Other Brands/Names

Cardiject, Dobucef, Dobutamin Giulini, Domine, Dobutel, Inotrop.

How It Works

Dobutamine stimulates the heart by binding to and activating beta-1 receptors in cardiac muscle. As a result, it increases the force of contraction and raises the amount of blood ejected from the heart with each beat.

Indications

Dobutamine is commonly used for:

• Reduced cardiac contractility due to heart failure
• Cardiac decompensation, where the heart cannot maintain effective circulation and contractions fall
• Support during cardiac surgical procedures
• Pharmacologic cardiac stress testing to assess how the heart responds to external stress when exercise testing is not feasible

Contraindication

According to the Food and Drug Administration (FDA), do not use dobutamine in patients with:

• Known hypersensitivity or allergy to dobutamine
• Acute myocardial infarction
• Unstable angina
• Severe hypertension
• Significant arrhythmias
• Myocarditis or pericarditis
• Hypokalemia (low potassium serum levels)
• Pheochromocytoma, a rare adrenal gland tumor

Side Effects

Potential adverse effects of dobutamine include:

• Increased heart rate
• Increased systolic blood pressure
• Chest pain
• Palpitations
• Skin rash
• Nausea or vomiting
• Shortness of breath
• Fever

Types

Injectable solution, commonly supplied in vials or ampules at 50 mg/mL.

Dosage

Dobutamine is administered by intravenous infusion.

Acute heart failure

• Adults:
  • 2.5–10 micrograms per kilogram per minute, within a range of 0.5–40 micrograms/kg/min.
  • Dosing is titrated based on clinical response, including blood pressure, heart rate, urine output, and cardiac performance.
• Children:
  • The initial dose is 5 mcg/kg/min,with a range of 2–20 mcg/kg/min.
  • The dose is adjusted according to treatment response.

Cardiac stress testing

• Infuse 5 mcg/kg/min for 8 minutes using an infusion pump.
• The rate may be increased stepwise up to 20 micrograms/kg/min as required.

Safety

Dobutamine is a prescription medicine. During pregnancy it is categorized as FDA Category B. Animal studies have not shown fetal risk, but controlled data in pregnant women are lacking; use when the anticipated benefit outweighs potential risks.

Patients receiving dobutamine are typically monitored for heart rhythm, electrical activity, and blood pressure to ensure safe and effective therapy.

Drug Interactions

• Increased risk of tachycardia and hypotension with alpha-blockers such as phenoxybenzamine
• Higher likelihood of arrhythmias with antiarrhythmic agents like quinidine

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