Dobutamine-Hameln
Generic Name
Dobutamine
Manufacturer
Hameln pharma GmbH
Country
Germany
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dobutamine hameln 250 mg injection | ৳ 1,000.00 | N/A |
Description
Overview of the medicine
Dobutamine is a direct-acting inotropic agent used to treat cardiac decompensation due to depressed contractility, such as in cardiogenic shock or heart failure.
Uses & Indications
Dosage
Adults
Initial dose 2.5-10 mcg/kg/min as a continuous intravenous infusion; may be titrated up to 20 mcg/kg/min based on patient response and hemodynamic parameters. Doses up to 40 mcg/kg/min have been used in severe cases.
Elderly
No specific dose adjustment for elderly patients; however, careful monitoring and titration are recommended due to potential age-related physiological changes.
Renal_impairment
No specific dose adjustment guidelines; monitor hemodynamic response closely.
How to Take
Dobutamine is administered as a continuous intravenous infusion after dilution in an appropriate intravenous fluid (e.g., 5% Dextrose Injection, 0.9% Sodium Chloride Injection). It should be administered via an infusion pump to ensure accurate dosing.
Mechanism of Action
Dobutamine primarily stimulates beta-1 adrenergic receptors in the heart, leading to increased myocardial contractility (inotropy) and stroke volume, with relatively minor effects on heart rate (chronotropy) and peripheral vascular resistance at therapeutic doses.
Pharmacokinetics
Onset
1-10 minutes (following initiation of infusion).
Excretion
Excreted mainly in the urine as metabolites.
Half life
Approximately 2 minutes.
Absorption
Administered intravenously, hence 100% bioavailability. Rapidly distributed.
Metabolism
Primarily metabolized in the liver and other tissues by catechol-O-methyltransferase (COMT) to inactive metabolites, including 3-O-methyl dobutamine.
Side Effects
Contraindications
- Known hypersensitivity to dobutamine or any component of the formulation.
- Idiopathic hypertrophic subaortic stenosis (IHSS), as dobutamine may exacerbate outflow obstruction.
- Pheochromocytoma.
Drug Interactions
Beta-blockers
May antagonize the cardiac effects of dobutamine, leading to reduced inotropic response.
MAO Inhibitors
Concurrent use may lead to hypertensive crisis due to enhanced adrenergic activity. Avoid co-administration.
Alpha-adrenergic blockers
Co-administration may result in dominant beta-2 effects, leading to vasodilation and hypotension.
Vasodilators (e.g., Sodium Nitroprusside)
May have an additive or synergistic effect, increasing cardiac output and reducing pulmonary wedge pressure more effectively.
Inhaled anesthetics (e.g., Halothane, Cyclopropane)
May sensitize the myocardium to arrhythmogenic effects of dobutamine.
Storage
Store below 25°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include excessive cardiac stimulation (e.g., tachycardia, arrhythmias, hypertension, myocardial ischemia), peripheral vasodilation, and headache. Management: Reduce or discontinue the dobutamine infusion. The effects are usually short-lived due to its short half-life. Supportive measures should be instituted.
Pregnancy & Lactation
Pregnancy Category B/C (risk cannot be ruled out). Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether dobutamine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Known hypersensitivity to dobutamine or any component of the formulation.
- Idiopathic hypertrophic subaortic stenosis (IHSS), as dobutamine may exacerbate outflow obstruction.
- Pheochromocytoma.
Drug Interactions
Beta-blockers
May antagonize the cardiac effects of dobutamine, leading to reduced inotropic response.
MAO Inhibitors
Concurrent use may lead to hypertensive crisis due to enhanced adrenergic activity. Avoid co-administration.
Alpha-adrenergic blockers
Co-administration may result in dominant beta-2 effects, leading to vasodilation and hypotension.
Vasodilators (e.g., Sodium Nitroprusside)
May have an additive or synergistic effect, increasing cardiac output and reducing pulmonary wedge pressure more effectively.
Inhaled anesthetics (e.g., Halothane, Cyclopropane)
May sensitize the myocardium to arrhythmogenic effects of dobutamine.
Storage
Store below 25°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include excessive cardiac stimulation (e.g., tachycardia, arrhythmias, hypertension, myocardial ischemia), peripheral vasodilation, and headache. Management: Reduce or discontinue the dobutamine infusion. The effects are usually short-lived due to its short half-life. Supportive measures should be instituted.
Pregnancy & Lactation
Pregnancy Category B/C (risk cannot be ruled out). Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether dobutamine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, refer to specific product labeling for exact duration.
Availability
Hospitals, Clinics, Pharmacies (with prescription)
Approval Status
Approved
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Dobutamine has undergone extensive clinical trials demonstrating its efficacy and safety in patients with cardiac decompensation since its approval. Ongoing studies may explore its use in specific patient populations or novel applications.
Lab Monitoring
- Continuous ECG monitoring for arrhythmias.
- Frequent monitoring of blood pressure, heart rate, and cardiac output (if available).
- Urine output.
- Electrolyte balance (especially potassium).
Doctor Notes
- Crucial to continuously monitor hemodynamic parameters (BP, HR, CVP, PCWP, CO) and ECG during infusion.
- Dose must be individualized and carefully titrated to achieve desired effects while minimizing adverse reactions.
- Correct hypovolemia prior to initiating dobutamine, if possible.
- Use with caution in patients with severe coronary artery disease as it may exacerbate myocardial ischemia.
Patient Guidelines
- This medication is administered in a hospital setting by healthcare professionals.
- Report any discomfort, chest pain, shortness of breath, or palpitations immediately to your healthcare provider.
- The dosage will be carefully adjusted based on your response and vital signs.
Missed Dose Advice
Dobutamine is administered in a controlled clinical setting, usually as a continuous infusion. Missed doses are not applicable as the infusion is constantly monitored and adjusted by healthcare professionals.
Driving Precautions
Not applicable, as dobutamine is administered to hospitalized patients who are not expected to drive.
Lifestyle Advice
- Not applicable, as this medication is used in acute care settings and is not intended for long-term or outpatient use.
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