Dopamine hydrochloride is available as a concentrate for injection in 5- and 10-mL single-dose vials.3675 Each mL of the concentrate for injection contains 40 mg of dopamine hydrochloride, sodium metabisulfite 9 mg as an antioxidant, citric acid anhydrous 10 mg and sodium citrate dihydrate 5 mg.3675 Additional citric acid and/or sodium citrate may be used to adjust the pH.3675 Dopamine hydrochloride concentrate for injection must be diluted in a compatible infusion solution prior to use.3675
Dopamine hydrochloride also is available in plastic bags as premixed solutions in concentrations of 800, 1600, and 3200 mcg/mL in dextrose 5%.3676; 3677 Each bag of the premixed infusion solution (Hospira) also contains sodium metabisulfite 0.5 mg/mL and may contain hydrochloric acid and/or sodium hydroxide to adjust the pH.3676 Each bag of the premixed infusion solution (Baxter) also contains sodium bisulfite approximately 0.005 mEq/mL and hydrochloric acid to adjust the pH.3677
pH
Dopamine hydrochloride concentrate for injection has a pH of 3.3 with a range from 2.5 to 5.3675 The premixed infusion solution in dextrose 5% (Hospira) has a pH of 3.8 with a range from 2.5 to 4.5.3676 The premixed infusion solution in dextrose 5% (Baxter) has a pH of 3.5 with a range from 2.5 to 4.5.3677
Osmolality
The osmolality of dopamine hydrochloride 40 mg/mL was 619 mOsm/kg by freezing-point depression and 581 mOsm/kg by vapor pressure.1071 At a concentration of 10 mg/mL (diluent unspecified), the osmolality was determined to be 277 mOsm/kg.1233
Osmolarity
The calculated osmolarity of premixed dopamine hydrochloride in dextrose 5% is 261, 269, and 286 mOsm/L for the 800-, 1600-, and 3200-mcg/mL concentrations, respectively.3676; 3677
Dopamine hydrochloride is administered by intravenous infusion using an infusion pump or other infusion control device (e.g., precision volume control infusion set); dopamine hydrochloride should not be infused through an ordinary intravenous apparatus regulated only by gravity and mechanical clamps.3675; 3676; 3677 Bolus administration should be avoided.3675; 3676; 3677 The premixed infusion solutions are suitable for administration without dilution.3676; 3677 The dosage of dopamine hydrochloride in some pediatric patients (e.g., neonates) is so low that the premixed infusion solution may require considerable dilution for use in such patients; careful consideration should be given to the use of this product in such situations.3677 The concentrate for injection must be diluted for use.3675 Five or 10 mL of the concentrate for injection should be added to 250, 500, or 1000 mL of compatible infusion solution.3675 The dosage and rate of infusion should be individualized according to the patient’s response and fluid requirements.3675; 3676; 3677
Dopamine hydrochloride should be administered through a large vein whenever possible to prevent the possibility of extravasation into the tissue surrounding the infusion site.3675; 3676; 3677 Extravasation may cause necrosis and sloughing of the surrounding tissue.3675; 3676; 3677 Large veins of the antecubital fossa are preferred to veins of the dorsum of the hand or ankle.3675; 3676; 3677 A less desirable infusion site should be used only when a larger vein is unavailable and when the patient’s condition requires immediate attention; if this occurs, the infusion site should be continuously monitored for free flow and the site should be switched to a more suitable one as soon as possible.3675; 3676; 3677
Vasospastic events have been reported when dopamine hydrochloride is administered through umbilical vessels.3677 Inadvertent infusion into the umbilical artery has resulted in vasoconstrictive effects.3676 Administration of dopamine hydrochloride into an umbilical artery catheter is not recommended;3676 caution should be exercised if infusion through umbilical vessels becomes necessary.3677
Intact containers of dopamine hydrochloride should be stored at controlled room temperature.3675; 3676; 3677 Premixed solutions should be protected from freezing.3676; 3677 One manufacturer (Baxter) also states that premixed solutions should be protected from excessive heat.3677 Dopamine hydrochloride products should not be used if they are darker than slightly yellow or discolored in any other way.3675; 3676; 3677
Dopamine hydrochloride under simulated summer conditions in paramedic vehicles was exposed to temperatures ranging from 26 to 38°C over 4 weeks. Analysis found no loss of the drug under these conditions.2562
