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: parenteral concentrate for injection for iv infusion, parenteral injection for iv infusion
Side effects include:
Ectopic heartbeats, tachycardia, angina, palpitation, vasoconstriction, hypotension, dyspnea, nausea, vomiting, headache.
For Healthcare Professionals
Applies to dopamine: intravenous solution
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 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.
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 side effects may be important in patients with respiratory insufficiency. Dopamine may blunt the tachypneic response to hypercapneic hypoxemia, resulting in respiratory depression.
Dermatologic side effects including vasoconstriction and piloerection are common dermatologic reactions to dopamine. Skin rashes are rare.
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 side effects including decreased thyrotropin (TSH) secretion have been reported.
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