Dobutamine

What it is used for

• Short-term treatment of acute heart failure
• Unspecified cardiac support
• Unspecified cardiac support
• Short-term inotropic support (heart failure, shock, anesthesia hypotension)
• Unspecified cardiac support
• Hemodynamic support in foals (after volume repletion)
• Short-term treatment of acute heart failure
• Shock where fluid therapy alone not adequate
• Severe, decompensated, congestive heart failure
• Short-term treatment of low cardiac output and acute heart failure
• Hemodynamic support
• Unspecified cardiac support
• Vasodilatory shock if fluid resuscitation is not successful

How it is given

Possible side effects

• Tachycardia
• Facial twitching (especially in dogs)
• Seizures
• Tachyphylaxis (increasing dosages required over time)
• CNS effects such as tremors or seizures (especially in cats at >5 mcg/kg/min)
• Ectopic beats
• Increased blood pressure
• Chest pain and palpitations (reported in humans)
• Proarrhythmia (ventricular arrhythmias)
• Hypertension
• Hypokalaemia (with prolonged use)
• Nausea
• Vomiting
• Seizures (particularly in cats at higher doses)

Cautions & contraindications

• Known hypersensitivity to dobutamine or the preservative sodium bisulfite
• Idiopathic hypertrophic subaortic stenosis (IHSS)
• Uncorrected hypovolemic states
• Cardiac outflow obstruction (e.g., aortic stenosis)
• > **Warning:** Hypovolemic states must be corrected before administering dobutamine. - **Cardiac Arrhythmias:** Use with extreme caution in patients with ventricular tachyarrhythmias or atrial fibrillation. Dobutamine can enhance atrioventricular conduction; animals with atrial fibrillation should be digitalized prior to receiving dobutamine. - **Myocardial Infarction:** Use very cautiously post-MI as it may increase myocardial oxygen demand and infarct size. - **Equine Electrocardioversion:** In horses receiving electrocardioversion for atrial fibrillation, stop dobutamine for at least 5 minutes before shock delivery.

Drug interactions

• Halogenated hydrocarbon anesthetics (e.g., halothane, cyclopropane): May result in increased incidences of ventricular arrhythmias
• Beta-blockers (e.g., metoprolol, propranolol): May antagonize the cardiac effects of dobutamine, resulting in a preponderance of alpha-adrenergic effects and increased total peripheral resistance
• Nitroprusside: Synergistic effects (increased cardiac output and reduced wedge pressure) can result
• Oxytocic drugs: May induce severe hypertension when used with dobutamine in obstetric patients
• Insulin: Increased insulin requirements in diabetic patients
• Propranolol: Increased systemic vascular resistance
• Doxapram: Increased systemic vascular resistance
• Selegiline: Increased systemic vascular resistance (MAOI interaction)
• Halothane: Increased incidence of arrhythmias
• Digoxin: Recommended prior/concurrently in cases of atrial fibrillation to prevent increased ventricular rate

Frequently asked questions