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Dobutamine Intravenous for Adults
Who can administer
Administration RESTRICTED: see Appendix 1
Important information
Cardiovascular monitoring required (see monitoring requirements)
For Y-site compatibility see below
Available preparations
Dobutamine 250mg per 20ml ampoule
Reconstitution
Already in solution
Draw up using a 5 micron filter needle
Dilute further prior to administration
Infusion fluids
Sodium chloride 0.9% or Glucose 5%
Methods of intravenous administration
Continuous intravenous infusion(adminster using an electronically controlled infusion device)
Add 250mg dobutamine to make a final volume of 50ml, 250ml or 500ml of infusion fluid:
| Amount to add (mg) | Final vol (ml) | Final concentration | |
|---|---|---|---|
| 250mg | 50ml | 5mg per ml (5,000micrograms per ml) (usual strength) | Central line only (unless as part of St Marys ward protocol- CLN-CR-083) |
| 250mg | 250ml | 1mg per ml (1,000 micrograms per ml) | Central line or large peripheral vein (ref 2) |
| 250mg | 500ml | 0.5mg per ml (500 micrograms per ml) | |
- Set up as a continuous infusion and adjust rate according to dose information opposite
- Provided the concentration is not >5mg/ml, larger volumes of infusion may be prepared e.g. 500mg in 100ml
- Fluid restricted patients: If absolutely necessary, anecdotal evidence suggests a 10mg/ml or even undiluted solution may be given via a central line (ref 1)
Dose in adults
Usual dose
- 2.5 to 10 microgram/kg/minute, adjusted according to response
- For a 70kg patient (using 250mg in 50ml) this corresponds to 2.1 to 8.4ml/hour
- Doses up to 40 microgram/kg/minute have been required, but this is rare
- It is recommended that treatment with dobutamine should be discontinued gradually
| Using a 250mg in 50ml solution | ||||
|---|---|---|---|---|
| Dose (micrograms/kg/minute) | 2.5 | 5 | 7.5 | 10 |
| Weight (KG) | Rate in ml per hour | |||
| 40 | 1.2 | 2.4 | 3.6 | 4.8 |
| 45 | 1.4 | 2.7 | 4 | 5.4 |
| 50 | 1.5 | 3 | 4.5 | 6 |
| 55 | 1.7 | 3.3 | 5 | 6.6 |
| 60 | 1.8 | 3.6 | 5.4 | 7.2 |
| 65 | 2 | 3.9 | 5.9 | 7.8 |
| 70 | 2.1 | 4.2 | 6.3 | 8.4 |
| 75 | 2.3 | 4.5 | 6.8 | 9 |
| 80 | 2.4 | 4.8 | 7.2 | 9.6 |
| 85 | 2.6 | 5.1 | 7.7 | 10.2 |
| 90 | 2.7 | 5.4 | 8.1 | 10.8 |
| 95 | 2.9 | 5.7 | 8.6 | 11.4 |
| 100 | 3 | 6 | 9 | 12 |
| 105 | 3.2 | 6.3 | 9.5 | 12.6 |
| 110 | 3.3 | 6.6 | 9.9 | 13.2 |
| 115 | 3.5 | 6.9 | 10.4 | 13.8 |
| 120 | 3.6 | 7.2 | 10.8 | 14.4 |
Table 1: Dobutamine 250mg in 50ml (5mg per ml) - rates of administration
Other concentrations
- If using a 250mg in 250ml strength (1mg/ml)- you can multiply the rates in Table 1 by five to get the appropriate rate in ml/hour
- Example: for a 95kg patient on 5 micrograms/kg/minute- using a 250mg in 50ml solution, the rate is 5.7ml per hour. If using a 250mg in 250ml strength, the rate is 28.5ml per hour
Monitoring
- Heart rate and rhythm, arterial blood pressure and infusion rate should be monitored closely
- Telemetry monitoring required (But see also guideline 'Continuous Dobutamine infusion in the treatment of refractory fluid overload in patients with Advanced Heart Failure in St Marys ward in University Hospital Galway'- see Q-Pulse document CLN-CR-083- telemetry monitoring may not be required in a certain subset of patients)
Further information
- Solutions of dobutamine may have a pink discolouration
- This discolouration, which will increase with time results from a slight oxidation of the drug
- However there is no significant loss of drug potency during the 24 hour infusion period
- For information concerning continuous dobutamine infusion in the treatment of refractory fluid overload in ward areas, see Q pulse policy CLN-CR-083
Storage
- Store below 250C
- A slight pink discoloration should not concern those administering the drug
References
SPC November 2020
1: Critical care group. Minimum infusion volumes 4th edition 2012
2: Injectable Medicines Administration Guide Medusa downloaded 8th Dec 2021
Therapeutic classification
Inotropic sympathomimetics