pH Effects
The pH of the solution is one of the most critical factors determining dopamine hydrochloride stability.312 Dopamine hydrochloride is stable over a pH range of 4 to 6.4 when mixed with other drugs in dextrose 5%,312 but it is most stable at pH 5 or below.79 In alkaline solutions, the catechol moieties are oxidized, cyclized, and polymerized to colored materials,312 forming a pink to violet color.78 Dopamine hydrochloride should not be mixed with sodium bicarbonate or any other alkalinizing substance or alkaline solution.3675; 3676; 3677 Discolored solutions should not be used.312; 3675; 3676; 3677
Freezing Solutions
Dopamine hydrochloride 0.5 mg/mL in dextrose 5% was frozen at -20°C in polypropylene syringes (Codan Medical and B. Braun) for 6 months. No visible precipitation or color change was observed; however, layering or stratification occurred in the frozen samples. Repeated inversion of the syringes was required to yield a clear and uniform solution. Less than 2% dopamine loss occurred in 6 months to samples in the Codan syringes; however, samples frozen in the Braun syringes were less stable, with dopamine losses up to 14%. The Braun syringes when frozen allowed air to enter into the product, which could compromise sterility as well as stability.2530
Light Effects
Exposure of dopamine hydrochloride 100 mg/100 mL in dextrose 5% to fluorescent and blue phototherapy light for 36 hours at 25°C, while static or flowing through tubing at 2 mL/hr, resulted in no significant difference in drug concentration compared to controls stored in the dark. Because no unacceptable loss occurs, protection of dopamine hydrochloride infusions from blue phototherapy lights is not necessary.1100
Syringes
Dopamine hydrochloride (Abbott) 200 mg/50 mL in dextrose 5% exhibited no change in appearance and no drug loss when stored in 60-mL plastic syringes (Becton Dickinson) for 24 hours at 25°C.1579
Dopamine hydrochloride (Therabel Lucien Pharma) 4 mg/mL in dextrose 5% was packaged in 50-mL polypropylene syringes (Becton Dickinson) and stored at 4 and 24°C in the dark and exposed to room light for 48 hours. Dopamine losses were less than 10% throughout the study.1961
Sorption
Dopamine hydrochloride has been shown not to exhibit sorption to polyvinyl chloride (PVC) bags and tubing, polyethylene tubing, polypropylene syringes, and polypropylene-polystyrene syringes.536; 784; 1961
Filtration
Dopamine hydrochloride 100 mcg/mL in dextrose 5% or sodium chloride 0.9% was delivered over 5 hours through 4 kinds of 0.2-µm membrane filters varying in size and composition. Dopamine concentration losses of 3 to 5% were found during the first 60 minutes; subsequent dopamine levels returned to the original concentration when the binding sites became saturated.1399
Central Venous Catheter
Dopamine hydrochloride (Abbott) 3.2 mg/mL in dextrose 5% was found to be compatible with the ARROWg+ard Blue Plus (Arrow International) chlorhexidine-bearing triple-lumen central catheter. Essentially complete delivery of the drug was found with little or no drug loss occurring. Furthermore, chlorhexidine delivered from the catheter remained at trace amounts with no substantial increase due to the delivery of the drug through the catheter.2335
Standardize 4 Safety
One or more standardized concentrations for this drug have been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. (See Standardize 4 Safety in Users Guide.) Recommendations developed to date through this initiative are available at www.ashp.org/pharmacy-practice/standardize-4-safety-initiative.
Table 1: Standardize 4 Safety Continuous IV Infusion Standard Concentrations for Dopamine3635; 3636
| Patient Population | Concentration Standards | Dosing Units |
|---|---|---|
| Adultsa | 1600 mcg/mL 3200 mcg/mL | mcg/kg/minute |
| Pediatric patients (50 kg) | 800 mcg/mL 1600 mcg/mL 3200 mcg/mL | mcg/kg/minute |
a The S4S panel recommends considering limiting to 1 bag size for each recommended concentration (e.g., 250 vs 500 mL); this may reduce errors and also reduce inventory needs.
Drugs in Syringe Compatibility
Y-Site Injection Compatibility (1:1 Mixture)
Additional Compatibility Information
Infusion Solutions
In a simulated Y-site administration study, dopamine hydrochloride (Baxter) 1.6 mg/mL in dextrose 5% was physically compatible with Normosol R for up to 4 hours at 21°C protected from light.3719
For a list of references cited in the text of this monograph, search the monograph titled References.