Page 117 - 2026 SMOG

DOBUTAMINE (DOBUTREX)
Class/Mechanism of Action
• Adrenergic Agonist
Positive Inotropic agent. Stimulates beta -adrenergic receptors: Increases HR and contraction force
1
while sparing beta and alpha receptors.
2
˚ Onset—IV: 1–2min
Indications
• Labeled Indications
˚ Short-term management of cardiac decompensation
Contraindications
• Hypersensitivity to dobutamine or sulfites (some contain sodium metabisulfite), or any component of
the formulation
• Hypertrophic cardiomyopathy with outflow tract obstruction
Adverse Reactions/Precautions
• Always attempt to correct Hypovolemia 1st when using vasopressors and/or inotropes.
˚ May be combined with Dopamine or Norepinephrine for hypotension not responding to fluid
administration
˚ No applicable use in hemorrhagic shock until fluid replacement therapy is maximized
• An increase in BP is common, but it has a rare incidence of causing hypotension.
• Increases HR
• Hypotension and ventricular ectopy
• Pregnancy: Category B
• Lactation: Use caution
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Cardiac Decompensation Cardiac Decompensation
• IV • Continuous IV/IO
˚ 25mcg/kg/min. Start low and titrate to ˚ 2–20mcg/kg/min, titrate to effect
targeted MAP >60mmHg
■ Usual dosage: 2–10mcg/kg/min
■ Maximum dose: 20mcg/kg/min
˚ Preparation: Mix 250mg Dobutamine in
250mL D5W or NS for a concentration of
1000mcg/mL
Infusion Rates for Dobutamine
at 1000mcg/mL
Desired Delivery Rate Infusion Rate
(mcg/kg/min) (mL/kg/hr)
2.5 0.15
5 0.3
7.5 0.45
10 0.6
12.5 0.75
15 0.9
20 1.2

2026 Standard Medical Operating Guidelines (SMOG) • 109