What is Dopadic®?
Dopadic® is a medication form of a substance that occurs naturally in the body. It works by improving the pumping strength of the heart and improves blood flow to the kidneys.
Dopadic® injection (Intropin) is used to treat certain conditions, such as low pressure, that occur when you are in shock, which may be caused by heart attack, trauma, surgery, heart failure, kidney failure, and other serious medical conditions.
Dopadic® may also be used for purposes not listed in this medication guide.
Dopadic® indications
Dopadic® is indicated for the correction of hemodynamic imbalances present in the shock syndrome due to myocardial infarctions, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation as in congestive failure.
How should I use Dopadic®?
Use Dopadic® as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Dopadic® is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Dopadic® at home, carefully follow the injection procedures taught to you by your health care provider.
- If Dopadic® contains particles or is discolored (darker than slightly yellow), or if the vial is cracked or damaged in any way, do not use it.
- Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
- If you miss a dose of Dopadic®, contact your doctor right away.
Ask your health care provider any questions you may have about how to use Dopadic®.
Uses of Dopadic® in details
Use: Labeled Indications
Hemodynamic support: Adjunct in the treatment of shock (eg, MI, open heart surgery, renal failure, cardiac decompensation) that persists after adequate fluid volume replacement when indicated
Guideline recommendations:
Cardiogenic shock: To maintain systemic perfusion and preserve end-organ performance in patients with cardiogenic shock. Vasopressor therapy is indicated in patients with hemodynamic instability (eg, systolic blood pressure <90 mm Hg or evidence of end organ hypoperfusion) or the following etiologies of cardiogenic shock: Right ventricular failure, aortic regurgitation, mitral regurgitation, ventricular septal defect after MI, or bradycardia. Note: Norepinephrine is preferred over Dopadic® for most of these etiologies of cardiogenic shock due to lower likelihood for causing arrhythmias. However, in the case of shock due to bradycardia or aortic regurgitation, then Dopadic® is preferred (ACCF/AHA [Yancy 2013], AHA [van Diepen 2017]).
Inotropic support in advanced heart failure: Bridge therapy in stage D HF unresponsive to guideline-directed medical therapy and device therapy in patients awaiting heart transplant or mechanical circulatory support; short-term management of hospitalized patients with severe systolic dysfunction presenting with low blood pressure and significantly depressed cardiac output; long-term management (palliative therapy) in select patients with stage D heart failure unresponsive to guideline-directed medical therapy and device therapy who are not candidates for heart transplant or mechanical circulatory support (ACCF/AHA [Yancy 2013]).
Sepsis and septic shock: Suggested for use as an alternative vasopressor to norepinephrine only in highly selected patients (eg, patients with low risk of tachyarrhythmias and absolute or relative bradycardia) (SCCM [Rhodes 2017]).
Off Label Uses
Heart block unresponsive to atropine or pacing; Symptomatic bradycardia
Dopadic® description
Each 5 mL ampule of solution for infusion contains Dopamine Hcl (equivalent to Dopadic® 161.5 mg) 200 mg, sodium metabisulfite 50 mg and water for injection to make 5 mL.
Dopadic® is 4-(2-aminoethyl) benzene-1,2-diol hydrochloride.
Dopadic® is a naturally occurring biochemical catecholamine precursor of noradrenaline and adrenaline.
It is a white, odorless powder, freely soluble in water and soluble in alcohol. It is sensitive to light, alkalis, iron salts and oxidizing agents.
Sterile Dopadic® concentrate is a sterile solution of Dopadic® in water for injection, containing 1% sodium metabisulfite. The strength supplied by DBL is 200 mg/5 mL in a clear glass ampule. The pH of the solution is approximately 4.
Dopadic® dosage
WARNING: This is a potent drug: It must be diluted before administration to the patient.
Dopadic® Hydrochloride Injection, USP is administered (only after dilution) by intravenous infusion.
