Name: DOBUTAMINE (DobutrexR)
Classification: sympathomimetic; inotropic agent
  • synthetic derivative of isoproterenol; decreases afterload 
  • stimulates beta1 adrenergic receptors to increase myocardial contractility 
  • alpha adrenergic receptors increase blood pressure at low dose
Dose: Infusion:
2.5-10 mcg/kg/min (start at low dose and titrate to target cardiac index, venous oxygen saturation or other indicator of cardiac output)
Administration: IV Infusion
500 mg/250 mL D5W, NS, RL
  • Protect from light
  • May turn pink in solution without affecting potency
  • Hypovolemia, acidosis and hypoxemia should be corrected concurrently with therapy
  • Should be weaned off
Adverse Effects:
  • decreased BP (should not be started in hypotensive patients - increased hypotension at doses > 20 mcg/kg/min or in septic patients)
  • tachycardia
  • increased BP (associated with low doses)
  • arrhythmias (usually PVC)
  • increased blood glucose
  • extravasation of drug may cause tissue necrosis (may be Rx with 5-15 mg phentolamine in NS - see phentolamine monograph)
Drug Interactions:
  • dobutamine + other sympathomimetics = increased risk of toxicity
  • dobutamine + theophylline = increased risk of toxicity
  • dobutamine + general anaesthetics = arrhythmias
  • dobutamine + beta blockers = decreased inotropic effect
Monitoring Therapy:
  • HR, ECG
  • BP
  • cardiac index
  • blood glucose
  • PWP
  • electrolytes
  • arterial lactate
  • urine output
CCTC Protocol:
  • May be administered by IV infusion by an approved nurse in CCTC.
  • May be titrated by an approved nurse in CCTC.
  • Must be administered via central line.
  • Continuous infusion must be administered via an infusion pump.
  • Should not be infused through the proximal injectate port (blue) of the Swan Ganz catheter.
  • Patient requires placement of an arterial line to monitor BP.

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: January 12, 2017

LHSCHealth Professionals

Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada