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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES › Adrenergic and dopaminergic agents
dobutamine
C01CA07
Forms & Strengths
- Injection: 12.5 mg/mL in 20 mL vial
- Premixed infusion: 1 mg/mL, 2 mg/mL, 4 mg/mL in D5W
Adult Dosing
- Continuous IV infusion: 2 to 20 mcg/kg/min
- Titrate to desired hemodynamic response (heart rate, blood pressure, urine output)
- Rarely, rates up to 40 mcg/kg/min may be required
Pediatric Dosing
- Continuous IV infusion: 2 to 20 mcg/kg/min
- Titrate carefully based on clinical response and hemodynamic monitoring
- Neonates: 0.5 to 20 mcg/kg/min
Indications
- Short-term management of adults with cardiac decompensation due to depressed contractility
- Inotropic support in cardiac surgery, congestive heart failure, and acute myocardial infarction
- Pharmacological stress testing (dobutamine stress echocardiography)
Mechanism of Action
- Direct-acting inotropic agent with primary activity on beta-1 adrenergic receptors
- Mild beta-2 and alpha-1 receptor agonist activity
- Increases myocardial contractility and stroke volume with lesser effects on heart rate
Contraindications
- Idiopathic hypertrophic subaortic stenosis (IHSS) / hypertrophic cardiomyopathy
- Known hypersensitivity to dobutamine or sulfites (some formulations contain sodium metabisulfite)
Adverse Reactions
- Tachycardia and ectopic heartbeats
- Significant increases in systolic blood pressure or hypotension
- Chest pain, anginal pain, and palpitations
- Dyspnea, nausea, and headache
- Hypokalemia (with prolonged use)
Drug Interactions
- Beta-blockers may antagonize the therapeutic effects of dobutamine
- MAO inhibitors and tricyclic antidepressants may potentiate cardiovascular effects
- General anesthetics (e.g., halothane, cyclopropane) increase risk of ventricular arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use