Inotrope / vasopressor (dose-dependent) Pregnancy: Animal studies show no evidence of teratogenic effects; effect on human foetus unknown. Use in pregnancy only when expected benefits outweigh possible risks to the foetus. Breast-feeding: excretion in breast milk unknown — caution.

Dopamine hydrochloride

Brand names: various

Dopamine hydrochloride is the injectable salt of the catecholamine dopamine, given by intravenous infusion to support blood pressure and cardiac output in shock and other low-output states.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Begin infusion of dopamine hydrochloride solution at 2.5 micrograms/kg/min in patients likely to respond to modest increments of heart force and renal perfusion. In more severe cases, may be initiated at 5 micrograms/kg/min and increased gradually in 5-10 micrograms/kg/min increments up to 20-50 micrograms/kg/min as needed.

Route: Intravenous infusion (after dilution with appropriate diluents) only

Frequency: Continuous infusion, titrated to response

Max: Usual titration range up to 20-50 micrograms/kg/min; doses above 50 micrograms/kg/min require frequent urine output monitoring

Restore circulating blood volume with a suitable plasma expander or whole blood before administration where appropriate. If doses exceed 50 micrograms/kg/min, check urine output frequently; reduce dose if urinary flow decreases in the absence of hypotension. More than 50% of patients are satisfactorily maintained on doses <20 micrograms/kg/min. Adjust dose to response, watching for reduced urine flow, increasing tachycardia or new dysrhythmias as indications to decrease or temporarily suspend. MAO inhibitors within the preceding 2-3 weeks: substantially reduce dose — starting dose to at least 1/10 of the usual dose. Infuse into a large vein whenever possible, preferably with an infusion syringe pump; avoid inadvertent boluses. Do NOT add to sodium bicarbonate or other alkaline solution (inactivation). Extravasation may cause necrosis; ischaemia may be reversed with 10-15 mL saline containing 5-10 mg phentolamine mesylate infiltrated into the affected area. Elderly: cautious dose selection with an initial lower dose. Paediatric population: safety and efficacy not established.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Phaeochromocytoma
Uncorrected atrial or ventricular tachyarrhythmias or ventricular fibrillation

Side effects

Cardiovascular: ectopic heart beats, tachycardia, anginal pain, palpitation, hypotension and vasoconstriction
Gastrointestinal: nausea and vomiting
Nervous system: headache, anxiety, tremor
Respiratory: dyspnoea; Renal/urinary: polyuria
Serious/rare: gangrene of the extremities (higher doses, and lower doses in pre-existing vascular disease); fatal ventricular arrhythmias reported on rare occasions

Clinical monograph

How it works

It stimulates dopaminergic and adrenergic receptors in a dose-dependent manner, predominantly increasing myocardial contractility via beta-1 receptors and, at higher infusion rates, causing vasoconstriction via alpha-1 receptors.

Prescribing in practice

Administer through a central line using an infusion pump, because extravasation can cause severe ischaemic tissue necrosis requiring urgent treatment.
It is arrhythmogenic and can cause tachycardia and ectopy; correct hypovolaemia before starting.
Avoid in phaeochromocytoma and use cautiously in patients with tachyarrhythmias.

Monitoring

Monitor ECG, heart rate, blood pressure, urine output and the cannula site continuously throughout the infusion.

Counselling the patient

Team: give via a central line and check frequently for extravasation.
Team: monitor continuously for arrhythmias and titrate to target.

Evidence & guidelines

Its dose-dependent receptor effects and the risk of extravasation injury are well-established properties guiding its use in critical care.

Reference: ESC HF guidelines; NICE NG51 sepsis; AAGBI/FICM; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways