dobutamine

doe-BYOO-ta-meen

Therapeutic Classification: inotropics

Pharmacologic Classification: adrenergics

High Alert

Short-term management of HF caused by depressed contractility from organic heart disease or surgical procedures.

Stimulates beta₁(myocardial)-adrenergic receptors with relatively minor effect on heart rate or peripheral blood vessels.

Therapeutic Effects:

Increased cardiac output without significantly increased heart rate.

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Metabolized by the liver and other tissues.

Half-life: 2 min.

(inotropic effects)

ROUTE	ONSET	PEAK	DURATION
IV	1–2 min	10 min	brief (min)

Contraindicated in:

Hypersensitivity to dobutamine or bisulfites
Idiopathic hypertrophic subaortic stenosis.

Use Cautiously in:

Hypertension (↑ risk of exaggerated pressor response)
MI
Atrial fibrillation
History of ventricular atopic activity (may be exacerbated)
Hypovolemia (correct before administration)
OB: Safety not established in pregnancy
Lactation: Safety not established in breastfeeding.

CV: hypertension, premature ventricular contractions, tachycardia, angina, arrhythmias, hypotension, palpitations.

GI: nausea, vomiting.

Local: phlebitis.

Neuro: headache.

Resp: shortness of breath.

Misc: hypersensitivity reactions, nonanginal chest pain.

Drug-Drug:

Beta blockers may negate the effect of dobutamine.
↑ risk of arrhythmias or hypertension with some anesthetics (cyclopropane, halothane), MAO inhibitors, oxytocics, or tricyclic antidepressants.

IV (Adults and Children): 2.5–15 mcg/kg/min; titrate to response (max dose = 40 mcg/kg/min).
IV (Neonates): 2–15 mcg/kg/min.

(Generic available)

Solution for injection (requires dilution): 12.5 mg/mL;
Premixed infusion: 250 mg/250 mL; 500 mg/250 mL; 1000 mg/250 mL;

Monitor BP, heart rate, ECG, pulmonary capillary wedge pressure (PCWP), cardiac output, central venous pressure (CVP), and urinary output continuously during the administration. Report significant changes in vital signs or arrhythmias. Consult physician for parameters for pulse, BP, or ECG changes for adjusting dose or discontinuing medication.
Palpate peripheral pulses and assess appearance of extremities routinely during dobutamine administration. Notify health care professional if quality of pulse deteriorates or if extremities become cold or mottled.

Lab Test Considerations:

Monitor potassium concentrations during therapy; may cause hypokalemia.
- Monitor electrolytes, BUN, creatinine, and prothrombin time weekly during prolonged therapy.

Toxicity and Overdose:

If overdose occurs, reduction or discontinuation of therapy is the only treatment necessary because of the short duration of dobutamine.

High Alert:IV vasoactive medications are potentially dangerous. Have second practitioner independently check original order, dose calculations, and infusion pump settings. Do not confuse dobutamine with dopamine. If available as floor stock, store in separate areas.
Correct hypovolemia with volume expanders before initiating dobutamine therapy.
- Administer into a large vein and assess administration site frequently. Extravasation may cause pain and inflammation.

IV Administration:

