Dobutrex Side Effects
Generic Name: dobutamine
Note: This page contains information about the side effects of dobutamine. Some of the dosage forms included on this document may not apply to the brand name Dobutrex.
Not all side effects for Dobutrex may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to dobutamine: parenteral concentrate for injection for iv infusion, parenteral injection for iv infusion
Side effects include:
Ectopic heartbeats, increased heart rate, elevations in BP, hypotension, phlebitis, local inflammatory changes.
For Healthcare Professionals
Applies to dobutamine: intravenous solution
Cardiovascular side effects have included hypertension (increases of 50 mm Hg in up to 8% of patients) or hypotension (unusual), increased heart rate (10%), chest pain (8% to 19%), ectopic depolarizations (increased frequency of PVCs in 3% to 15%), and ventricular tachycardia (including rare cases of sustained VT) in approximately 4% of patients. Patients with atrial fibrillation may develop a more rapid ventricular response to dobutamine-induced AV conduction enhancement. Tolerance to the hemodynamic effects of dobutamine (the active ingredient contained in Dobutrex) may occur after 72 to 96 hours, which may necessitate increased doses. A case of cardiac rupture and death during dobutamine stress testing has been reported. A case of dobutamine-induced complete heart block has also been reported.[Ref]
Dobutamine rarely has caused ventricular tachycardia. The de novo occurrence of a sustained ventricular tachyarrhythmia during dobutamine infusion has been associated with a significant risk of arrhythmia recurrence of approximately 47%, which can occur in the presence or absence of dobutamine therapy. Reexposure to low-dose dobutamine in patients with hemodynamically stable conditions appears to be relatively safe.
In a study of 20 patients who developed hypotension associated with dobutamine and who underwent cardiac catheterization, 13 were found to have dobutamine-induced wall motion abnormalities. These 13 also had significant coronary artery disease (greater than 70% narrowing in at least one vessel), whereas the 7 who had no drug-induced wall motion abnormalities did not have significant coronary artery disease.
Rare cases of acute myocardial infarction have been associated with dobutamine infusion, including administration during dobutamine stress echocardiography. The mechanism is not known, but may involve alpha-1-mediated coronary vasoconstriction. Limited data suggest that most affected patients have significant underlying coronary artery disease.
A 66-year-old patient with recent myocardial infarction died while undergoing low dose dobutamine stress echocardiography. Baseline characteristics revealed dyskinesia and diastolic thinning of the proximal inferior wall with preserved function. Following an uneventful dosage titration of dobutamine from 4 mcg to 10 mcg, the patient experienced atypical chest pain at the base of the right hemithorax and a new onset pericardial effusion was noted. The patient died despite immediate pericardiocentesis and cardiopulmonary resuscitation.[Ref]
Rare cases of scalp pruritus and dermal cellulitis have been associated with the use of dobutamine (the active ingredient contained in Dobutrex) These reactions are believed to be due to hypersensitivity to the drug.[Ref]
Dermatologic side effects are related to administration via a peripheral vein. Extravasation of dobutamine can cause local skin necrosis. For this reason, central venous administration is recommended.[Ref]
Hypersensitivity reactions, including rash, drug fever, eosinophilia, and bronchospasm have been rarely associated with the use of this drug.[Ref]
Gastrointestinal side effects include nausea and vomiting in 1% to 3% of patients.[Ref]
Metabolic changes that have been associated with the use of dobutamine (the active ingredient contained in Dobutrex) include decreased blood glucose and plasma potassium, and elevated plasma glycerol and free fatty acid concentrations. (Dobutamine stimulates insulin secretion and is lypolytic.)[Ref]
