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Dobutamine (Dobutamine Hydrochloride) - Indications and Dosage

 
 



INDICATIONS AND USAGE

Dobutamine injection is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.

In patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine hydrochloride.

DOSAGE AND ADMINISTRATION

Note — Do not add dobutamine injection to 5% Sodium Bicarbonate Injection or to any other strongly alkaline solution. Because of potential physical incompatibilities, it is recommended that dobutamine hydrochloride not be mixed with other drugs in the same solution. Dobutamine hydrochloride should not be used in conjunction with other agents or diluents containing both sodium bisulfite and ethanol.

Preparation and Stability — At the time of administration, dobutamine injection must be further diluted in an IV container. Dilute 20 mL of dobutamine in at least 50 mL of diluent and dilute 40 mL of dobutamine in at least 100 mL of diluent. Use one of the following intravenous solutions as a diluent: Dextrose Injection 5%, Dextrose 5% and Sodium Chloride 0.45% Injection, Dextrose 5% and Sodium Chloride 0.9% Injection, Dextrose Injection 10%, Isolyte® M with 5% Dextrose Injection, Lactated Ringer’s Injection, 5% Dextrose in Lactated Ringer’s Injection, Normosol®-M in D5-W, 20% Osmitrol® in Water for Injection, Sodium Chloride Injection 0.9%, or Sodium Lactate Injection. Intravenous solutions should be used within 24 hours.

Recommended Dosage — The rate of infusion needed to increase cardiac output usually ranged from 2.5 to 15 mcg/kg/min (see table). On rare occasions, infusion rates up to 40 mcg/kg/min have been required to obtain the desired effect.

Dobutamine Injection

Rates of Infusion for Concentrations of 250, 500, and 1,000 mcg/mL

Drug Delivery Rate

Infusion Delivery Rate

250 mcg/mL*

500 mcg/mL†

1,000 mcg/mL‡

(mcg/kg/min)

(mL/kg/min)

(mL/kg/min)

(mL/kg/min)

2.5

0.01

0.005

  0.0025

5

0.02

0.01

 0.005

7.5

0.03

0.015

  0.0075

10

0.04

0.02

0.01

12.5

0.05

0.025

  0.0125

15

0.06

0.03

 0.015

*   250 mcg/mL of diluent

† 500 mcg/mL or 250 mg/500 mL of diluent

‡ 1,000 mcg/mL or 250 mg/250 mL of diluent

Rates of infusion in mL/h for Dobutamine Injection concentrations of 500 mcg/mL, 1000 mcg/mL, and 2000 mcg/mL are given in Table 2.

Table 2

Dobutamine Injection Infusion Rate (mL/h) for 500 mcg/mL concentration

Drug Delivery Rate

Patient Body Weight (kg)

(mcg/kg/min)

30

40

50

60

70

80

90

100

110

  2.5

9

12

15

 18

 21

 24

27

 30

 33

   5

18

24

30

 36

 42

 48

54

 60

 66

  7.5

27

36

45

 54

 63

 72

81

 90

 99

  10

36

48

60

 72

 84

 96

108

120

132

12.5

45

60

75

 90

105

120

135

150

165

  15

54

72

90

108

126

144

162

180

198

Dobutamine Injection Infusion Rate (mL/h) for 1,000 mcg/mL concentration

Drug Delivery Rate

Patient Body Weight (kg)

(mcg/kg/min)

30

40

50

60

70

80

90

100

110

  2.5

 4.5

 6

 7.5

 9

10.5

12

13.5

15

16.5

   5

   9

12

  15

18

  21

24

  27

30

  33

  7.5

13.5

18

22.5

27

31.5

36

40.5

45

49.5

  10

  18

24

  30

36

  42

48

  54

60

  66

12.5

22.5

30

37.5

45

52.5

60

67.5

75

82.5

  15

  27

36

  45

54

  63

72

  81

90

  99

Dobutamine Injection Infusion Rate(mL/h) for 2,000 mcg/mL concentration

Drug Delivery Rate

Patient Body Weight (kg)

(mcg/kg/min)

30

40

50

60

70

80

90

100

110

  2.5

  2

 3

  4

 4.5

  5

 6

  7

 7.5

  8

   5

 4.5

 6

 7.5

  9

10.5

12

13.5

  15

16.5

  7.5

   7

 9

  11

13.5

  16

18

  20

22.5

  25

  10

  9

12

  15

  18

  21

24

  27

  30

  33

12.5

  11

15

  19

22.5

  26

30

  34

37.5

  41

  15

13.5

18

22.5

  27

31.5

36

40.5

  45

49.5

The rate of administration and the 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.

Concentrations of up to 5,000 mcg/mL have been administered to humans (250 mg/50 mL). The final volume administered should be determined by the fluid requirements of the patient.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

HOW SUPPLIED

Dobutamine Injection, USP, 12.5 mg/mL is available as:

20 mL Single-Dose Vials containing 250 mg dobutamine (as the hydrochloride), boxes of 10 (List 2025).

40 mL Single-Dose Vials containing 500 mg dobutamine (as the hydrochloride), boxes of 10 (List 2025).

Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]

©Hospira 2005

EN-0801

Printed in USA

HOSPIRA, INC., LAKE FOREST, IL 60045 USA

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