In the US, Cytosar-U (cytarabine systemic) is a member of the drug class antimetabolites and is used to treat Acute Myeloid Leukemia, Acute Nonlymphocytic Leukemia, Chronic Myelogenous Leukemia, Leukemia, Meningeal Leukemia and Non-Hodgkin's Lymphoma.
US matches:
Cytarabine is reported as an ingredient of Cytosar-U in the following countries:
International Drug Name Search
Utagen may be available in the countries listed below.
Potassium Sodium Hydrogen Citrate is reported as an ingredient of Utagen in the following countries:
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Bisoprolol/Hydrochlorothiazide Biogaran may be available in the countries listed below.
Bisoprolol fumarate (a derivative of Bisoprolol) is reported as an ingredient of Bisoprolol/Hydrochlorothiazide Biogaran in the following countries:
Hydrochlorothiazide is reported as an ingredient of Bisoprolol/Hydrochlorothiazide Biogaran in the following countries:
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Co-Lisinopril-1A Pharma may be available in the countries listed below.
Hydrochlorothiazide is reported as an ingredient of Co-Lisinopril-1A Pharma in the following countries:
Lisinopril dihydrate (a derivative of Lisinopril) is reported as an ingredient of Co-Lisinopril-1A Pharma in the following countries:
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Tylosine Kela may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Tylosin tartrate (a derivative of Tylosin) is reported as an ingredient of Tylosine Kela in the following countries:
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Alginate de sodium/Bicarbonate de sodium Biogaran may be available in the countries listed below.
Sodium Alginate is reported as an ingredient of Alginate de sodium/Bicarbonate de sodium Biogaran in the following countries:
Sodium Bicarbonate is reported as an ingredient of Alginate de sodium/Bicarbonate de sodium Biogaran in the following countries:
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Clavukem may be available in the countries listed below.
Amoxicillin trihydrate (a derivative of Amoxicillin) is reported as an ingredient of Clavukem in the following countries:
Clavulanic Acid potassium (a derivative of Clavulanic Acid) is reported as an ingredient of Clavukem in the following countries:
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Samezil may be available in the countries listed below.
Mesalazine is reported as an ingredient of Samezil in the following countries:
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Naquadem may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Dexamethasone is reported as an ingredient of Naquadem in the following countries:
Trichlormethiazide is reported as an ingredient of Naquadem in the following countries:
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Fortradol may be available in the countries listed below.
Tramadol hydrochloride (a derivative of Tramadol) is reported as an ingredient of Fortradol in the following countries:
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Thioprine may be available in the countries listed below.
Azathioprine is reported as an ingredient of Thioprine in the following countries:
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Treating prostate cancer. Bicalutamide is used in combination with a luteinizing-hormone releasing hormone (LHRH) analog (eg, goserelin, leuprolide). It may also be used for other conditions as determined by your doctor.
Bicalutamide is a nonsteroidal antiandrogen. It works by blocking the action of testosterone.
Contact your doctor or health care provider right away if any of these apply to you.
Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:
Some MEDICINES MAY INTERACT with Bicalutamide. Tell your health care provider if you are taking any other medicines, especially any of the following:
This may not be a complete list of all interactions that may occur. Ask your health care provider if Bicalutamide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Use Bicalutamide as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Bicalutamide.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Back, pelvic, stomach, or general body pain; constipation; decreased sexual ability; diarrhea; dizziness; frequent urination, especially at night; gas; headache; hot flashes; nausea; stomach upset; sweating; trouble sleeping; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; difficulty swallowing; unusual hoarseness); black or bloody stools; blurred vision or other vision changes; bone pain; breast growth or pain; changes in the amount of urine produced; chest pain; dark or bloody urine; fainting; fever, chills, or persistent sore throat; flu-like symptoms; increased hunger, thirst, or urination; joint pain, stiffness, or swelling; loss of appetite; mental or mood changes (eg, anxiety, depression); muscle aches or weakness; numbness or tingling of the skin; pale stools; severe or persistent cough; severe or persistent dizziness, drowsiness, or headache; severe or persistent nausea or stomach pain; shortness of breath; swelling of the ankles, legs, or feet; unusual bruising or bleeding; unusual tiredness or weakness; vomiting; weight change; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
See also: Bicalutamide side effects (in more detail)
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.
Store Bicalutamide at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Bicalutamide out of the reach of children and away from pets.
This information is a summary only. It does not contain all information about Bicalutamide. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
In the US, Isosulfan Blue (isosulfan blue systemic) is a member of the drug class lymphatic staining agents and is used to treat Diagnosis and Investigation.
