Catecholamine vasopressor / inotrope (dose-dependent) Pregnancy: Use only in life-threatening emergency.

Dopamine

Brand names: Dopamine Injection

Adult dose

Dose: Low: 2–4 mcg/kg/min (renal vasodilation); Medium: 5–10 mcg/kg/min (cardiac); High: 10–20+ mcg/kg/min (vasoconstriction)

Route: IV infusion (central line preferred)

Frequency: Continuous infusion, titrated

Max: 20 mcg/kg/min (standard); higher possible in extremis

'Low-dose dopamine' for renal protection is NOT evidence-based (ANZICS trial). Use for shock when both inotropy and vasopressor needed. Increasingly replaced by noradrenaline ± dobutamine. Central line preferred (peripheral extravasation causes necrosis).

Paediatric dose

Dose: 5 mcg/min/kg

Route: IV central

Frequency: Continuous infusion

Max: 20 micrograms/kg/min

Concentration: 1600 mcg/min/ml

2–20 mcg/kg/min. Weight-based calculation essential. Neonatal: 2–5 mcg/kg/min for renal and cardiac support. Weight-based drug tables (Broselow) used in paediatric emergencies.

Dose adjustments

Renal

Low-dose dopamine for renal protection is NOT recommended.

Hepatic

No specific adjustment.

Paediatric weight-based calculator

Patient weight (kg)

2–20 mcg/kg/min. Weight-based calculation essential. Neonatal: 2–5 mcg/kg/min for renal and cardiac support. Weight-based drug tables (Broselow) used in paediatric emergencies.

Clinical pearls

No role for 'renal-dose dopamine' — abandoned (ANZICS trial 2000)
SOAP-II: noradrenaline preferred over dopamine (fewer arrhythmias in septic shock)
High-dose dopamine increasingly replaced by noradrenaline + dobutamine combination
Peripheral extravasation: treat immediately with phentolamine 5 mg in 10 mL saline injected into affected area
MAOI interaction critical — check medication history

Contraindications

Phaeochromocytoma
Uncorrected tachyarrhythmias
Ventricular fibrillation

Side effects

Tachycardia and arrhythmias (more than noradrenaline)
Hypertension or hypotension
Necrosis and gangrene (peripheral extravasation)
Nausea and vomiting
Ischaemia (high doses)

Interactions

MAOIs — greatly increase pressor response (reduce dose to 1/10th)
Phenytoin — hypotension and bradycardia with IV combination
Halothane — cardiac arrhythmias

Monitoring

Cardiac rhythm (ECG)
BP
Urine output
Peripheral perfusion

Reference: BNFc; BNF; SOAP-II trial; ANZICS trial; Surviving Sepsis Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways