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Myocard-DX Dosage

Dosage form: injection

Medically reviewed by Last updated on Sep 16, 2022.

Dopamine Hydrochloride in 5% Dextrose Injection USP is for intravenous use only.

Dosage is to be directed by a physician.

The less concentrated 400 mcg/mL or 800 mcg/mL solutions may be preferred when fluid expansion is not a concern.

Rate of Administration — Dopamine Hydrochloride in 5% Dextrose Injection USP is administered intravenously through a suitable intravenous catheter or needle. An IV drip chamber or other suitable metering device is essential for controlling the rate of flow in drops/min. Each patient must be individually titrated to the desired hemodynamic and/or renal response with dopamine. In titrating to the desired increase in systolic blood pressure, the optimum dosage rate for renal response may be exceeded, thus necessitating a reduction in rate after the hemodynamic condition is stabilized.

Administration at rates greater than 50 mcg/kg/min have safely been used in advanced circulatory decompensation states. If unnecessary fluid expansion is of concern, adjustment of drug concentration may be preferred over increasing the flow rate of a less concentrated dilution.

Suggested Regimen

  1. When appropriate, increase blood volume with whole blood or plasma until central venous pressure is 10 to 15 cm H2O or pulmonary wedge pressure is 14 to 18 mm Hg.
  2. Begin infusion of dopamine hydrochloride solution at doses of 2.5 mcg/kg/min in patients who are likely to respond to modest increments of heart force and renal perfusion.
    In more seriously ill patients, begin infusion of dopamine hydrochloride at doses of 5 mcg/kg/min and increase gradually using 5 to 10 mcg/kg/min increments up to a rate of 20 to 50 mcg/kg/min as needed. If doses in excess of 50 mcg/kg/min are required, it is suggested that the urine output be checked frequently. Should urine flow begin to decrease in the absence of hypotension, reduction of dopamine dosage should be considered. Multiclinic trials have shown that more than 50% of the patients were satisfactorily maintained on doses of dopamine hydrochloride less than 20 mcg/kg/min. In patients who do not respond to these doses with adequate arterial pressure or urine flow, additional increments of dopamine may be employed in an effort to produce an appropriate arterial pressure and central perfusion.
  3. Treatment of all patients requires constant evaluation of therapy in terms of blood volume, augmentation of myocardial contractility, and distribution of peripheral perfusion. Dosage of dopamine should be adjusted according to the patient’s response, with particular attention to diminution of established urine flow rate, increasing tachycardia or development of new dysrhythmias as indices for decreasing or temporarily suspending the dosage.
  4. As with all potent intravenously administered drugs, care should be taken to control the rate of infusion so as to avoid inadvertent administration of a bolus of the drug.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

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