Catecholamine (Dose-Dependent Vasopressor/Inotrope) Pregnancy: No human data. Risks to mother and fetus from untreated shock can be fatal; life-sustaining therapy should not be withheld from a pregnant woman. Adverse developmental outcomes seen in animal studies.

Dopamine (ICU — Vasopressor/Inotrope)

Brand names: Intropin

Dopamine is an endogenous catecholamine given by continuous intravenous infusion in intensive care as a vasopressor and inotrope to support blood pressure and cardiac output in shock.

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: 2 to 5 micrograms/kg/minute (mcg/kg/minute) as a continuous intravenous infusion (recommended starting dosage)

Route: Continuous intravenous infusion into a large vein via an infusion pump, preferably in an intensive care setting

Frequency: Continuous infusion

Max: Not more than 50 micrograms/kg/minute

Titrate the infusion rate in 5 to 10 micrograms/kg/minute increments based on haemodynamic response and tolerability, up to but not more than 50 micrograms/kg/minute. Correct hypovolaemia, acidosis and hypoxia before initiating. Gradually reduce the infusion rate on discontinuation while expanding blood volume with IV fluids. MAO-inhibitor–treated patients (within 2–3 weeks): reduce the starting dosage to no greater than one-tenth (1/10) of the recommended dose. Use higher-concentration premixed solutions (e.g. 3,200 or 1,600 mcg/mL) in fluid-restricted patients. Do not mix with alkalinising solutions (dopamine is inactivated), blood, or iron salts.

Dose auto-extracted from 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

Phaeochromocytoma

Side effects

Localised vasoconstriction due to extravasation (may cause necrosis/sloughing; gangrene with high-dose/prolonged infusion) — most common
Ectopic beats and arrhythmias; palpitation; anginal pain
Hypertension
Nausea and vomiting
Headache, anxiety, dyspnoea; azotaemia

Interactions

Halogenated anaesthetics (desflurane, enflurane, isoflurane, sevoflurane) — increased cardiac autonomic irritability; may sensitise myocardium leading to ventricular arrhythmias and hypertension; monitor cardiac rhythm
MAO inhibitors (isocarboxazid, phenelzine, tranylcypromine, rasagiline, selegiline, linezolid) — prolonged/potentiated effect; reduce starting dose to ≤1/10 in patients treated within 2–3 weeks
Tricyclic antidepressants — may potentiate cardiovascular effects (e.g. hypertension); monitor blood pressure
Other vasopressors — may cause severe hypertension

Clinical monograph

How it works

It acts on dopaminergic and adrenergic receptors with dose-dependent effects, predominantly stimulating beta-1 receptors to increase cardiac contractility and, at higher infusion rates, alpha-1 receptors to cause vasoconstriction and raise blood pressure.

Prescribing in practice

Give through a central venous line via an infusion pump, as extravasation causes severe local tissue ischaemia and necrosis; if extravasation occurs treat promptly.
It frequently causes tachyarrhythmias, and noradrenaline is generally preferred as first-line vasopressor in septic shock because dopamine carries a higher arrhythmia risk.
Correct hypovolaemia before use and monitor for excessive cardiac stimulation.

Monitoring

Monitor ECG, heart rate, blood pressure, urine output and the infusion site continuously during administration.

Counselling the patient

Team: administer centrally and inspect the line for extravasation, which can cause tissue necrosis.
Team: watch for tachyarrhythmias and titrate to haemodynamic targets.

Evidence & guidelines

Sepsis guidance favours noradrenaline over dopamine as the first-line vasopressor owing to dopamine's greater arrhythmogenicity.

Reference: SOAP II Trial (NEJM 2010); Surviving Sepsis Campaign 2021; 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