Generic drug of the therapeutic class: Anesthesia, resuscitation, analgesics
Active ingredients: Dobutamine
Injection solution for IV infusion
Dobutamine is indicated in patients requiring positive inotropic treatment in the event of cardiac decompensation due to a decrease in contractility following either organic cardiac involvement or surgery, particularly when low cardiac output is associated with an increase in cardiac output. pulmonary capillary pressure.
Dosage DOBUTAMINE BAXTER 1 mg / ml Solution for infusion Box of 10 Pockets of 250 ml
- Adults :
Regardless of the indication, the usual dose varies between 2.5 and 10 μg / kg / min, a dosage of between 250 mg / day and 1000 mg / day approximately in patients with a body weight of 70 kg. A low dose up to 0.5 μg / kg / min may also be effective in some cases. The initial dose is usually 2.5 μg / kg / min, without loading dose, and the dosage is increased depending on the patient's symptoms and hemodynamic response.
The duration of treatment is determined by the pre-existing condition of the patient and the therapeutic response obtained.
Due to the high concentration of metabisulfites of DOBUTAMINE BAXTER, the duration of administration should be limited to 48 hours (see warnings and precautions for use).
- General information about dobutamine :
Tolerance is likely to develop during continuous long-term infusions.
Therefore, to achieve the same effects, it may be necessary to administer higher doses up to 40 mg / kg / day, the maximum recommended daily dose.
To avoid tolerance, intermittent infusions may be performed pending further treatment, particularly in the case of a heart transplant.
- Administration :
DOBUTAMINE BAXTER solution for infusion should always be administered by intravenous infusion.
In order to obtain a precise and regular delivery rate, the administration of DOBUTAMINE BAXTER must always be carried out by means of a positive displacement pump.
Administration rate (ml / h) of DOBUTAMINE BAXTER 1 mg / ml:
Infusion rate (μg / kg / min): 2.5 / 5 / 7.5 / 10 / 12.5 / 15.
. 30 kg: 4.5 / 9 / 13.5 / 18 / 22.5 / 27.
. 40 kg: 6/12/18/24/30/36.
. 50 kg: 7.5 / 15 / 22.5 / 30 / 37.5 / 45.
. 60 kg: 9/18/27/36/45/54.
. 70 kg: 10.5 / 21 / 31.5 / 42 / 52.5 / 63.
. 80 kg: 12/24/36/48/60/72.
. 90 kg: 13.5 / 27 / 40.5 / 54 / 67.5 / 81.
. 100 kg: 15/30/45/60/75/90.
. 110 kg: 16.5 / 33 / 49.5 / 66 / 82.5 / 99.
- Surveillance :
The rate of administration and duration of treatment should be appropriate to the patient's response, as determined by heart rate, blood pressure, presence of ectopic activity, urinary flow, and if possible, venous pressure measurement. central, pulmonary arterial occlusion pressure and cardiac output. Treatment with dobutamine should not be abruptly discontinued, but the dose should be reduced gradually to avoid rebounding.
- Children :
Particular care must be taken in children under one year of age as their reactions may be qualitatively and quantitatively different from those of adults.
Dobutamine was administered to low-flow children resulting from decompensated heart failure, cardiac surgery, and cardiogenic or septic shock. Some hemodynamic effects of dobutamine may be different in children compared with adults. The increase in heart rate and blood pressure seems to be more frequent and more intense in children. Unlike adults, pulmonary capillary pressure may not be lowered in children; but may increase, especially in children under one year old. Therefore, the use of dobutamine in children should be closely monitored, taking into account these pharmacodynamic characteristics.
- Seniors :
No particular problem should be considered when using DOBUTAMINE BAXTER in these patients.
This medicine should never be used in case of:
- Hypersensitivity to dobutamine or any of the excipients.
- Mechanical obstruction to filling or ejection of the left ventricle, including obstructive cardiomyopathy, aortic stenosis, constrictive pericarditis.
- Intraventricular dynamic obstruction.
- Decompensation associated with hypertrophic cardiomyopathy.
- Patients with asthma, atopic or allergic to aspirin or nonsteroidal anti-inflammatory drugs (see warnings and precautions for use).
Glucose should not be used after an acute stroke, or in the first 24 hours after a head injury.
Breast-feeding: There is no data to know if dobutamine passes into breast milk. Breastfeeding should be interrupted if treatment is needed during this period.
Adverse effects Dobutamine Baxter
- Very common (> 1/10):
Cardiovascular disorders : increased systolic pressure from 10 to 20 mmHg and increased heart rate by 5 to 15 beats per minute.
- Frequent (> 1/100 and <1/10):
. Cardiovascular disorders : increased systolic blood pressure, increased heart rate, ventricular extrasystoles, angina, nonspecific chest pain, palpitations.
. Gastrointestinal disorders : nausea.
. Respiratory, thoracic and mediastinal disorders : dyspnea.
- Uncommon (> 1/1000 and <1/100):
. Cardiovascular disorders : thrombophlebitis.
. Skin and subcutaneous reactions: Local inflammatory reactions have been described following accidental extravasation.
- Rare (> 1/10000 and <1/1000):
. Immune system disorders : reactions suggestive of hypersensitivity with skin rash or urticaria, edema, fever, eosinophilia and bronchospasm.
. Cardiovascular disorders : hypotension, intensification of ischemia, ventricular tachycardia.
. Metabolic disorders : slight decrease in serum potassium, even rare cases of hypokalemia in patients at risk, especially those undergoing treatment with diuretics hypokaliémiants.