Dopamine is an emergency medicine used in hospital to raise blood pressure and improve heart function in patients in severe shock (from infection, weak heart or blood loss).
Also known as: Dopamina HCl, Revimine
Dopamine plus salbutamol adds adrenergic stimulation, with risk of tachyarrhythmias, myocardial ischaemia and hypokalaemia.
Both activate β-adrenergic receptors; additive stimulation raises cardiac output and O2 consumption and shifts K+ intracellularly (labels of both; Prontuário, beta-2 agonists).
Continuous ECG, serum potassium, heart rate, blood pressure.
Tachycardia > 120 bpm, extrasystoles, chest pain, hypokalaemia.
Monitor continuous ECG and serum potassium; limit doses; stop the beta-2 agonist if arrhythmias develop.
DailyMed — Dopamine HCl Injection label [RLD]: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1f306ad2-3606-4525-5a8a-ce78f426c1a2; Ventolin HFA (albuterol) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adb8d669-b91c-46f1-8a86-19f504840eff
Methylergometrine (vasoconstrictor) plus dopamine (vasopressor) adds peripheral and central vasoconstriction, with risk of hypertensive crisis, coronary/cerebral vasospasm and ischaemia.
Ergot alkaloids cause dose-dependent peripheral vasoconstriction ("overdose leads to peripheral vasoconstriction" — Prontuário); dopamine activates α/β-adrenergic receptors; the pressor sum can be severe.
Invasive BP, urine output, peripheral perfusion, ECG (ischaemia).
Sudden headache, chest pain, pale/cold extremities, seizures.
Avoid co-administration; if a uterotonic is needed in a vasopressor-dependent patient, prefer oxytocin alone and monitor invasive BP; taper the vasopressor gradually.
EMC-UK — Ergometrine Injection BP 0.05% w/v (hameln pharma), SmPC 4.4/4.5 (vasoconstriction, hypertension, angina/infarction): https://www.medicines.org.uk/emc/product/6265/smpc; INFARMED Prontuário Terapêutico (11th ed., 2012), Methylergometrine: peripheral vasoconstriction in overdose.
No documented food or drink interactions.
Dopamine releases endogenous noradrenaline — hypertensive/arrhythmic crisis in phaeochromocytoma.
Contraindicated; if vasopressor needed, titrated with invasive BP monitoring.
Site monograph (dopamine — caution in prior arrhythmias and phaeochromocytoma).
Dopamine increases myocardial oxygen consumption and afterload — may decompensate; continuous cardiac monitoring mandatory.
Continuous monitoring in shock; constant reassessment.
Site monograph (dopamine — continuous cardiac monitoring in shock).
No specific Annex 1 entry; IV dopamine is used in maternal shock with intensive monitoring. Sympathomimetics can cause placental vasoconstriction and fetal ischaemia at high doses — use the lowest effective dose and only if maternal benefit (shock stabilisation) justifies; fetal perfusion depends on maternal stabilisation.
Emergency use in maternal shock (ICU); lowest effective dose; monitor fetal perfusion if viable gestation is ongoing.
Compatible as an emergency drug; dopamine does not significantly pass into milk (minutes half-life).
EMC-UK (MHRA) — Dopamine hydrochloride SmPC (section 4.6). Prontuário Terapêutico INFARMED — 2.4 (Cardiovascular sympathomimetics).
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
↑ contractility and heart rate (β1) and dose-dependent peripheral vasoconstriction (α).
Direct D1, β1 and α1 agonist, and indirect (noradrenaline release from terminals); renal vasodilator effect at low dose via D1.
IV exclusive; does not significantly cross the blood-brain barrier.
Rapid metabolism by MAO and COMT (plasma, liver, kidney); plasma half-life < 2 min → continuous infusion mandatory.
~ 2 min (IV).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