US matches:
USAN
0068238-36-8
C27-H31-N2-Na-O6-S2
566
Diagnostic agent
[4-[α-[p-(Diethylamino)phenyl]-2,5-disulfobenzylidene]-2,5-cyclohexadien-1-ylidene]diethylammonium hydroxide, inner salt, sodium salt
Ethanaminium, N-[4-[[4-(diethylamino)phenyl](2,5-disulfophenyl)methylene]-2,5-cyclohexadien-1-ylidene]-N-ethyl-, hydroxide, inner salt, sodium salt
N-[4-[[4-(Diethylamino)phenyl](2,5-disulfophenyl)methylene]-2,5-cyclohexadien-1-ylidene]-N-ethyl-ethanaminiumhydroxide, inner salt, monosodium salt
Natrium 4-[bis(4-diethylaminophenyl)methylio]-3-sulfonatobenzolsulfonat
α-[4-(Diethylamino)phenyl]-α-[4-(diethyliminio)-2,5-cyclohexadienylidene]toluene-2,5-disulfonic acid innner salt
Sodium α-(4-Diethylaminophenyl)-α-(4-diethyliminiocyclohexa-2,5-dienylidene)toluene-2,5-disulfonate
International Drug Name Search
Glossary
| BAN | British Approved Name |
| IS | Inofficial Synonym |
| OS | Official Synonym |
| USAN | United States Adopted Name |
Alfetim may be available in the countries listed below.
Alfuzosin hydrochloride (a derivative of Alfuzosin) is reported as an ingredient of Alfetim in the following countries:
International Drug Name Search
Apizolin may be available in the countries listed below.
Naphazoline hydrochloride (a derivative of Naphazoline) is reported as an ingredient of Apizolin in the following countries:
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Citalopram Bexal may be available in the countries listed below.
Citalopram hydrobromide (a derivative of Citalopram) is reported as an ingredient of Citalopram Bexal in the following countries:
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Pholcolin may be available in the countries listed below.
Pholcodine is reported as an ingredient of Pholcolin in the following countries:
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Gamofa may be available in the countries listed below.
Famotidine is reported as an ingredient of Gamofa in the following countries:
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Evaflox may be available in the countries listed below.
Ofloxacin is reported as an ingredient of Evaflox in the following countries:
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Sinopren may be available in the countries listed below.
Lisinopril is reported as an ingredient of Sinopren in the following countries:
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Detebencil may be available in the countries listed below.
Permethrin is reported as an ingredient of Detebencil in the following countries:
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Coagulation Factor VIII, Human is reported as an ingredient of Hemofil M in the following countries:
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Mebutit may be available in the countries listed below.
Trimebutine maleate (a derivative of Trimebutine) is reported as an ingredient of Mebutit in the following countries:
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Valproat Chrono Desitin may be available in the countries listed below.
Valproic Acid is reported as an ingredient of Valproat Chrono Desitin in the following countries:
Valproic Acid sodium (a derivative of Valproic Acid) is reported as an ingredient of Valproat Chrono Desitin in the following countries:
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Furtulon may be available in the countries listed below.
Doxifluridine is reported as an ingredient of Furtulon in the following countries:
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Torasemide-Eurogenerics may be available in the countries listed below.
Torasemide is reported as an ingredient of Torasemide-Eurogenerics in the following countries:
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Propafenon AL may be available in the countries listed below.
Propafenone hydrochloride (a derivative of Propafenone) is reported as an ingredient of Propafenon AL in the following countries:
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Treating chronic chest pain (angina). It may be used alone or in combination with other medicines.
Ranolazine is an antianginal medicine. Exactly how it works is not known.
Contact your doctor or health care provider right away if any of these apply to you.
Some medical conditions may interact with Ranolazine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
Some MEDICINES MAY INTERACT with Ranolazine. Tell your health care provider if you are taking any other medicines, especially any of the following:
This may not be a complete list of all interactions that may occur. Ask your health care provider if Ranolazine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Use Ranolazine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Ranolazine.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Constipation; dizziness; headache; nausea.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); blood in the urine; blurred vision; change in the amount of urine produced; chest pain; confusion; decreased sense of touch; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; numbness, burning, prickling, or tingling of the skin; severe or persistent dizziness, light-headedness, or weakness; shortness of breath; swelling of the hands or feet; tremor; unusual bruising or bleeding.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
See also: Ranolazine side effects (in more detail)
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; double vision; fainting; numbness, burning, prickling, or tingling of the skin; severe or persistent dizziness, nausea, or vomiting.
Store Ranolazine at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ranolazine out of the reach of children and away from pets.
