Brand and Other Names:
- Classes: Inotropic Agents
Dosing & Uses
Dosage Forms & Strengths
infusion solution, in D5W
Serious - Use Alternative
Significant - Monitor Closely
Eosinophilic myocarditis (≤7%)
Premature ventricular beats (5%; dose related)
Frequency Not Defined
Exacerbation of coronary arteriosclerosis
10- to 20-mm Hg increase in systolic blood pressure and increase in heart rate of 5 to 15 beats/min
Hypersensitivity to drug or components
Idiopathic hypertrophic subaortic stenosis
To optimize hemodynamics, correct hypovolemia if needed
Clinical experience with dobutamine following myocardial infarction has been insufficient to establish safety of drug for this use; there is concern that any agent that increases contractile force and heart rate may increase size of infarction by intensifying ischemia, but not known whether dobutamine does so
Severe coronary artery disease (CAD)
Hypertension common; hypotension may also occur
May cause a marked increase in heart rate or blood pressure,especially systolic pressure; because dobutamine facilitates atrioventricular conduction, patients with atrial fibrillation are at risk of developing rapid ventricular response; in patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine; patients with pre-existing hypertension appear to face an increased risk of developing an exaggerated pressure response
During administration of dobutamine, monitor blood pressure continuously; pulmonary wedge pressure and cardiac output should be monitored whenever possible to aid safe and effective infusion of dobutamine in 5% dextrose Injection, USP
Ventricular ectopy exacerbation may occur
Pregnancy & Lactation
Pregnancy category: B
Lactation: Unknown whether drug is excreted into breast milk; avoid use
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Strong beta1 and weak beta2/alpha effects, resulting in increased cardiac output, blood pressure, and heart rate, as well as decreased peripheral vascular resistance
Onset: 1-10 min
Duration: 10 min
Time to peak effect: ~15 min
Vd: 0.2 L/kg
Metabolized in tissues and liver by catechol-O-methyl transferase
Metabolites: Glucuronide conjugate, 3-0-methylated dobutamine (inactive)
Half-life: 2 min
Clearance: 90 mL/kg/min
Solution: Sodium bicarbonate 5%
Additive: Acyclovir, alteplase, aminophylline, bretylium(?), bumetanide, calcium chloride(?), calcium gluconate, diazepam, digoxin, floxacillin, furosemide, heparin(?), insulin, magnesium sulfate, phenytoin, potassium phosphates, sodium bicarbonate
Y-site: Acyclovir, alatrofloxacin, alteplase, aminophylline, amphotericin B cholesteryl sulfate, cefepime, foscarnet, furosemide(?), heparin(?), indomethacin, phytonadione, piperacillin-tazobactam, thiopental, warfarin
Solution: Most common solvents (D5/LR, D5/NS, D5W, LR, NS)
Additive (partial list): Amiodarone, atropine, ciprofloxacin, dopamine, epinephrine, flumazenil, hydralazine, lidocaine, meperidine, morphine sulfate, nitroglycerin, nitroglycerin with nitroprusside(?), norepinephrine, potassium chloride(?), verapamil (incompatible at higher concentrations)
Syringe: Caffeine citrate, heparin, ranitidine
Y-site (partial list): Amiodarone, atracurium, calcium gluconate, ciprofloxacin, diazepam, diltiazem, dopamine, epinephrine, fentanyl, inamrinone, labetalol, lidocaine, lorazepam, magnesium sulfate, midazolam(?), morphine sulfate, nitroglycerin, norepinephrine, potassium chloride, propofol, sodium nitroprusside, tacrolimus, vasopressin, verapamil, zidovudine
Solution: Dilute 250 mg in 250 mL of compatible solution to yield final concentration of 1000 mcg/mL; not to exceed 5000 mcg/mL
Infuse into large vein via infusion pump
Store intact vials at room temperature; protect from excessive heat or freezing conditions
Diluted solutions may be stored for 24 hours
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Select a box to add or remove a plan.
Select a class to view formulary status for similar drugs