Nervous system side effects, such as paresthesias and lightheadedness, have been reported in patients after inadvertently receiving high doses of dobutamine (the active ingredient contained in Dobutrex) In a study using dobutamine during stress echocardiography, anxiety was reported in 6%, headache in 4%, and tremors in 4% of patients. Myoclonus has also been associated with dobutamine administration in patients with renal insufficiency.[Ref]
1. Paulman PM, Cantral K, Meade JG, Vettel K, Loperena R, Odrezin M "Dobutamine overdose ." JAMA 264 (1990): 2386-7
2. Picano E, Mathias W, Pingitore A, Bigi R, Previtali M "Safety and tolerability of dobutamine-atropine stress echocardiography: a prospective, multicentre study." Lancet 344 (1994): 1190-2
3. Reisenhofer B, Squarcini G, Picano E "Cardiac rupture during dobutamine stress test." Ann Intern Med 128 (1998): 605
4. Heinle SK, Tice FD, Kisslo J "Hypotension during dobutamine stress echocardiography: is it related to dynamic intraventricular obstruction?" Am Heart J 130 (1995): 314-7
5. Rosamond TL, Vacek JL, Hurwitz A, Rowland AJ, Beauchamp GD, Crouse LJ "Hypotension during dobutamine stress echocardiography: initial description and clinical relevance." Am Heart J 123 (1992): 403-7
6. Reed W, Newman K, Applefeld M, Sutton F "Drug extravasation as a complication of venous access ports." Ann Intern Med 102 (1985): 788-91
7. Baudhuin T, Marwick T, Melin J, Wijns W, D'Hondt AM, Detry JM "Diagnosis of coronary artery disease in elderly patients: safety and efficacy of dobutamine echocardiography." Eur Heart J 14 (1993): 799-803
8. Previtali M, Lanzarini L, Fetiveau R, Poli A, Diotallevi P "Dobutamine-induced and spontaneous sustained ventricular tachycardia in recent myocardial infarction." Eur Heart J 17 (1996): 803-4
9. Mertes H, Sawada SG, Ryan T, Segar DS, Kovacs R, Foltz J, Feigenbaum H "Symptoms, adverse effects, and complications associated with dobutamine stress echocardiography. Experience in 1118 patients." Circulation 88 (1993): 15-9
10. Poldermans D, Fioretti PM, Boersma E, Forster T, Vanurk H, Cornel JH, Arnese M, Roelandt JRTC "Safety of dobutamine-atropine stress echocardiography in patients with suspected or proven coronary artery disease." Am J Cardiol 73 (1994): 456-9
11. Tisdale JE, Patel R, Webb CR, Borzak S, Zarowitz BJ "Electrophysiologic and proarrhythmic effects of intravenous inotropic agents." Prog Cardiovasc Dis 38 (1995): 167-80
12. Cohen A, Chauvel C, Benhalima B, Blanchard B "Complication of dobutamine stress echocardiography." Lancet 345 (1995): 201-2
13. Kinder C, Chamberlain J, Kall J, Kopp D, Johnson M, Costanzo MR, Wilber D "Prognostic significance of sustained ventricular tachyarrhythmia occurring during dobutamine infusion." J Heart Lung Transplant 13 (1994): 1045-50
14. Vaidyanathan L, Anand N, Stead LG, Boie ET, Sztajnkrycer MD, Goyal DG "Dobutamine-induced complete heart block." South Med J 101 (2008): 988
15. Wirtz CE "Sustained atrial fibrillation after dobutamine stress echocardiography in an older patient with left atrial enlargement." West J Med 162 (1995): 268-9
16. Unverferth DV, Blanford M, Kates RE, Leier CV "Tolerance to dobutamine after a 72 hour continuous infusion." Am J Med 69 (1980): 262-6
17. Green CJ, Frazer RS, Underhill S, Maycock P, Fairhurst JA, Campbell IT "Metabolic effects of dobutamine in normal man." Clin Sci 82 (1992): 77-83
18. Bianchi C, Diaz R, Gonzales C, Beregovich J "Effects of dobutamine on atrioventricular conduction." Am Heart J 90 (1975): 474-8
19. McCauley CS, Blumenthal MS "Dobutamine and pruritus of the scalp ." Ann Intern Med 105 (1986): 966
20. Applefeld MM, Newman KA, Sutton FJ, Reed WP, Roffman DS, Talesnick BS, Grove WR "Outpatient dobutamine and dopamine infusions in the management of chronic heart failure: clinical experience in 21 patients." Am Heart J 114 (1987): 589-95
21. Chapman SA, Stephan T, Lake KD, Sonnesyn SW, Emery RW "Fever induced by dobutamine infusion." Am J Cardiol 74 (1994): 517
22. Cernek PK "Dermal cellulitis--a hypersensitivity reaction from dobutamine hydrochloride." Ann Pharmacother 28 (1994): 964
23. Wood SM, Milne JR, Evans SF, Rogers P "Effect of dobutamine on insulin requirement in diabetic ketoacidosis." Br Med J (Clin Res Ed) 282 (1981): 946-7
24. Boord A, Benson B "Myoclonus associated with continuous dobutamine infusion in a patient with end-stage renal disease." Am J Health Syst Pharm 64 (2007): 2241-3
More about Dobutrex (dobutamine)
Related treatment guides
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.