This information is a summary only. It does not contain all information about Ranolazine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
Aténolol Biogaran may be available in the countries listed below.
Atenolol is reported as an ingredient of Aténolol Biogaran in the following countries:
International Drug Name Search
Diclofenac Apotex may be available in the countries listed below.
Diclofenac sodium salt (a derivative of Diclofenac) is reported as an ingredient of Diclofenac Apotex in the following countries:
International Drug Name Search
Cefalekol may be available in the countries listed below.
Cefotaxime sodium salt (a derivative of Cefotaxime) is reported as an ingredient of Cefalekol in the following countries:
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Biotin beta may be available in the countries listed below.
Biotin is reported as an ingredient of Biotin beta in the following countries:
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Hexon may be available in the countries listed below.
Bromhexine hydrochloride (a derivative of Bromhexine) is reported as an ingredient of Hexon in the following countries:
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Cromoptic may be available in the countries listed below.
Cromoglicic Acid disodium salt (a derivative of Cromoglicic Acid) is reported as an ingredient of Cromoptic in the following countries:
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Prilenal may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Enalapril maleate (a derivative of Enalapril) is reported as an ingredient of Prilenal in the following countries:
International Drug Name Search
Fluxol may be available in the countries listed below.
Ambroxol hydrochloride (a derivative of Ambroxol) is reported as an ingredient of Fluxol in the following countries:
Atorvastatin calcium (a derivative of Atorvastatin) is reported as an ingredient of Fluxol in the following countries:
International Drug Name Search
In the US, Teslac (testolactone systemic) is a member of the following drug classes: aromatase inhibitors, hormones/antineoplastics and is used to treat Breast Cancer, Palliative.
US matches:
Testolactone is reported as an ingredient of Teslac in the following countries:
International Drug Name Search
Pantoprazol Heumann may be available in the countries listed below.
Pantoprazole sodium (a derivative of Pantoprazole) is reported as an ingredient of Pantoprazol Heumann in the following countries:
International Drug Name Search
Amlodipina Pharmakern may be available in the countries listed below.
Amlodipine besilate (a derivative of Amlodipine) is reported as an ingredient of Amlodipina Pharmakern in the following countries:
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In the US, Betasept (chlorhexidine topical) is a member of the following drug classes: antiseptic and germicides, mouth and throat products and is used to treat Gingivitis, Mucositis and Periodontitis.
US matches:
Chlorhexidine digluconate (a derivative of Chlorhexidine) is reported as an ingredient of Betasept in the following countries:
International Drug Name Search
Prop.INN
S01AA22
0052093-21-7
C20-H41-N5-O7
463
Antibacterial: Aminoglycoside
O-2-Amino-2,3,4,6-tetradeoxy-6-(methylamino)-α-D-erythro-hexopyranosyl-(1-4)-O-[3-deoxy-4-C-methyl-3-(methylamino)-ß-L-arabinopyranosyl-(1-6)]-2-deoxy-D-streptamine
International Drug Name Search
Glossary
| DCF | Dénomination Commune Française |
| IS | Inofficial Synonym |
| JAN | Japanese Accepted Name |
| OS | Official Synonym |
| PH | Pharmacopoeia Name |
| Prop.INN | Proposed International Nonproprietary Name (World Health Organization) |
Docpirace may be available in the countries listed below.
Piracetam is reported as an ingredient of Docpirace in the following countries:
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Amiodarex may be available in the countries listed below.
Amiodarone hydrochloride (a derivative of Amiodarone) is reported as an ingredient of Amiodarex in the following countries:
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Atébémyxine may be available in the countries listed below.
Neomycin sulfate (a derivative of Neomycin) is reported as an ingredient of Atébémyxine in the following countries:
Polymyxin B sulfate (a derivative of Polymyxin B) is reported as an ingredient of Atébémyxine in the following countries:
International Drug Name Search
Calcium-dura Vit D3 may be available in the countries listed below.
Calcium Carbonate is reported as an ingredient of Calcium-dura Vit D3 in the following countries:
Colecalciferol is reported as an ingredient of Calcium-dura Vit D3 in the following countries:
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Calcium Pantothenicum may be available in the countries listed below.
Calcium Pantothenate is reported as an ingredient of Calcium Pantothenicum in the following countries:
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Otodolor may be available in the countries listed below.
Glycerol is reported as an ingredient of Otodolor in the following countries:
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Glytop may be available in the countries listed below.
Triamcinolone 16α,17α-acetonide (a derivative of Triamcinolone) is reported as an ingredient of Glytop in the following countries:
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In some countries, this medicine may only be approved for veterinary use.
