Dopamine HCl is used to treat hemodynamic imbalances caused by myocardial infarction, shock, trauma, endotoxic septicemia, open-heart surgery, renal failure, and chronic cardiac decompensation as in congestive failure.

• This is a strong medication that must be diluted before being administered to the patient. Dopamine Hydrochloride Injection, USP is administered intravenously (only after dilution).
• Correct hypovolemia, acidosis, and hypoxia prior to use.
• Administer in a large vein with an infusion pump preferably in an intensive care setting.
• Recommended starting dosage in adults and pediatric patients is 2 to 5 mcg/kg/minute as a continuous intravenous infusion. Titrate in 5 to 10 mcg/kg/minute increments based on hemodynamic response and tolerability, up to not more than 50 mcg/kg/minute.

The following adverse reactions have been observed:

• Arrythmia (tachycardia)
• palpitation
• hypotension
• hypertension
• headache
• anxiety

Tachycardia

Hypotension

Headache

Anxiety

• Tissue ischemia: Severe peripheral and visceral vasoconstriction can occur. Address hypovolemia prior to use, monitor extremities, and infuse into large vein.
• Cardiac arrhythmias: Monitor closely.
• Hypotension after abrupt discontinuation: Gradually reduce infusion rate while expanding blood volume with intravenous fluids.
• Severe hypersensitivity reactions due to sodium metabisulfite excipient: May cause anaphylaxis including life-threatening or less severe asthmatic episodes in susceptible individuals. 
• Hypoxia, Hypercapnia, Acidosis: These conditions, which may also reduce dopamine's effectiveness and/or increase the likelihood of adverse effects, must be identified and corrected prior to or concurrently with dopamine HCl administration.
• Hypotension: If hypotension occurs at lower infusion rates, the infusion rate should be rapidly increased until adequate blood pressure is obtained. If hypotension persists, discontinue dopamine HCl and replace it with a more potent vasoconstrictor, such as norepinephrine.
• Antidote for Peripheral Ischemia: To prevent sloughing and necrosis in is chemic areas, 10 to 15 mL of saline solution containing 5 to 10 mg of phentolamine mesylate, an adrenergic blocking agent, should be infiltrated as soon as possible. The solution should be liberally infiltrated throughout the is chemic area using a syringe with a fine hypodermic needle. If the area is infiltrated within 12 hours, sympathetic blockade causes immediate and noticeable local hyperemic changes. As a result, phentolamine should be administered as soon as possible after the extravasation is detected.