Dobutamine

DOBUTREX

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Pronunciation: doe-BYOO-ta-meen

Dobutamine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Dobutamine ballicule

What it isBeta-1 selective agonist; cardiogenic shock, decompensated heart failure and pharmacological stress testing.

Why this oneIt raises contractility more than heart rate at moderate doses, and is titratable within minutes.

What limits itTachyarrhythmia and increased myocardial oxygen demand. Tolerance develops within days; it lowers blood pressure through beta-2 vasodilation.

Dobutamine molecular structure (skeletal formula) — Molecular structure: Dobutamine

FDA-approved for

acute heart failure (inotropic support) (1978)

FDA label

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FDA dosing	Population	Start	Target	Max
Short-term inotropic support for cardiac decompensation	Adult (IV infusion)	0.5–1 mcg/kg/min	2–20 mcg/kg/min, titrated to response	40 mcg/kg/min (rare)

Titration Titrate at intervals of a few minutes, guided by patient response.

Renal Undefined

Hepatic Undefined

Instructions

Administer IV via calibrated electronic infusion device
Do not add supplementary medications to the solution
Do not administer simultaneously with sodium bicarbonate or strong alkaline solutions, or through the same set as blood
Container may be inappropriate for pediatric patients under 30 kg

Available strengths

inj 12.5 mg/mL

Contraindications

Idiopathic hypertrophic subaortic stenosis (IHSS)

Cautions

Increased heart rate, blood pressure, and ventricular ectopic activity (dose-related)
Hypotension
Stress cardiomyopathy (with cardiac stress testing)
Hypokalemia
Phlebitis / local inflammation at infusion site

Adverse reactions

Increased systolic BP and heart rate
Increased premature ventricular beats
Hypotension
Phlebitis
Nausea, headache, anginal/chest pain, palpitations, dyspnea
Hypokalemia

Pregnancy Undefined

Lactation Undefined

Cost

Dobutamine (DOBUTREX)

Strength		#/mo	generic $/unit	CostPlus
12.5 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Dobutamine is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryBy 2023

NO BOXED WARNINGS

Principal riskTachyarrhythmia and raised myocardial oxygen demand

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityUsually well tolerated at replacement doses; excessive dosing can cause agent-specific metabolic or organ toxicity.

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