Dopamine Side Effects

Some side effects of dopamine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to dopamine: intravenous solution

Get emergency medical help if you have any of these signs of an allergic reaction while taking dopamine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

• chest pain;

• fast, slow, or pounding heartbeats;

• painful or difficult urination, blood in your urine;

• weakness, confusion, swelling in your feet or ankles, urinating less than usual or not at all;

• weak or shallow breathing;

• feeling like you might pass out, even while lying down;

• burning, pain, or swelling around the IV needle;

• cold feeling, numbness, or blue-colored appearance in your hands or feet; or

• darkening or skin changes in your hands or feet.

Less serious side effects of dopamine may include:

• headache;

• feeling anxious;

• nausea, vomiting; or

• chills, goosebumps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to dopamine: intravenous solution

Cardiovascular

Cardiovascular side effects include hypotension and induction of arrhythmias (ventricular arrhythmia, atrial fibrillation). Although dopamine is 1/10th as potent as norepinephrine in increasing heart rate, tachycardia and increased AV conduction have been reported.

Bradycardia has been reported in patients receiving 16 mcg per kg per minute, which may have been a dose high enough to induce vasoconstriction, increased peripheral vascular resistance, and reflex bradycardia.

A case in which pulmonary artery pressure increased in a patient with normal arterial oxygenation who was receiving dopamine 5.6 mcg per kg per minute has been reported.

At high doses (greater than 5 mcg per kg per minute), dopamine may cause local reactions and hypertension.

Local

Local reactions due to use of dopamine in a peripheral vein may be severe. Although rare, even at high doses, cases of skin necrosis, sloughing, and even gangrene and amputations due to extravasation of dopamine in a peripheral intravenous site have been reported. This may be more likely and more severe in patients with vascular diseases (such as atherosclerosis, Raynaud's phenomenon, etc). It is highly recommended that dopamine be administered via a central venous catheter, if possible, especially in high risk patients.

If extravasation occurs, it is recommended that infusion at the intravenous site be stopped and phentolamine 5 to 10 mg in 10 to 15 mL normal saline be liberally infiltrated with a hypodermic needle into the affected site as soon as possible.

Renal

Limited data from patients with sepsis or septic shock have revealed the benefit of dopamine on diuresis and renal function (creatinine clearance) may significantly decrease over time, suggestive of a desensitization of renal dopaminergic receptors.

Renal side effects are more likely when doses exceed 5 mcg/kg/min. At these higher doses, dopamine may induce vasoconstriction, resulting in decreased renal blood flow, glomerular filtration, and renal function.

Unlike dobutamine, most doses of dopamine cause a natriuresis.

Respiratory

Respiratory side effects may be important in patients with respiratory insufficiency. Dopamine may blunt the tachypneic response to hypercapneic hypoxemia, resulting in respiratory depression.

Dermatologic

Dermatologic side effects including vasoconstriction and piloerection are common dermatologic reactions to dopamine. Skin rashes are rare.

Endocrine

Endocrine side effects including significant endocrinologic dysfunction may be induced or aggravated by prolonged infusions of this catecholamine. Prolonged infusions of dopamine can cause a decrease in serum prolactin concentrations and impair T-lymphocyte proliferation (associated with hyperprolactinemia), attenuate pulsatile growth hormone and leutinizing hormone secretion, suppress serum concentrations of dehydroepiandrosterone sulfate, and inhibit TSH release and T4 to T3 conversion. The latter can result in an iatrogenic "low T3 syndrome" or hypothyroidism.

Metabolic

Metabolic side effects including decreased thyrotropin (TSH) secretion have been reported.

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