venous catheter only. Incompatible with bicarbonate and
other strong alkaline solutions.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: solution for infusion
Solution for infusion
EXCIPIENTS:May contain Sulfites
▶Dobutamine (Non-proprietary)
Dobutamine (as Dobutamine hydrochloride) 5 mg per
1mlDobutamine 250 mg/ 50 ml solution for infusion vials|
1 vialP£ 7. 50
Dobutamine (as Dobutamine hydrochloride) 12.5 mg per
1mlDobutamine 250 mg/ 20 ml concentrate for solution for infusion
ampoules| 5 ampouleP£ 10. 00 – £ 26. 25
Dopamine hydrochloride
lDRUG ACTIONDopamine is a cardiac stimulant which acts
on beta 1 receptors in cardiac muscle, and increases
contractility with little effect on rate.
lINDICATIONS AND DOSE
To correct the haemodynamic imbalance due to acute
hypotension, shock, cardiac failure, adjunct following
cardiac surgery
▶BY CONTINUOUS INTRAVENOUS INFUSION
▶Neonate:Initially 3 micrograms/kg/minute (max. per
dose 20 micrograms/kg/minute), adjusted according to
response.▶Child:Initially 5 micrograms/kg/minute (max. per dose
20 micrograms/kg/minute), adjusted according to
responselUNLICENSED USENot licensed for use in children under
12 years.
lCONTRA-INDICATIONSPhaeochromocytoma.
tachyarrhythmia
lCAUTIONSCorrect hypovolaemia.hypertension (may raise
blood pressure).hyperthyroidism
lINTERACTIONS→Appendix 1 : sympathomimetics,
inotropic
lSIDE-EFFECTSAngina pectoris.anxiety.arrhythmias.
azotaemia.cardiac conduction disorder.dyspnoea.
gangrene.headache.hypertension.mydriasis.nausea.
palpitations.piloerection.polyuria.tremor.
vasoconstriction.vomiting
lPREGNANCYNo evidence of harm inanimalstudies—
manufacturer advises use only if potential benefit
outweighs risk.
lBREAST FEEDINGMay suppress lactation—not known to
be harmful.
lDIRECTIONS FOR ADMINISTRATIONDopamine concentrate
for intravenous infusion to be diluted before use.
Forcontinuous intravenous infusion, dilute to a max.
concentration of 3. 2 mg/mL with Glucose 5 %orSodium
Chloride 0. 9 %. Infuse higher concentrations through
central venous catheter using a syringe pump to avoid
extravasation andfluid overload. Incompatible with
bicarbonate and other alkaline solutions.
▶In neonatesNeonatal intensive care, dilute 30 mg/kg body-
weight to afinal volume of 50 mL with infusionfluid; an
intravenous infusion rate of 0. 3 mL/hour provides a dose of
3 micrograms/kg/minute; max. concentration of
3. 2 mg/mL; infuse higher concentrations through central
venous catheter. Incompatible with bicarbonate and other
alkaline solutions.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: solution for infusion
Solution for infusion
▶Dopamine hydrochloride (Non-proprietary)
Dopamine hydrochloride 40 mg per 1 mlDopamine 200 mg/ 5 ml
solution for infusion ampoules| 5 ampouleP£ 20. 00 (Hospital
only)| 5 ampouleP£ 20. 00 | 10 ampouleP£ 9. 04
Dopamine 200 mg/ 5 ml concentrate for solution for infusion ampoules
| 10 ampoulePs
Dopamine hydrochloride 160 mg per 1 mlDopamine 800 mg/ 5 ml
solution for infusion ampoules| 10 ampouleP£ 34. 00SYMPATHOMIMETICS›VASOCONSTRICTOR
Ephedrine hydrochloride
lINDICATIONS AND DOSE
Reversal of hypotension from spinal or epidural
anaesthesia
▶BY SLOW INTRAVENOUS INJECTION
▶Child 1–11 years: 500 – 750 micrograms/kg every
3 – 4 minutes, adjusted according to response,
alternatively 17 – 25 mg/m^2 every 3 – 4 minutes,
adjusted according to response, injection solution to
contain ephedrine hydrochloride 3 mg/ml; maximum
30 mg per course
▶Child 12–17 years: 3 – 7. 5 mg every 3 – 4 minutes (max. per
dose 9 mg), adjusted according to response, injection
solution to contain ephedrine hydrochloride 3 mg/ml;
maximum 30 mg per courselCAUTIONSDiabetes mellitus.hypertension.
hyperthyroidism.susceptibility to angle-closure glaucoma
lINTERACTIONS→Appendix 1 : sympathomimetics,
vasoconstrictor
lSIDE-EFFECTS
▶Common or very commonAnxiety.arrhythmias.asthenia.
confusion.depression.dyspnoea.headache.
hyperhidrosis.insomnia.irritability.nausea.palpitations
.vomiting
▶Rare or very rareAcute urinary retention
▶Frequency not knownAcute angle closure glaucoma.
angina pectoris.appetite decreased.cardiac arrest.
dizziness.hypokalaemia.intracranial haemorrhage.
psychotic disorder.pulmonary oedema.tremor
lPREGNANCYIncreased fetal heart rate reported with
parenteral ephedrine.
lBREAST FEEDINGPresent in milk; manufacturer advises
avoid—irritability and disturbed sleep reported.
lRENAL IMPAIRMENTUse with caution.
lDIRECTIONS FOR ADMINISTRATIONForslow intravenous
injection, give via central venous catheter using a solution
containing ephedrine hydrochloride 3 mg/ml.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: solution for injection
Solution for injection
▶Ephedrine hydrochloride (Non-proprietary)
Ephedrine hydrochloride 3 mg per 1 mlEphedrine 30 mg/ 10 ml
solution for injection ampoules| 10 ampouleP£ 84. 56
Ephedrine 30 mg/ 10 ml solution for injection pre-filled syringes| 1 pre-
filled disposable injectionP£ 7. 59 – £ 9. 50 | 12 pre-filled disposable
injectionP£ 114. 00
Ephedrine hydrochloride 30 mg per 1 mlEphedrine 30 mg/ 1 ml
solution for injection ampoules| 10 ampouleP£ 5. 48 – £ 54. 80BNFC 2018 – 2019 Hypotension and shock 123
Cardiovascular system2