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

Dopamine

Brand names: Dopamine Injection

Dopamine is an intravenous catecholamine vasopressor and inotrope used 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: Begin infusion 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) only

Frequency: Continuous infusion, titrated to response

Max: Usual titration range up to 20-50 micrograms/kg/min; doses in excess of 50 micrograms/kg/min require frequent urine output checks

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. More than 50% of patients are satisfactorily maintained on doses <20 micrograms/kg/min. Adjust dose to patient's response (urine flow, tachycardia, new dysrhythmias as indications to decrease or temporarily suspend). Patients treated with MAO inhibitors in the preceding 2-3 weeks require a substantially reduced dose — starting dose reduced 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 (drug inactivation). Elderly: cautious dose selection, an initial lower dose is regularly used, with close monitoring. Paediatric population: safety and efficacy in paediatric patients have not been 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 (following higher doses, and at lower doses in patients with pre-existing vascular disease); fatal ventricular arrhythmias reported on rare occasions

Clinical monograph

How it works

It stimulates dopaminergic and adrenergic receptors, with effects shifting from predominantly inotropic at lower infusion rates to increasingly vasoconstrictive at higher rates.

Prescribing in practice

Give by infusion into a large or central vein with continuous monitoring, as extravasation can cause severe local ischaemia and tissue necrosis.
Correct hypovolaemia before use and be alert to tachyarrhythmias, particularly at higher infusion rates.
Reduce the rate gradually rather than stopping abruptly to avoid marked hypotension.

Monitoring

Monitor continuous ECG, blood pressure, heart rate, peripheral perfusion and urine output, and inspect the infusion site frequently.

Counselling the patient

Explain that this is a drip used to support blood pressure and circulation.
Advise reporting palpitations, chest pain or pain at the drip site.
Tell the team to treat any extravasation urgently per local protocol.

Evidence & guidelines

Dopamine is an established vasoactive agent in the management of shock, though noradrenaline is often preferred as a first-line vasopressor in current critical care practice.

Reference: SOAP-II trial; ANZICS trial; Surviving Sepsis Guidelines; 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

📚 MRCEM Revision

Featured in these MRCEM clinical pathways

Dopamine is a core drug in the following exam-focused workups on our sister siteReviseMRCEM.

Cardiogenic Shock

MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.