2 DOSAGE AND ADMINISTRATION
2.1 Administration Instructions
Correct Hypovolemia, Acidosis, and Hypoxia
Address hypovolemia, acidosis, and hypoxia before initiating Dopamine HCl in Dextrose Injection. If patient does not respond to therapy, suspect occult hypovolemia. Acidosis may reduce the effectiveness of dopamine [see Warnings and Precautions (5.1)].
Dopamine HCl in Dextrose Injection is a premixed infusion solution that does not require dilution prior to intravenous administration. Administer Dopamine HCl in Dextrose Injection into a large vein [see Warnings and Precautions (5.1)] with the use of an infusion pump preferably in an intensive care setting.
Remove outer wrap (moisture and oxygen barrier) only when ready to administer the product. Discard product if outer wrap is damaged (e.g., tears or holes). Inspect Dopamine HCl in Dextrose Injection for particulate matter and discoloration prior to administration (the solution is clear to slightly yellow). Do not administer if the solution is darker than slightly yellow or the container is damaged.
Use higher concentration premixed solutions (e.g., 3200 mcg/mL or 1600 mcg/mL strengths) in patients requiring fluid restriction.
When discontinuing Dopamine HCl in Dextrose Injection, gradually reduce the infusion rate while expanding blood volume with intravenous fluids [see Warnings and Precautions (5.3)].
2.2 Recommended Dosage
The recommended starting dosage in adults and pediatric patients is 2 to 5 mcg/kg/minute as a continuous intravenous infusion [see Dosage and Administration (2.3)]. Titrate the infusion rate in 5 to 10 mcg/kg/minute increments based on hemodynamic response and tolerability, up to but not more than 50 mcg/kg/minute.
Infusion rates may be calculated using the following formula:
|Infusion Rate (mL/hour) =||[Dose (mcg/kg/minute) × Weight (kg) × 60 (minutes/hour)]|
Example calculations for infusion rates are as follows:
Example 1: for a 60 kg person at the recommended initial dose of 2 mcg/kg/minute using an 800 mcg/mL concentration, the infusion rate would be as follows:
|Infusion Rate (mL/hour) =||[2 (mcg/kg/minute) × 60 (kg) × 60 (minutes/hour)]||= 9 (mL/hour)|
Example 2: for a 70 kg person at a dose of 5 mcg/kg/minute using a 3,200 mcg/mL concentration, the infusion rate would be as follows:
|Infusion Rate (mL/hour) =||[5 (mcg/kg/minute) × 70 (kg) × 60 (minutes/hour)]||= 6.56 (mL/hour)|
2.3 Drug Incompatibilities
Dopamine HCl in Dextrose Injection is incompatible with the following products; therefore, avoid simultaneous administration (through the same infusion set):
- Sodium bicarbonate or other alkalinizing substances, because dopamine is inactivated in alkaline solution.
- Blood, because of the risk of pseudoagglutination of red cells
- Iron salts
Do not add additional medications in the premixed infusion solution.