Neomycin sulfate (a derivative of Neomycin) is reported as an ingredient of Neomix in the following countries:
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Dofétilide may be available in the countries listed below.
Dofétilide (DCF) is known as Dofetilide in the US.
International Drug Name Search
Glossary
| DCF | Dénomination Commune Française |
Metformine HCl Bluefish may be available in the countries listed below.
Metformin hydrochloride (a derivative of Metformin) is reported as an ingredient of Metformine HCl Bluefish in the following countries:
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Litomen may be available in the countries listed below.
Ursodeoxycholic Acid is reported as an ingredient of Litomen in the following countries:
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Ibuprofeno Kern Pharma may be available in the countries listed below.
Ibuprofen is reported as an ingredient of Ibuprofeno Kern Pharma in the following countries:
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Class: Selective beta-1-Adrenergic Agonists
VA Class: AU100
CAS Number: 49745-95-1
Brands: Dobutrex
Dobutamine is a synthetic sympathomimetic that is structurally related to dopamine and generally is considered a relatively selective β1-adrenergic agonist.
Used to increase cardiac output in the short-term treatment of cardiac decompensation caused by depressed contractility from organic heart disease, cardiac surgical procedures, cardiac arrest† (ACLS; see CPR under Uses), or acute MI† (see MI under Uses).103 107 110 111 a b
May be particularly useful in the management of cardiogenic shock, including drug-induced cardiogenic shock, in patients with normal DBP and SBP >100 mm Hg, since the drug provides the best sympathomimetic support.104 112
May be preferable to dopamine in the period immediately following cardiopulmonary bypass surgery.b
Safety and efficacy in the long-term (e.g., exceeding 48 hours) treatment of CHF have not been established.103 107 109 a b Patients with NYHA class IV disease appear at particular risk of adverse effects of long-term cAMP-dependent inotropic therapy.a
May be ineffective and potentially harmful in marked mechanical obstruction (e.g., severe valvular aortic stenosis).b
Should not be used alone in severely hypotensive patients (e.g., when SBP is <100 mm Hg).b
Should not be used in patients with drug-induced distributive shock, since the drug may worsen hypotension by further decreasing systemic vascular resistance.112
Used as a potent inotropic agent to increase cardiac output in ACLS during CPR.110 b
May be particularly useful for low cardiac output secondary to poor myocardial function, such as following cardiac arrest.110
Predominant β-adrenergic effects increase myocardial contractility in a dose-dependent manner and decrease left ventricular filling pressures.110
Arterial blood pressure may remain unchanged due to reflex peripheral vasodilation (baroreceptor mediated) in response to increased stroke volume.110
Useful in the management of postresuscitation shock (e.g., when combined with dobutamine).110 c
Although the manufacturers state that safety following MI has not been established, use in combination with dopamine in acute MI† management is recommended by the ACC and AHA for the management of heart failure and low-output syndromes associated with left ventricular dysfunction and for inotropic support following hypotension management associated with right ventricular ischemia.111
May be useful as an adjunct (to increase cardiac output) to volume replacement in patients with right ventricular infarction, since dopamine may increase pulmonary vascular resistance.b
Usually administered by IV infusionb
Has also been administered by intraosseous infusion†.110
Infuse IV using an infusion pump or other apparatus to control the rate of flow and avoid inadvertent administration of a bolus of drug.107 a b
Commercially available premixed dobutamine hydrochloride in 5% dextrose should be administered only by IV infusion via a suitable catheter or needle.107
Do not be use in series connections.107
When the commercially available IV infusion solution of dobutamine hydrochloride in 5% dextrose is used, the accompanying labeling should be consulted for proper methods of administration and other associated precautions.b
The concentrate for injection must be diluted prior to administration; alternatively, commercially available diluted injections for IV infusion may be used.103 b
20 mL of the concentrate for injection should be diluted in at least 50 mL of diluent and 40 mL of concentrate should be diluted in at least 100 mL of diluent.b
The concentration used is individualized according to patient dosage and fluid requirements, but should not exceed 5000 mcg (5 mg)/mL.103 110 a b
Amount of Concentrate | Add (volume of concentrate) | To Compatible IV Solution (volume of solution) | To Make (final dilution concentration) |
|---|---|---|---|
250 mg | 20 mL | 1 L | 250 mcg (0.25 mg)/mL |
250 mg | 20 mL | 500 mL | 500 mcg (0.5 mg)/mL |
250 mg | 20 mL | 250 mL | 1000 mcg (1 mg)/mL |
250 mg | 20 mL | 50 mL | 5000 mcg (5 mg)/mL |
Avoid bolus administration.b
Rate of IV infusion varies according to individual dose requirements titrated to response.103 107 110 a b
Initiate at a slow rate (e.g., 0.5–1 mcg/kg per minute) and carefully adjust at intervals of a few minutes according to response;b usually 2–20 mcg/kg per minute is needed.103 107 110 a b
When IV administration is not possible, dobutamine may be given by intraosseous infusion† for emergency uses such as CPR.110 112
Limit intraosseous administration to personnel well trained in the technique.100
Place a cannula in a noncollapsible marrow venous plexus; such access often can be achieved in 30–60 seconds.100 Use a rigid needle, preferably a specially designed intraosseous or Jamshidi-type bone marrow needle; a styleted needle is preferred to prevent obstruction of the needle with cortical bone.100
Insert the intraosseous needle into the anterior tibial bone marrow; alternatively, the distal femur, medial malleolus, or anterior superior iliac spine can be used.100 In older children and adults, intraosseous cannulas also have been inserted successfully into the distal radius or ulna in addition to the proximal tibia.100
Successful placement outside the hospital (e.g., by emergency medical services) generally is more difficult in older than in younger children.100
Onset of action and systemic concentrations are comparable to those achieved with intravascular administration.100 112
Same as those for IV infusion. (See Dilution under IV Infusion.)
