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

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.

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.

Dermatologic

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.

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.

Hypersensitivity

Hypersensitivity reactions, including rash, drug fever, eosinophilia, and bronchospasm have been rarely associated with the use of this drug.

Gastrointestinal

Gastrointestinal side effects include nausea and vomiting in 1% to 3% of patients.

Metabolic

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.)

Nervous system

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.

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