Dobutamine
DOBUTREX
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.
FDA-approved for
- acute heart failure (inotropic support) (1978)
FDA label
Read the full label on DailyMed ↗
| 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
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
NO BOXED WARNINGS
Principal riskTachyarrhythmia and raised myocardial oxygen demand
Cost, est. cash$10–$500/bag or supply
Generic entryBy 2023
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityUsually well tolerated at replacement doses; excessive dosing can cause agent-specific metabolic or organ toxicity.
Mechanism of action: Dobutamine ballicule