Intraosseous infusion rates are the same as those for IV infusion.100 (See Rate of Administration under IV Infusion.)
Complications are uncommon (less than 1% of patients), and include tibial fracture, lower-extremity compartment syndrome, extravasation, and osteomyelitis; careful technique can minimize the risk.100 Local effects on bone marrow and bone growth appear to be minimal.100 Risk of microscopic pulmonary fat and bone marrow emboli does not appear to be increased.100
Available as dobutamine hydrochloride; dosage expressed in terms of dobutamine.103 107 a b
Hemodynamic end points rather than a specific dose should be used to optimize therapy.110 112
Individual response to dobutamine is variable, and infusion rate should be titrated to achieve the desired clinical response.b
Rate and duration should be carefully adjusted according to patient response as indicated by heart rate, BP, urine flow, peripheral perfusion, presence of ectopic heartbeats, and, whenever possible, by measurement of central venous or pulmonary wedge pressure and cardiac output.103 107 a b
Pharmacokinetics and clinical responses to specific doses vary widely.110
Usually initiate slowly (e.g., 0.5–1 mcg/kg per minute).b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.110 b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.110 112 b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.110 b
Individual response to dobutamine is variable, and infusion rate should be titrated to achieve the desired clinical response.103 107 110 a b
Initiate at a slow rate (e.g., 0.5–1 mcg/kg per minute) and carefully adjust at intervals of a few minutes according to response.b
Dobutamine has been infused for up to 72 hours without decreased effectiveness.b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.112 b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.112 b
Usually, 2–20 mcg/kg per minute is needed to increase cardiac output.112 b
Dosages >20 mcg/kg per minute may produce tachycardia and ventricular ectopy and could induce or exacerbate myocardial ischemia.104 112
Dosages >20 mcg/kg per minute often increase heart rate by more than 10%, and such increases potentially could induce or exacerbate myocardial ischemia.104 112
Rarely, dosages as great as 40 mcg/kg per minute,103 107 112 but these may substantially increase adverse effects, (e.g. ,tachycardia, hypotension) and usually should be avoided.104 112
No specific hepatic dosage recommendations.a
No specific renal dosage recommendations.a
Initiate therapy at lower end of usual range because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.108 However, geriatric patients may exhibit a substantially decreased response.110 112
Idiopathic hypertropic subaortic stenosis.
Known hypersensitivity to dobutamine hydrochloride or any ingredient in the formulation.103 106 107 a b
Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.107 a
Marked increases in heart rate and BP (especially systolic pressure) can occur.103 a b Heart rate of ≥30 beats per minute or an increase in systolic BP of ≥50 mm Hg reported.b
Cardiovascular effects are usually dose related, and dosage should be reduced or the infusion temporarily discontinued if such effects occur.b
Patients with preexisting hypertension are at increased risk of an exaggerated pressor response.103 a b
Patients with atrial fibrillation should be digitalized because of the risk of developing a rapid ventricular response.103 a b
Can precipitate or exacerbate ventricular ectopic activity; rarely, causes ventricular tachycardia.103
Hypersensitivity, including skin rash, fever, eosinophilia, and bronchospasm, have been reported occasionally.103 107
Some formulations contain sulfites, which may cause allergic-type reactions (including anaphylaxis and life-threatening or less severe asthmatic episodes) in certain susceptible individuals.102 103 106 107 a b
Dextrose-containing solutions may be contraindicated in patients who are sensitive to corn or corn products.107 a
Hypovolemia should be corrected with an appropriate plasma volume expander before initiating dobutamine.103 107 a b
Clinical experience insufficient to rule out possibility of intensified or extended myocardial ischemia; use with extreme caution following MI.103 107 a b (See MI under Uses.)
