ROYAL HOSPITAL FOR WOMEN

Approved by Neonatal Clinical Committee

CLINICAL POLICIES AND PROCEDURES

NEWBORN USE ONLY

GIVEN ON DOCTORS ORDER ONLY

DOBUTAMINE
DESCRIPTION A synthetic catecholamine with primarily beta-1 adrenergic activity. An
inotropic vasopressor which increases myocardial contractility, cardiac
index, oxygen delivery and oxygen consumption. It decreases systemic and
pulmonary vascular resistance (adults). Dobutamine has a more prominent
effect on cardiac output than dopamine but less of an effect on blood
pressure. There is no evidence of a significant difference between
dopamine and dobutamine in terms of left ventricular output, tachycardia,
neonatal mortality, incidence of periventricular leukomalacia or severe
periventricular haemorrhage. Dopamine was more successful than
dobutamine in treating systemic hypotension, with fewer infants having
treatment failure.

USE Hypoperfusion and hypotension

PHARMACOKINETICS Onset of action is 2-4 minutes with peak effect in 10 minutes. Duration of
action is 7 minutes, necessitating a continuous IV infusion. Half-life is 2
minutes. Rapidly metabolised in the liver. Pharmacokinetic studies have
demonstrated wide variations in plasma concentrations between individuals
for a given dose of dobutamine. This is likely to be related to differences in
plasma clearance rates which are independent of birthweight and
gestational age. In addition, there is a poor correlation between plasma
dobutamine concentration and blood pressure response.

PRESENTATION 250mg/20ml solution vial

DOSE 2-20mcg/kg/min depending on patients response

Infusion strength Prescribed amount

1ml/hr=20mcg/kg/min 60mg/kg Dobutamine to make a 50ml solution

RECONSTITUTION SOLUTION Add prescribed amount to 5% or 10% dextrose to make a

total of 50ml solution.

ADMINISTRATION Continuous IV infusion only!

DOBUTAMINE SHOULD ALWAYS HAVE ITS OWN LINE AND NOT BE MIXED WITH ANYTHING
TO AVOID ACCIDENTAL BOLUS.

STORAGE Diluted solution is stable for 24 hours. Dobutamine solution may exhibit a
pink colour that, if present, will increase with time. This is due to slight
oxidation of the drug but does not lose its potency.

MONITORING Continuous cardio-respiratory and intra-arterial blood pressure monitoring is

preferable. Observe IV site closely for extravasation.

ADVERSE EFFECT 1. May cause hypotension if patient is hypovolemic.

2. Tachycardia and arrhythmia.
3. Tissue sloughing may occur with IV infiltration.
ROYAL HOSPITAL FOR WOMEN
Approved by Neonatal Clinical Committee

CLINICAL POLICIES AND PROCEDURES

NEWBORN USE ONLY

GIVEN ON DOCTORS ORDER ONLY

DOBUTAMINE cont

SOLUTION COMPATIBILITY 5%dextrose, 10%dextrose

INCOMPATIBILITY acyclovir, aminophylline, amphotericin B, diazepam, digoxin, furosemide,

indomethacin, phenytoin, and sodium bicarbonate.

TERMINAL INJECTION SITE COMPATIBILITY dextrose, amino acid and fat emulsion, atropine,
amiodarone, calcium chloride and gluconate, dopamine, epinephrine, fluconazole, heparin,
hydrocortisone, lidocaine, magnesium sulphate, meropenem, midazolam, morphine, pancuronium,
penicillin G, potassium chloride, propofol, ranitidine, vecuronium.

REFERENCE
Young TE, Magnum B: Neofax: A Manual of drugs used in neonatal care, ed 14. Raleigh, North Carolina: Acorn Publishing,
USA, 2001, p.94-95.
Subhedar NV, Shaw NJ. Dopamine versus dibutamine for hypotensive preterm infants. Cochrane
Database Syst Rev 2000; CD001242.