Isoprenaline Hydrochloride Intravenous for Adults

Who can administer

Administration restricted- see appendix 1

Important information

Doses in the literature are usually given as Isoprenaline hydrochloride.

Doses are not equivalent for isoprenaline sulphate. Take care to use the correct version, or doses would have to be adjusted.

Two very different doses and infusion concentrations are listed here for two very different indications. Take time to read this carefully.

Available preparations

Isoprenaline hydrochloride 1mg in 5ml (0.2mg in 1ml, 200 micrograms in 1ml) Macure

Isoprenaline hydrochloride (Isoprenalina cloridrato monico) 0.2mg in 1ml (200 micrograms in 1ml) (unlicensed)

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Intravenous infusion (administer using an electronically controlled infusion device)

  • Add 2mg (= 10ml of 0.2mg/1ml injection solution) isoprenaline to 490ml infusion fluid
  • This produces a solution containing 4 microgram per ml

Dose in adults

Bradycardia due to AV block

Continuous IV infusion

  • Starting dose: 0.01mcg/kg/minute
  • Increase in 0.01mcg/kg/minute increments, to a maximum dose of 0.15mcg/kg/minute, adjusted to achieve a heart rate of 50 to 60 beats per minute
  • See table below
Dosage table for Bradycardia due to AV block
Dose(mcg/kg/min) Weight 55kg Weight 60kg Weight 65kg Weight 70kg Weight 75kg Weight 80kg Weight 85kg Weight 90kg Weight 95kg Weight 100kg
  Rate in ml/hour of a 4microgram/ml solution prepared as above
0.01 8.3 9 9.8 10.5 11.3 12 12.8 13.5 14.3 15
0.02 16.5 18 19.5 21 22.5 24 25.5 27 28.5 30
0.03 24.8 27 29.3 31.5 33.8 36 38.3 40.5 42.8 45
0.04 33 36 39 42 45 48 51 54 57 60
0.05 41.3 45 48.8 52.5 56.3 60 63.8 67.5 71.3 75
0.1 82.5 90 97.5 105 112.5 120 127.5 135 142.5 150
0.15 123.8 135 146.3 157.5 168.8 180 191.3 202.5 213.8 225

Titrate to patient response.

Monitoring

  • Monitor ECG continuously

Further information

Search synonym: Isoproterenol

Storage

  • Macure brand: Store in refrigerator 2-80C
  • Unlicensed brand: Store <150C.(ref 1)
  • Do not use if solution is coloured (pink to pinky-brown) or a precipitate is present.

References

SPC (Macure pharma) June 2022

1: SPC (translated) document downloaded 7th Feb 2019

Therapeutic classification

Adrenergic and dopaminergic agent. Inotrope sympathomimetic