Who can administer
Administration RESTRICTED - see Appendix 1
Important information
For Y-site compatibility see below
Available preparations
Dopamine Hydrochloride 200mg per 5ml vial
Reconstitution
Already in solution
Dilute further prior to administration
Infusion fluids
Sodium chloride 0.9% or Glucose 5%
Methods of intravenous administration
Continuous intravenous infusion (administer using an electronically controlled infusion device)
Central line (ref 1)
- Add 5ml (200mg) to 45ml infusion fluid (200mg in 50ml) (unlicensed)
- This contains 4mg (4000micrograms) per ml
- Rate is adjusted according to response - see under 'dose'
Peripheral line (ref 1)
- Add 10ml (400mg) to 240ml infusion fluid (400mg in 250ml)
- This contains 1.6mg (1600micrograms) per ml
- To avoid tissue necrosis dopamine is best given via a large vein
- Rate is adjusted according to response - see under 'Dose'
Dose in adults
Usual dose
- Initial rate is 2.5 micrograms/kg/minute adjusted according to response - gradually increased in 5 to 10 micrograms/kg/minute increments
- ACLS guidelines (to treat hypotension especially if associated with symptomatic bradycardia in the immediate post-cardiac arrest care setting): an initial rate of 5 to 10micrograms/kg/min may be used - titrated to effect (ref 2)
- Increases should be made according to the patient's blood pressure, cardiac output, and urinary output
- Up to 20 to 50 micrograms/kg/minute may be required in seriously ill patients (ref 3)
- A reduction in urinary flow without hypotension may indicate a need to reduce the dose (ref 3)
- When gradually stopping dopamine, it is advised that care be taken to avoid undue hypotension associated with very low dosage levels, where vasodilation could predominate (ref 3)
- See tables of rates of administration on following page
| Dopamine 200mg in 50ml CENTRAL line administration |
| Dose (micrograms/kg/minute) |
2.5 |
5 |
7.5 |
10 |
|
Rate in ml per hour |
| 40kg |
1.5 |
3 |
4.5 |
6 |
| 45kg |
1.7 |
3.4 |
5.1 |
6.8 |
| 50kg |
1.9 |
3.8 |
5.6 |
7.5 |
| 55kg |
2.1 |
4.1 |
6.2 |
8.3 |
| 60kg |
2.3 |
4.5 |
6.8 |
9 |
| 65kg |
2.4 |
4.9 |
7.3 |
9.8 |
| 70kg |
2.6 |
5.3 |
7.9 |
10.5 |
| 75kg |
2.8 |
5.6 |
8.4 |
11.3 |
| 80kg |
3 |
6 |
9 |
12 |
| 85kg |
3.2 |
6.4 |
9.6 |
12.8 |
| 90kg |
3.4 |
6.8 |
10.1 |
13.5 |
| 95kg |
3.6 |
7.1 |
10.7 |
14.3 |
| 100kg |
3.8 |
7.5 |
11.3 |
15 |
| 105kg |
3.9 |
7.9 |
11.8 |
15.8 |
| 110kg |
4.1 |
8.3 |
12.4 |
16.5 |
| 115kg |
4.3 |
8.6 |
12.9 |
17.3 |
| 120kg |
4.5 |
9 |
13.5 |
18 |
| Dopamine 400mg in 250ml PERIPHERAL line administration |
| Dose (micrograms/kg/minute) |
2.5 |
5 |
7.5 |
10 |
|
Rate in ml per hour |
| 40kg |
3.8 |
7.5 |
11.3 |
15 |
| 45kg |
4.2 |
8.4 |
12.7 |
16.9 |
| 50kg |
4.7 |
9.4 |
14.1 |
18.8 |
| 55kg |
5.2 |
10.3 |
15.5 |
20.6 |
| 60kg |
5.6 |
11.3 |
16.9 |
22.5 |
| 65kg |
6.1 |
12.2 |
18.3 |
24.4 |
| 70kg |
6.6 |
13.1 |
19.7 |
26.3 |
| 75kg |
7 |
14.1 |
21.1 |
28.1 |
| 80kg |
7.5 |
15 |
22.5 |
30 |
| 85kg |
8 |
15.9 |
23.9 |
31.9 |
| 90kg |
8.4 |
16.9 |
25.3 |
33.8 |
| 95kg |
8.9 |
17.8 |
26.7 |
35.6 |
| 100kg |
9.4 |
18.8 |
28.1 |
37.5 |
| 105kg |
9.8 |
19.7 |
29.5 |
39.4 |
| 110kg |
10.3 |
20.6 |
30.9 |
41.3 |
| 115kg |
10.8 |
21.6 |
32.3 |
43.1 |
| 120kg |
11.3 |
22.5 |
33.8 |
45 |
Monitoring
- Monitor blood pressure, ECG and cardiac and urinary output
- When used in patients with a history of occlusive vascular disease, closely monitor for any changes in colour or temperature of the skin of the extremities
Further information
- Low-dose dopamine has no role in reducing renal dysfunction
- If extravasation occurs, dopamine may cause necrosis and sloughing of surrounding tissue. To prevent sloughing and necrosis, the area should be infiltrated as soon as possible with 10 to 15ml of a Sodium chloride 0.9% solution containing 5 to 10mg phentolamine
Storage
References
Dopamine SPC March 2021
1: Injectable medicines guide (Medusa)- downloaded 18/10/2021
2: Uptodate - downloaded 22/12/2021
3: Martindale The Complete Drug Reference accessed online via www.medicinescomplete.com on 22/12/2021
Therapeutic classification
Inotropic sympathomimetics
