Indications
Dobutamine is a hospital medicine given by infusion into a vein to support a weak heart. It is used for short-term treatment when the heart is not pumping strongly enough, such as in acute heart failure, cardiogenic shock (very low blood pressure caused by heart failure), after heart surgery, or in septic shock alongside other treatments. It is also used during a dobutamine stress test, which checks blood flow to the heart in people who cannot exercise.
How It Works
Dobutamine stimulates beta-1 receptors in the heart muscle. This makes the heart contract more strongly, so it pumps more blood with each beat, improving blood flow to the organs. It has only a mild effect on heart rate and blood pressure at usual doses.
Dosage and Administration
Dobutamine is given only by a doctor or nurse in hospital, as a continuous infusion into a vein using an infusion pump. The dose is calculated by body weight and adjusted minute by minute according to heart rate, blood pressure, urine output and other measurements. Patients are monitored closely, usually with continuous heart (ECG) monitoring. The infusion is reduced gradually before stopping.
Interactions
Beta blockers such as Propranolol or Metoprolol can reduce its effect. MAO inhibitors and some anaesthetic gases can increase the risk of high blood pressure or irregular heartbeat. It should not be mixed in the same line with sodium bicarbonate or other alkaline solutions. The medical team will review all your medicines.
Contraindications
Dobutamine is not used in people allergic to it (including to sulphites in some products), or in certain heart conditions where blood flow out of the heart is blocked, such as hypertrophic obstructive cardiomyopathy or severe aortic stenosis, unless specialists decide otherwise.
Side Effects
Possible side effects include a faster heartbeat, extra or irregular heartbeats, raised or sometimes lowered blood pressure, chest pain, headache, nausea, shortness of breath, low blood potassium and irritation at the infusion site. Allergic reactions are rare.
Patients receiving dobutamine are monitored in hospital. Tell the nurse or doctor at once if you notice chest pain, a racing or pounding heartbeat, breathlessness, dizziness, or pain, swelling or redness where the drip goes in.
Pregnancy and Lactation
There is limited information on use in pregnancy and breastfeeding. Dobutamine is used only when the doctor decides the benefit to the mother is greater than any risk to the baby, which is often the case in emergencies.
Precautions and Warnings
Low blood volume should be corrected before starting. Use with care in people with atrial fibrillation, recent heart attack, high blood pressure or allergy to sulphites. Long infusions can lead to reduced effect over time. Blood potassium and heart rhythm are checked during treatment.
Overdose
Too much dobutamine can cause a very fast heartbeat, high blood pressure, chest pain, tremor and dangerous heart rhythms. Because it works for only a few minutes, the team will reduce or stop the infusion and give supportive treatment.
Therapeutic Class
Inotropic agent, beta-1 adrenergic agonist (sympathomimetic).
Storage
Hospital medicine: store as directed on the pack, usually below 30°C, away from light and out of the reach of children. Diluted solutions are used within the time stated on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.