Continuous Infusion:
Rate: Based on patient's weight (see Route/Dosage section). Administer via infusion pump to ensure precise amount delivered. Titrate to patient response (heart rate, presence of ectopic activity, BP, urine output, CVP, PCWP, cardiac index). Dose should be titrated so heart rate does not increase by >10% of baseline.
Y-Site Compatibility:
- alemtuzumab
- alprostadil
- amifostine
- amikacin
- aminocaproic acid
- anidulafungin
- argatroban
- arsenic trioxide
- ascorbic acid
- atracurium
- atropine
- azithromycin
- aztreonam
- benztropine
- bleomycin
- bumetanide
- buprenorphine
- butorphanol
- calcium chloride
- calcium gluconate
- cangrelor
- carboplatin
- caspofungin
- chlorpromazine
- ciprofloxacin
- cisatracurium
- cisplatin
- cladribine
- clindamycin
- cyanocoblamin
- cyclophosphamide
- cyclosporine
- cytarabine
- dactinomycin
- daptomycin
- daunorubicin hydrochloride
- dexmedetomidine
- digoxin
- diltiazem
- diphenhydramine
- docetaxel
- dopamine
- doxorubicin hydrochloride
- doxorubicin liposomal
- doxycycline
- enalaprilat
- ephedrine
- epinephrine
- epirubicin
- epoetin alfa
- eptifibatide
- erythromycin
- esmolol
- etoposide phosphate
- famotidine
- fentanyl
- fluconazole
- fludarabine
- gemcitabine
- gentamicin
- glycopyrrolate
- granisetron
- hetastarch
- hydromorphone
- idarubicin
- ifosfamide
- irinotecan
- isoproterenol
- ketamine
- labetalol
- leucovorin calcium
- levofloxacin
- lidocaine
- linezolid
- lorazepam
- magnesium sulfate
- mannitol
- meperidine
- mesna
- methylprednisolone
- metoclopramide
- metoprolol
- milrinone
- mitoxantrone
- morphine
- moxifloxacin
- multivitamins
- mycophenolate
- nafcillin
- nalbuphine
- naloxone
- nicardipine
- nitroglycerin
- norepinephrine
- octreotide
- ondansetron
- oxaliplatin
- oxytocin
- paclitaxel
- palonosetron
- pamidronate
- papaverine
- pentamidine
- phentolamine
- phenylephrine
- posaconazole
- potassium acetate
- potassium chloride
- procainamide
- prochlorperazine
- promethazine
- propranolol
- protamine
- pyridoxine
- remifentanil
- rituximab
- rocuronium
- sodium acetate
- succinylcholine
- sufentanil
- tacrolimus
- televancin
- theophylline
- thiamine
- thiotepa
- tigecycline
- tirofiban
- tobramycin
- topotecan
- trastuzumab
- vancomycin
- vasopressin
- vecuronium
- verapamil
- voriconazole
- zidovudine
- zoledronic acid
Y-Site Incompatibility:
- acyclovir
- alteplase
- aminophylline
- amphotericin B deoxycholate
- amphotericin B lipid complex
- amphotericin B liposomal
- ampicillin
- ampicillin/sulbactam
- azathioprine
- bivalirudin
- carmustine
- cefazolin
- cefotaxime
- cefotetan
- cefoxitin
- ceftriaxone
- cefuroxime
- chloramphenicol
- dacarbazine
- dantrolene
- dexamethasone
- dexrazoxane
- diazoxide
- ertapenem
- fluorouracil
- folic acid
- foscarnet
- fosphenytoin
- ganciclovir
- hydrocortisone
- ibuprofen
- indomethacin
- ketorolac
- methotrexate
- micafungin
- mitomycin
- oxacillin
- pantoprazole
- pemetrexed
- penicillin G
- pentobarbital
- phenobarbital
- phenytoin
- piperacillin/tazobactam
- sodium bicarbonate
- thiopental
- trimethoprim/sulfamethoxazole

Explain to patient the dobutamine and the need for frequent monitoring.
Advise patient to inform nurse immediately if chest pain; dyspnea; or numbness, tingling, or burning of extremities occurs.
Instruct patient to notify nurse immediately of pain or discomfort at the site of administration.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Home Care Issues: Instruct caregiver on proper care of IV equipment.
- Instruct caregiver to report signs of worsening HF (shortness of breath, orthopnea, decreased exercise tolerance), abdominal pain, and nausea or vomiting to health care professional promptly.

Increase in cardiac output.
- Improved hemodynamic parameters.
- Increased urine output.

~~Dobutrex~~

NDC Code^*

0338- Baxter Healthcare Corporation
0338-1073- Dobutamine Hydrochloride in Dextrose 0338-1073-02- 18 BAG in 1 CARTON (0338-1073-02) > 250 mL in 1 BAG

0338- Baxter Healthcare Corporation
0338-1075- Dobutamine Hydrochloride in Dextrose 0338-1075-02- 18 BAG in 1 CARTON (0338-1075-02) > 250 mL in 1 BAG

0338- Baxter Healthcare Corporation
0338-1077- Dobutamine Hydrochloride in Dextrose 0338-1077-02- 18 BAG in 1 CARTON (0338-1077-02) > 250 mL in 1 BAG

0409- Hospira, Inc.
0409-2025- DOBUTAMINE 0409-2025-20- 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-2025-20) > 20 mL in 1 VIAL, SINGLE-DOSE (0409-2025-60)

0409- Hospira, Inc.
0409-2025- DOBUTAMINE 0409-2025-54- 10 CARTON in 1 PACKAGE (0409-2025-54) > 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-2025-64) > 40 mL in 1 VIAL, SINGLE-DOSE

0409- Hospira, Inc.
0409-2344- DOBUTAMINE 0409-2344-88- 10 VIAL, SINGLE-DOSE in 1 TRAY (0409-2344-88) > 20 mL in 1 VIAL, SINGLE-DOSE (0409-2344-68)

0409- Hospira, Inc.
0409-2344- DOBUTAMINE 0409-2344-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-2344-01) > 20 mL in 1 VIAL, SINGLE-DOSE

0409- Hospira, Inc.
0409-2344- DOBUTAMINE 0409-2344-02- 10 VIAL, SINGLE-DOSE in 1 TRAY (0409-2344-02) > 20 mL in 1 VIAL, SINGLE-DOSE (0409-2344-62)

50090- A-S Medication Solutions
50090-4562- Dobutamine Hydrochloride in Dextrose 50090-4562-0- 250 mL in 1 BAG (50090-4562-0)

51662- HF Acquisition Co LLC, DBA HealthFirst
51662-1330- DOBUTAMINE 51662-1330-1- 250 mL in 1 BAG (51662-1330-1)

51662- HF Acquisition Co LLC, DBA HealthFirst
51662-1337- DOBUTAMINE 51662-1337-1- 20 mL in 1 VIAL, SINGLE-DOSE (51662-1337-1)

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Code ⬆