DOBUTamine

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

DOBUTamine

Indication

  • An inotropic agent used to increase cardiac output
  • Stimulates myocardial beta1-adrenergic receptors, increasing contractility and heart rate

Dosage Guidelines

  • 5-20 microgram/kg/minute IV continuous infusion
  • Begin at low dose and titrate to effect every 15 to 30 minutes as per MD/NP order

Administration

  • IV continuous infusion
  • For patients 1 kg or less:

    • Use DOBUTamine 1 mg/mL

      To make 50 mL of DOBUTamine [1 mg/mL] [50 mg/50 mL]:

      Add 4 mL (50 mg) of DOBUTamine [12.5 mg/mL] to 46 mL of solution

  • For patients over 1 kg:

    • Use DOBUTamine 2 mg/mL

      To make 50 mL of DOBUTamine [2 mg/mL] [100 mg/50 mL]:

      Add 8 mL (100 mg) of DOBUTamine [12.5 mg/mL] to 42 mL of solution

  • Administer via central line whenever possible

Adverse Effects

  • Generally, dose-related: arrhythmias, increased heart rate and blood pressure
  • Phlebitis

Comments

  • Monitor blood pressure and ECG, urine output, heart rate and O2 saturation
  • Hypovolemia should be corrected prior to use
  • Check IV site routinely for extravasation
  • If extravasation occurs, consider the use of phentolamine 
  • Non-response/poor response in blood pressure after DOBUTamine use can be related to its peripheral vasodilatory properties

Supplied As

  • 12.5 mg/mL, 20 mL vial
  • Supplied by Pharmacy as standard concentrations: of 1 mg/mL (supplied as 50 mg/50 mL of IV fluid ordered) and 2 mg/mL (100 mg/50 mL of IV fluid ordered)
    • 1 kg or less: 1 mg/mL, supplied as 50 mg in 50 mL IV solution
    • Over 1 kg:  2 mg/mL, supplied as 100 mg in 50 mL IV solution
  • At LHSC, standard concentration reference charts are available on the NICU Intranet site

References

Lexi Sick Kids and Lexi Pediatric and Neonatal