No benefit may be apparent in the presence of marked mechanical obstruction (e.g., severe valvular aortic stenosis).103 107 a
Monitor ECG, BP and, when possible, cardiac output and pulmonary wedge pressure.103 107 a b
May produce slight reductions in serum potassium concentrations and hypokalemia may occur rarely; monitor serum potassium concentrations.b
Category B.103 a
Not known whether dobutamine is distributed into human milk.103 Caution if used in nursing women.103
May increase cardiac output and systemic pressure in pediatric patients of all age groups.103 107 Such increases generally are seen at lower infusion rates than those associated with substantial tachycardia.103 107
Premature neonates: May be less effective in increasing systemic BP without causing undue tachycardia, and dobutamine has not been shown to provide any additional benefit when administered to such infants who are already receiving optimal dopamine therapy.103 107
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults; some clinical experience showed no differences.a
Use with caution since renal, hepatic, and cardiovascular dysfunction and concomitant disease or other drug therapy are more common in this age group.108 a However, geriatric patients generally have a substantially reduced response to dobutamine.110 112
Ectopic heartbeats, increased heart rate, elevations in BP, hypotension, phlebitis, local inflammatory changes.103 a b
No evidence of interactions in clinical studies when used with atropine, cardiac glycosides (digoxin), furosemide, heparin, lidocaine, morphine, nitrates, potassium chloride, or spironolactone.103 103 a
Drug | Interaction | Comments |
|---|---|---|
β-Adrenergic blocking agents | Cardiac effects of dobutamine are antagonized, resulting in predominant α-adrenergic effects and increased peripheral resistance; dobutamine may be ineffective103 a b | Use concomitantly with cautionb |
Anesthetics, general (e.g., halogenated hydrocarbons [e.g., halothane], cyclopropane) | May increase cardiac irritability, resulting in ventricular arrhythmias with usual dobutamine dosesb | Use concomitantly with cautionb |
Sodium nitroprusside | Potentiated effects on cardiac output and pulmonary wedge pressurea |
Onset occurs within 2 minutes after initiation of IV infusion; peaks within 10 minutes.b
Effects cease shortly after infusion discontinuance.b
Not known if dobutamine crosses the placentab or is distributed into milk.103 b
Metabolized in the liver and other tissues by catechol-O-methyltransferase (COMT) to an inactive compound, 3-O-methyldobutamine, and by conjugation with glucuronic acid.b
Conjugates of dobutamine and 3-O-methyldobutamine excreted mainly in urine and to a minor extent in feces.b
About 2 minutes.a b
Pink discoloration indicates slight oxidation of the drug; however, there is no important loss of potency if administered within the recommended time period.b
Store at 15–30°C.b
Solutions of dobutamine hydrochloride in 5% dextrose should be protected from excessive heat or freezing and stored at room temperature (25°C); however, brief exposure of the solutions to temperatures up to 40°C does not adversely affect the products.107
Solutions diluted for IV infusion should be used within 24 hours; unused portions should be discarded.b
15–30°C.103 b
25°C; may be exposed briefly to temperatures up to 40°C.a Do not freeze.a
For information on systemic interactions resulting from concomitant use, see Interactions.
