it is necessary to reduce the dose of dopamine.
With the simultaneous use of monoamine oxidase (MAO) inhibitors, the dose of dopamine must be reduced by 10 times.
Application during pregnancy and lactation
During pregnancy, dopamine is prescribed only if the potential benefits of treatment to the mother significantly outweigh the possible risks to the fetus.
There is no information on the penetration of the substance into breast milk. If Dopamine is used in situations that pose an immediate threat to life, breastfeeding is not considered a contraindication to the use of the drug.
With impaired renal function
In patients with renal dysfunction, Dopamine is used strictly according to indications and with caution.
Drug interactions
With the simultaneous use of Dopamine:
- Diuretics: enhance the diuretic effect of the drug;
- Furazolidone, selegiline, procarbazine and other MAO inhibitors, guanethidine: can increase the duration and intensity of the cardiac stimulating and pressor effect of dopamine;
- Octadine: increases the sympathomimetic effect of dopamine;
- Cyclopropane, enflurane, chloroform, halothane, methoxyflurane, isoflurane and other inhalants for general anesthesia (hydrocarbon derivatives): increase the risk of severe cardiac arrhythmias;
- Thyroid hormones: can enhance their action and the action of dopamine;
- Levodopa: the likelihood of developing arrhythmias increases;
- Beta-blockers, butyrophenone derivatives: reduce the effect of dopamine;
- Cocaine and other sympathomimetics: enhance the cardiotoxic effect of the drug;
- Cardiac glycosides: May increase the risk of developing cardiac arrhythmias;
- Oxytocin, ergometrine, methylergometrine, ergotamine: increase the vasoconstrictor effect, the risk of ischemia and gangrene, severe arterial hypertension, up to the threat of intracranial hemorrhage;
- Maprotiline and other tricyclic antidepressants: increasing the effect of dopamine, can cause the development of arrhythmias, tachycardia, severe arterial hypertension;
- Phenytoin: the risk of severe arterial hypotension increases;
- Guanethidine, guanadrel, methyldopa, rauwolfia alkaloids: their hypotensive effect decreases.
According to the instructions, Dopamine reduces the antianginal effect of nitrates, and they, in turn, reduce the pressor effect of sympathomimetics, increasing the risk of arterial hypotension.
Dopamine solution is incompatible with oxidants, iron salts, alkaline solutions, thiamine.
Analogs
Dopamine analogs are: Dopamine, Dopamine Giulini, Dopamine Solvay 50, Dopamine Solvay 200, Dopex injection, Dopamine hydrochloride, Dopamine-Darnitsa, Dopamine.
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Dopamine
Currently, reviews about Dopamine are extremely rare. It is mainly used in a hospital setting, patients respond positively to drug treatment. Side effects are observed exclusively with the introduction of high doses.
Dopamine price in pharmacies
The average price for Dopamine in ampoules 5 mg / ml is 78-125 rubles, depending on the pharmacy and the region of sale. You can buy Dopamine in 40 mg / ml ampoules for 204–250 rubles (prices are for a pack containing 10 ampoules).
Dopamine: Prices in Online Pharmacies
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Drug name Price Pharmacy |
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Dopamine 5 mg / ml concentrate for preparation of solution for infusion 5 ml 10 pcs. RUB 54 Buy |
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Dopamine 5 mg / ml concentrate for preparation of solution for infusion 5 ml 10 pcs. RUB 69 Buy |
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Dopamine 40 mg / ml concentrate for preparation of solution for infusion 5 ml 10 pcs. 193 r Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