Suggested Dilution: Transfer contents of one or more ampuls or vials by aseptic technique to either 250 mL or 500 mL of one of the following sterile intravenous solutions:
- Sodium Chloride Injection, USP
- Dextrose (5%) Injection, USP
- Dextrose (5%) and Sodium Chloride (0.9%) Injection, USP
- 5% Dextrose in 0.45% Sodium Chloride Solution Injection, USP
- Dextrose (5%) and Lactated Ringer'™s Solution Injection
- Sodium Lactate Injection, USP (1/6 Molar)
- Lactated Ringer'™s Injection, USP
Dopadic® Hydrochloride Injection, USP has been found to be stable for a minimum of 24 hours after dilution in the sterile intravenous solutions listed above. However, as with all intravenous admixtures, dilution should be made just prior to administration.
Do NOT add Dopadic® Hydrochloride to Sodium Bicarbonate Injection, USP or other alkaline intravenous solutions, since the drug is inactivated in alkaline solution.
Rate of Administration: Dopadic® Hydrochloride Injection, USP, after dilution, is administered intravenously by infusion through a suitable intravenous catheter or needle. When administering Dopadic® Hydrochloride (or any potent medication) by continuous intravenous infusion, it is advisable to use a precision volume control intravenous set. Each patient must be individually titrated to the desired hemodynamic or renal response to Dopadic®.
Administration rates greater than 50 mcg/kg/minute have safely been used in advanced circulatory decompensation states. If unnecessary fluid expansion is of concern, adjustment of drug concentration may be preferred over increasing the flow rate of a less concentrated dilution.
Suggested Regimen
- When appropriate, increase blood volume with whole blood or plasma until central venous pressure is 10 to 15 cm H2O or pulmonary wedge pressure is 14 to 18 mm Hg.
- Begin infusion of diluted solution at doses of 2 to 5 mcg/kg/minute of Dopadic® Hydrochloride in patients who are likely to respond to modest increments of heart force and renal perfusion.
In more seriously ill patients, begin infusion of diluted solution at doses of 5 mcg/kg/minute of Dopadic® Hydrochloride and increase gradually using 5 to 10 mcg/kg/minute increments up to 20 to 50 mcg/kg/minute as needed. If doses in excess of 50 mcg/kg/minute are required, it is advisable to check urine output frequently. Should urinary flow begin to decrease in the absence of hypotension, reduction of Dopadic® dosage should be considered. Multiclinic trials have shown that more than 50% of the patients have been satisfactorily maintained on doses of Dopadic® less than 20 mcg/kg/minute. In patients who do not respond to these doses with adequate arterial pressures or urine flow, additional increments of Dopadic® may be given in an effort to produce an appropriate arterial pressure and central perfusion.
- Treatment of all patients requires constant evaluation of therapy in terms of the blood volume, augmentation of cardiac contractility, and distribution of peripheral perfusion. Dosage of Dopadic® should be adjusted according to the patient's response, with particular attention to diminution of established urine flow rate, increasing tachycardia or development of new dysrhythmias as indices for decreasing or temporarily suspending the dosage.
- As with all potent intravenously administered drugs, care should be taken to control the rate of administration to avoid inadvertent administration of a bolus of drug.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
How supplied
Dopadic® Injection, USP is available as follows:
| Product No. | Dopadic® mg per | volume fill How Packaged |
| NDC 0517-1805-25 | 200 mg/5 mL Vial (40 mg/mL) | Packages of 25 vials (color-coded WHITE) |
| NDC 0517-1905-25 | 400 mg/5 mL Vial (80 mg/mL) | Packages of 25 vials (color-coded GREEN) |
| NDC 0517-1305-25 | 800 mg/5 mL Vial (160 mg/mL) | Packages of 25 vials (color-coded YELLOW) |
Avoid contact with alkalies (including sodium bicarbonate), oxidizing agents or iron salts.
Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F).
NOTE - Do not use the injection if it is darker than slightly yellow or discolored in any other way.
WARNING: NOT FOR DIRECT INTRAVENOUS INJECTION, MUST BE DILUTED BEFORE USE.
INTRAVENOUS INFUSION ONLY.
The vial stopper is not made with natural rubber latex.
American Regent, Inc., Shirley, NY 11967. Revised: Dec 2014
Dopadic® interactions
See also:
What other drugs will affect Dopadic®?
Cyclopropane and halogenated hydrocarbon anaesthetics may sensitise myocardium to Dopadic® and precipitate ventricular arrhythmias. MAO inhibitors prolong and increase Dopadic® effects. Ergots potentiate vasoconstriction action of Dopadic®. Alpha-blockers unmask Dopadic®’s beta action.
Lab Interference
Suppresses pituitary secretion of thyroid-stimulating hormone, growth hormone and prolactin.
Dopadic® side effects
See also:
What are the possible side effects of Dopadic®?
Nausea, vomiting, tachycardia, ectopic beats, palpitation, anginal pain, hypotension, vasoconstriction, bradycardia, hypertension, dyspnoea, headache, widened QRS complexes, azotaemia.
Dopadic® contraindications
See also:
What is the most important information I should know about Dopadic®?
Pheochromocytoma, uncorrected tachyarrhythmias, ventricular fibrillation. Hypersensitivity.
Active ingredient matches for Dopadic®:
List of Dopadic® substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Baxter Dopamine Hydrochloride & 5% Dextrose Injection (Philippines) | |
| Baxter Dopamine Hydrochloride & 5% Dextrose Injection 800 mcg/1 mL x 1's | |
| Baxter Dopamine Hydrochloride & 5% Dextrose Injection 3200 mcg/1 mL x 1's | |
| Dokard (Philippines) | |
| Dokard 40 mg/1 mL x 5 mL x 10's | |
| DOPADICВ® | |
| Dopamin 50 | |
| Dopamin-alpha | |
| Dopamine 50 | |
| Dopamine Abbott (Vietnam) | |
| Dopamine Abbott 40 mg/1 mL x 1 Bottle 10 mL | |
| Dopamine Hydrochloride-Hospira (Hongkong) | |
| Dopamine Hydrochloride-Hospira 200 mg/5 mL x 1's | |
| Dopamine Hydrochloride-Hospira 200 mg/5 mL x 25's | |
| Dopamine in Dextrose (Taiwan) | |
| Dopamine in Dextrose 250 mL | |
| Dopamine in Dextrose 500 mL | |
| Dopamine larjan (Vietnam) | |
| Dopamine larjan 200 mg/5 mL x 10 tube x 5 mL | |
| Dopamine Rotexmedica (Vietnam) | |
| Dopamine Rotexmedica 40 mg/1 mL x 1 tube 5 mL | |
| Easydopa (Taiwan) | |
| Easydopa 250 mL | |
| Easydopa 500 mL | |
| Ezdopa (Taiwan) | |
| Ezdopa 250 mL | |
| Ezdopa 500 mL | |
| Inopan (Vietnam) | |
| Inopan 200 mg/5 mL x 10 tube x 5 mL | |
| Limdopa (Vietnam) | |
| Limdopa 200 mg/1 mL x 1 Blister x 5 tube 5 mL | |
| Limdopa 400 mg/1 mL x 1 Blister x 5 tube 5 mL | |
| Tropin 200 Injection 200 mg/5 mL (Singapore) | |
References
- PubChem. "dopamine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "dopamine". http://www.drugbank.ca/drugs/DB00988 (accessed September 17, 2018).
- DTP/NCI. "dopamine: The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents.". https://dtp.cancer.gov/dtpstandard/s... (accessed September 17, 2018).
Reviews
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Information checked by Dr. Sachin Kumar, MD Pharmacology
