Dobutamine is indicated for patients who require a positive inotropic support in the treatment of cardiac decompensation due to depressed contractility.
In cardiogenic shock characterised by heart failure with severe hypotension and in case of septic shock dobutamine may be useful if added to dopamine in case of disturbed ventricular function, raised filling pressure of the ventricles and raised systemic resistance.
For this indication, competent medicine agencies globally authorize below treatments:
Intravenous
2.5 - 40 ug per kg of body weight
From 2.5 To 40 ug per kg of body weight once every day
According to experience, the majority of patients respond to doses of 2.5-10 µg dobutamine/kg/min. In individual cases, doses up to 40 µg dobutamine/kg/min have been administered.
One ampoule or vial Dobutamine 5 mg/ml (250 mg in 50 ml) diluted to a solution volume of 500 ml (final concentration 0.5 mg/ml).
| Dosage range | Specifications in ml/h* (drops/min) | |||
|---|---|---|---|---|
| Patient’s weight | ||||
| 50 kg | 70 kg | 90 kg | ||
| Low 2.5 µg/kg/min | ml/h (drops/min) | 15 (5) | 21 (7) | 27 (9) |
| Medium 5 µg/kg/min | ml/h (drops/min) | 30 (10) | 42 (14) | 54 (18) |
| High 10 µg/kg/min | ml/h (drops/min) | 60 (20) | 84 (28) | 108 (36) |
* For double concentration, i.e. 500 mg dobutamine added to 500 ml, or 250 mg added to 250 ml solution volume, infusion rates must be halved.
One ampoule or vial Dobutamine 5 mg/ml (250 mg in 50 ml) undiluted (final concentration 5 mg/ml).
| Dosage range | Specifications in ml/h* (drops/min) | |||
|---|---|---|---|---|
| Patient’s weight | ||||
| 50 kg | 70 kg | 90 kg | ||
| Low 2.5 µg/kg/min | ml/h (ml/min) | 1.5 (0.025) | 2.1 (0.035) | 2.7 (0.045) |
| Medium 5 µg/kg/min | ml/h (ml/min) | 3.0 (0.05) | 4.2 (0.07) | 5.4 (0.09) |
| High 10 µg/kg/min | ml/h (ml/min) <> | 6.0 (0.10) | 8.4 (0.14) | 10.8 (0.18) |
The chosen syringe pump must be suitable for the volume and rate of administration.
Only for intravenous infusion (syringe pump). Dilution is not required.
Intravenous infusion of dobutamine is also possible after dilution with compatible infusion solutions such as: 5% glucose solution, 0.9% sodium chloride or 0.45% sodium chloride in 5% glucose solution. Infusion solutions should be prepared immediately before use.
Due to its short half-life, dobutamine must be administered as a continuous intravenous infusion.
The dose of dobutamine should be gradually reduced when discontinuing therapy.
The duration of treatment depends on the clinical requirements and is to be determined by the physician and should be as short as possible.
If dobutamine is administered continuously for more than 72 hours, tolerance may occur, requiring an increase in the dose.
During the course of dobutamine administration, heart rate, heart rhythm, blood pressure, diuresis and infusion rate should be closely monitored. Cardiac output, central venous pressure (CVP) and pulmonary capillary pressure (PCP) should be monitored if possible.