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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
| Primary (Ready-to-use IV Bags)
400 mg/ 250 ml [Titrate]
800 mg/ 250 ml [Titrate]
800 mg/ 500 ml [Titrate]
(200 to 800 mg/ 250 to 500 ml)
Stability / Miscellaneous
Calculation of drip rate (ml/hr) 400mg/250 ml: wt(kg) x mcg/min x 0.0375.
Refractory CHF: Initial dose: 2 to 5 mcg/kg/minute.
Renal: 1 to 3 mcg/kg/min.
Severely ill patient: initially 5 mcg/kg/min, increase by 5 to 10 mcg/kg/min (q10 to 30 min) up to max of 50 mcg/kg/min.
Used to support BP, CO and renal perfusion in shock.
Central line required.
EXTRAVASATION- May result in sloughing and tissue necrosis. Use central line or large veins e.g. cephalic or basilic, to decrease risk. Treatment: Stop infusion. Restart at new IV site and notify physician. Physician to infiltrate area of extravasation with phentolamine: 5 - 10 mg diluted in 10 mL NS (adults); 0.1 - 0.2 mg/kg up to 10 mg diluted in 10 mL NS (pediatrics). Use a fine needle. To be effective, use within 12 hours.
DOSAGE AND ADMINISTRATION
Suggested Dilution: Transfer contents of one or more ampuls or vials by aseptic technique to either 250 mL or 500 mL of one of the following sterile intravenous solutions:
1. Sodium Chloride Injection, USP
DOPAMINE has been found to be stable for a minimum of 24 hours after dilution in the sterile intravenous solutions listed above. However, as with all intravenous admixtures, dilution should be made just prior to administration.
Do NOT add DOPAMINE Injection to Sodium Bicarbonate or other alkaline intravenous solutions, since the drug is inactivated in alkaline solution.
Mixing of dopamine with alteplase in the same container should be avoided as visible particulate matter has been observed.
It is recommended that dopamine not be added to amphotericin B solutions because amphotericin B is physically unstable in dopamine-containing solutions.
Rate of Administration:
Administration rates greater than 50 mcg/kg/minute have safely been used in advanced circulatory decompensation states. If unnecessary fluid expansion is of concern, adjustment of drug concentration may be preferred over increasing the flow rate of a less concentrated dilution.
Begin administration of diluted solution at doses of 2-5 mcg/kg/minute DOPAMINE in patients who are likely to respond to modest increments of heart force and renal perfusion.
In more seriously ill patients, begin administration of diluted solution at doses of 5 mcg/kg/minute DOPAMINE and increase gradually, using 5 to 10 mcg/kg/minute increments, up to 20 to 50 mcg/kg/minute as needed. If doses of DOPAMINE in excess of 50 mcg/kg/minute are required, it is suggested that urine output be checked frequently. Should the urine flow begin to decrease in the absence of hypotension, reduction of DOPAMINE dosage should be considered. Multiclinic trials have shown that more than 50% of the patients were satisfactorily maintained on doses of DOPAMINE less than 20 mcg/kg/minute. In patients who do not respond to these doses with adequate arterial pressures or urine flow, additional increments of DOPAMINE may be employed in an effort to produce an appropriate arterial pressure and central perfusion.
Treatment of all patients requires constant evaluation of therapy in terms of the blood volume, augmentation of myocardial contractility, and distribution of peripheral perfusion. Dosage of DOPAMINE should be adjusted according to the patient's response, with particular attention to diminution of established urine flow rate, increasing tachycardia or development of new dysrhythmias as indices for decreasing or temporarily suspending the dosage.
As with all potent intravenously administered drugs, care should be taken to control the rate of administration so as to avoid inadvertent administration of a bolus of drug.
Store at controlled room temperature 15°-30°C (59°-86°F) (See USP).
Avoid contact with alkalis (including sodium bicarbonate), oxidizing agents or iron salts.
NOTE - Do not use the injection if it is darker than slightly yellow or discolored in any other way.
WARNING: NOT FOR DIRECT INTRAVENOUS INJECTION, MUST BE DILUTED BEFORE USE.
IV INFUSION ONLY.