Incompatible with strongly alkaline solutions.103 a b
Should not be used in conjunction with other drugs or diluents containing both sodium bisulfite and ethanol.103 b
Stable for 24 hours in dextrose 5 or 10%, dextrose 5% in sodium chloride 0.45 or 0.9%, dextrose 5% in lactated Ringer’s injection, Isolyte M with 5% dextrose, lactated Ringer's, Normosol-M with 5% dextrose, Osmitrol in water, sodium chloride 0.9%, and sodium lactate (1/6) M.103
Compatible |
|---|
Dextrose 2.5% in half-strength Ringer’s injection, lactated |
Dextrose 5% in Ringer’s injection, lactated |
Dextrose 2.5% in sodium chloride 0.45% |
Dextrose 5% in sodium chloride 0.45 or 0.9% |
Dextrose 5% in water |
Ringer’s injection, lactated |
Sodium chloride 0.45 or 0.9% |
Incompatible |
Sodium bicarbonate 5% |
Additives should not be introduced into the injection containers.a 107
Since dobutamine dosage must be titrated according to response, other drugs generally should not be added to the infusion fluid.c
Compatible |
|---|
Amiodarone HCl |
Atracurium besylate |
Atropine sulfate |
Ciprofloxacin |
Dopamine HCl |
Enalaprilat |
Epinephrine HCl |
Flumazenil |
Hydralazine HCl |
Isoproterenol HCl |
Lidocaine HCl |
Meperidine HCl |
Meropenem |
Metaraminol bitartrate |
Morphine sulfate |
Nitroglycerin |
Norepinephrine bitartrate |
Phentolamine mesylate |
Phenylephrine HCl |
Procainamide HCl |
Propranolol HCl |
Ranitidine HCl |
Zidovudine |
Incompatible |
Acyclovir sodium |
Alteplase |
Aminophylline |
Bumetanide |
Calcium gluconate |
Diazepam |
Digoxin |
Furosemide |
Magnesium sulfate |
Phenytoin sodium |
Potassium phosphates |
Sodium bicarbonate |
Variable |
Bretylium tosylate |
Calcium chloride |
Heparin sodium |
Nitroglycerin with sodium nitroprusside |
Potassium chloride |
Verapamil HCl |
Compatible |
|---|
Alcohol 10% in dextrose 5% |
Amifostine |
Amiodarone HCl |
Argatroban |
Atracurium besylate |
Aztreonam |
Bivalirudin |
Bretylium tosylate |
Calcium chloride |
Calcium gluconate |
Ciprofloxacin |
Cladribine |
Clarithromycin |
Dexmedetomidine HCl |
Diazepam |
Diltiazem HCl |
Docetaxel |
Dopamine HCl |
Dopamine HCl with lidocaine HCl |
Dopamine HCl with nitroglycerin |
Dopamine HCl with sodium nitroprusside |
Doxorubicin HCl liposome injection |
Enalaprilat |
Epinephrine HCl |
Etoposide phosphate |
Famotidine |
Fenoldopam mesylate |
Fentanyl citrate |
Fluconazole |
Gemcitabine HCl |
Granisetron HCl |
Haloperidol lactate |
Hetastarch in lactated electrolyte injection (Hextend) |
Hydromorphone HCl |
Inamrinone lactate |
Insulin, regular (Humulin R) |
Labetalol HCl |
Levofloxacin |
Lidocaine HCl |
Lidocaine HCl with dopamine HCl |
Lidocaine HCl with nitroglycerin |
Lidocaine HCl with sodium nitroprusside |
Linezolid |
Lorazepam |
Magnesium sulfate |
Meperidine HCl |
Milrinone lactate |
Morphine sulfate |
Nicardipine HCl |
Nitroglycerin |
Nitroglycerin with dopamine HCl |
Nitroglycerin with lidocaine HCl |
Nitroglycerin with sodium nitroprusside |
Norepinephrine bitartrate |
Oxaliplatin |
Pancuronium bromide |
Potassium chloride |
Propofol |
Ranitidine HCl |
Remifentanil HCl |
Sodium nitroprusside |
Sodium nitroprusside with dopamine HCl |
Sodium nitroprusside with lidocaine HCl |
Sodium nitroprusside with nitroglycerin |
Tacrolimus |
Theophylline |
Thiotepa |
Tirofiban HCl |
Vasopressin |
Vecuronium bromide |
Verapamil HCl |
Zidovudine |
Incompatible |
Acyclovir sodium |
Alteplase |
Aminophylline |
Amphotericin B cholesteryl sulfate complex |
Cefepime HCl |
Foscarnet sodium |
Indomethacin sodium trihydrate |
Lansoprazole |
Pantoprazole sodium |
Pemetrexed disodium |
Phytonadione |
Piperacillin sodium–tazobactam sodium |
Thiopental sodium |
Warfarin sodium |
Variable |
Cefepime HCI |
Ceftazidime |
Furosemide |
Heparin sodium |
Midazolam HCl |
The main effect of therapeutic doses is cardiac stimulation.b
Principally a selective, direct stimulatory effect on β1-adrenergic receptors, but the mechanisms of action are complex.100 101 110
In therapeutic doses, also mild β2- and α1-adrenergic receptor agonist effects.b
β1-Adrenergic effects exert a potent positive inotropic effect, resulting in increased myocardial contractility and cardiac output.110 b
Increased left ventricular filling pressure decreases in CHF.b 110
Therapeutic doses cause decreased peripheral resistance; however, systolic blood pressure and pulse pressure may remain unchanged or be increased because of augmented cardiac output.b
Usual doses do not substantially change heart rate.b
Coronary blood flow and myocardial oxygen consumption are usually increased because of increased myocardial contractility.b
May facilitate AV conduction and shorten or cause no important change in intraventricular conduction.b
Pulmonary vascular resistance may decrease if it is elevated initially and mean pulmonary artery pressure may decrease or remain unchanged.b
Unlike dopamine, dobutamine does not seem to affect dopaminergic receptors and causes no renal or mesenteric vasodilation; however, urine flow may increase because of increased cardiac output.
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.a b
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.a
Importance of informing patients of other important precautionary information.a b (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Parenteral | For injection concentrate, for IV infusion | 12.5 mg (of dobutamine) per mL* | Dobutamine Hydrochloride for Injection (with sulfites) | Bedford, Hospira, Sicor |
Dobutrex Solution (with sodium bisulfite) | Lilly |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Parenteral | Injection, for IV infusion | 0.5 mg (of dobutamine) per mL (125 or 250 mg) in 5% Dextrose* | Dobutamine in 5% Dextrose Injection (with sulfites; Lifecare [Braun, Hospira]) | Various Manufacturers |
1 mg (of dobutamine) per mL (250 or 500 mg) in 5% Dextrose* | Dobutamine in 5% Dextrose Injection (with sulfites; Lifecare [Hospira, McGaw]; Viaflex [Baxter]) | Various Manufacturers | ||
2 mg (of dobutamine) per mL (500 mg) in 5% Dextrose* | Dobutamine in 5% Dextrose Injection (with sulfites; Lifecare [Hospira]; Viaflex [Baxter]) | Various Manufacturers | ||
4 mg (of dobutamine) per mL (1000 mg) in 5% Dextrose* | Dobutamine in 5% Dextrose Injection (with sulfites; Lifecare [Hospira, Braun, McGaw]; Viaflex [Baxter]) | Various Manufacturers |
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
† Use is not currently included in the labeling approved by the US Food and Drug Administration.
Only references cited for selected revisions after 1984 are available electronically.
100. Leier CV, Unverferth DV. Dobutamine. Ann Intern Med. 1983; 99:490-6. [IDIS 176707] [PubMed 6625384]
101. Ruffolo RR Jr. The mechanism of action of dobutamine. Ann Intern Med. 1984; 100:313-4. [IDIS 181321] [PubMed 6140893]
102. Food and Drug Administration. Sulfiting agents; labeling in drugs for human use; warning statement: final rule [21 CFR Part 201]. Fed Regist. 1986; 51:43900-5.
103. Eli Lilly and Company. Dobutrex (dobutamine hydrochloride) solution prescribing information. Indianapolis, IN: 1999 Feb.
104. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. JAMA. 1992; 268:2171-2302. [PubMed 1404767]
105. Robison-Strane SR, Bubik JS. Dobutamine-induced fever. Ann Pharmacother. 1992; 26:1523-4. [IDIS 306620] [PubMed 1482808]
106. Gensia Laboratories, Inc. Dobutamine hydrochloride injection prescribing information. Irvine, CA; 1993 Apr.
107. Abbott Laboratories. Dobutamine in 5% dextrose injection prescribing information. North Chicago, IL: 1998 Aug.
108. Food and Drug Administration. Dobutamine in 5% dextrose in flexible containers [September 1, 1999; Abbott]. MedWatch drug labeling changes. Rockville, MD; September 1999. From FDA website ().
109. Food and Drug Administration. Dobutamine in 5% dextrose in plastic container [April 21, 1999; Baxter]. MedWatch drug labeling changes. Rockville, MD; April 1999. From FDA website ().
110. The American Heart Association in Collaboration with the International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2000; 102(Suppl I) I-132,I-328.
111. Ryan TJ, Antman EM, Brooks NH et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: 1999 update: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Circulation. 1999; 100:1016-30. [IDIS 437967] [PubMed 10468535]
112. The American Heart Association. Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005; 112(Suppl I): IV1-211.
pdh. Schilling McCann JA, Publisher. Pharmacists drug handbook. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins and American Society of Health-System Pharmacists; 2003.
HID. Trissel LA. Handbook on injectable drugs. 14th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2007:545-55.
a. Baxter Healthcare Corporation. Dobutamine hydrochloride in 5% injection prescribing information. Deerfield, IL; 2002 Jul.
b. AHFS drug information 2008. McEvoy GK, ed. Dobutamine. Bethesda, MD: American Society of Health-System Pharmacists; 2008:1334-6
c. AHFS drug information 2008. McEvoy GK, ed. Dopamine. Bethesda, MD: American Society of Health-System Pharmacists; 2008:1336-9
