Dopamine
3-hydroxytyramine hydrochloride
Also known as: Intropin · ASL-279 · dopamini hydrochloridum · 3-hydroxytyramine hydrochloride
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
This is a rate-based continuous infusion (CRI) dose. Calculate the infusion rate; do not use simple weight scaling.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Vasodilatory shock if fluid resuscitation and dobutamine is not successful | 2.5-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Adjunctive therapy for acute heart failure | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock | 1-3 micrograms/kg/minute CRI; higher dosages of 3-10 micrograms/kg/min CRI are indicated if greater cardiotonic and BP support are indicated | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Adjunctive therapy for oliguric renal failure | 1-3 micrograms/kg/min | IV | CRI | Until nonoliguric state achieved | 🌎 NA |
- Vasodilatory shock if fluid resuscitation and dobutamine is not successful: If not successful may try adding norepinephrine.
- Adjunctive therapy for acute heart failure: Initially, a dose of 2 micrograms/kg/min is usually used and titrated upward to desired clinical effect. Doses higher than 10 may increase peripheral vascular resistance and heart rate.
- Treatment of severe hypotension/shock: Not a substitute for adequate volume replacement therapy.
- Adjunctive therapy for oliguric renal failure: Used with diuretics (furosemide). Note: Many now believe that dopamine is not indicated for treating acute renal failure.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Vasodilatory shock if fluid resuscitation and dobutamine is not successful | 2.5-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock | 1-3 micrograms/kg/minute CRI; higher dosages of 3-10 micrograms/kg/min CRI are indicated if greater cardiotonic and BP support are indicated | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
- Vasodilatory shock if fluid resuscitation and dobutamine is not successful: If not successful may try adding norepinephrine.
- Treatment of severe hypotension/shock: Not a substitute for adequate volume replacement therapy.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Dopamine is an endogenous catecholamine and the immediate metabolic precursor to norepinephrine. In veterinary critical care, it is primarily utilized as a continuous rate infusion (CRI) to manage hemodynamic instability, particularly hypotensive shock and acute heart failure, after adequate fluid resuscitation.
Clinical Highlights
- Dose-Dependent Effects: Dopamine's receptor affinity shifts dramatically based on the infusion rate, progressing from dopaminergic (vasodilation) to beta-1 (inotropic) to alpha-1 (vasopressor) effects.
- Renal Dose Controversy: Historically, "low-dose" dopamine was used to promote diuresis in oliguric acute kidney injury. Modern evidence suggests it does not significantly improve Glomerular Filtration Rate (GFR) and is largely considered unproven or controversial in dogs, and potentially detrimental in cats.
- Strict Administration Rules: Must be given via a dedicated IV line with a syringe pump or fluid pump. Extravasation causes severe tissue necrosis.
Clinical Pearl: Dopamine is ineffective and potentially dangerous if administered to a hypovolemic patient. Always restore intravascular volume before initiating vasopressor or inotropic therapy.
Mechanism of action
Dopamine acts directly on dopaminergic, β1-adrenergic, and α1-adrenergic receptors, and indirectly by stimulating the release of endogenous norepinephrine from sympathetic nerve terminals. Its effects are highly dose-dependent:
- Low Dose (0.5–2 µg/kg/min): Primarily stimulates D1 and D2 dopaminergic receptors → vasodilation of renal, mesenteric, coronary, and intracerebral vascular beds. Increases renal blood flow and urine output, but does not appreciably increase GFR.
- Medium Dose (2–10 µg/kg/min): Stimulates β1-adrenergic receptors in the myocardium → increases intracellular cAMP → positive inotropic (increased contractility) and mild chronotropic (increased heart rate) effects. Improves cardiac output and organ perfusion.
- High Dose (>10–12 µg/kg/min): Overrides dopaminergic effects and strongly stimulates α1-adrenergic receptors in the vasculature → profound vasoconstriction → increases systemic vascular resistance (SVR) and blood pressure. Renal and peripheral blood flows are decreased at these rates.
Safety & warnings
Contraindications
- Pheochromocytoma
- Ventricular fibrillation
- Uncorrected tachyarrhythmias
- Uncorrected hypovolemia (must replace fluids first)
Adverse effects
- Nausea and vomiting
- Ectopic beats (arrhythmias)
- Tachycardia
- Palpitations
- Hypotension (at low doses) or Hypertension (at high doses)
- Dyspnea
- Vasoconstriction (reduced peripheral circulation)
- Severe tissue necrosis and sloughing (if extravasated)
Precautions
Critical Warnings
- Extravasation Risk: Extravasation can cause severe ischemic tissue necrosis and sloughing. Monitor IV sites continuously. If extravasation occurs, infiltrate the ischemic area with 5-10 mg phentolamine diluted in 10-15 mL of normal saline using a fine needle with multiple subcutaneous injections.
- Hypovolemia: Dopamine is not a substitute for adequate fluid, electrolyte, or blood product replacement. Volume deficits must be corrected prior to use.
- Cardiovascular Disease: Use with extreme caution in patients with ischemic heart disease or occlusive vascular disease. Discontinue or reduce dose if arrhythmias (e.g., PVCs) occur or if signs of reduced peripheral circulation develop.
- Feline Renal Failure: Cats are unlikely to benefit from low-dose dopamine for oliguric renal failure, and it may be detrimental.
Drug interactions
May antagonize the vasoconstrictive properties of high-dose dopamine.
May result in increased incidences of ventricular arrhythmias.
May potentiate adverse cardiovascular effects.
May antagonize the cardiac (inotropic/chronotropic) effects of dopamine.
May potentiate urine production effects of low-dose dopamine.
Can significantly prolong and enhance the effects of dopamine.
May cause severe hypertension when used concurrently.
May antagonize the renal and mesenteric vasodilatation effects of dopamine.
Concurrent use may cause severe hypertension.
Monitoring
- Continuous electrocardiogram (ECG) for cardiac rate and rhythm
- Direct or indirect blood pressure
- Urine output/flow
- IV catheter site (frequent checks for patency and signs of extravasation)
Pharmacokinetics
Half-life
Absorption
Not administered orally as it is rapidly metabolized in the GI tract. After IV administration, onset of action is usually within 5 minutes.
Distribution
Widely distributed in the body, but does not cross the blood-brain barrier in appreciable quantities. Placental transfer is unknown.
Metabolism
Metabolized in the kidney, liver, and plasma by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) to inactive compounds. Up to 25% is metabolized to norepinephrine in adrenergic nerve terminals.
Elimination
Rapidly cleared; effects persist for less than 10 minutes after the infusion is stopped.
Overdose
Accidental overdosage is primarily manifested by excessive blood pressure elevation (severe hypertension) and arrhythmias.
- Treatment: Because dopamine's half-life is extremely short (~2 minutes), treatment usually consists only of temporarily discontinuing the IV infusion or reducing the rate until parameters normalize.
- If the patient's condition fails to stabilize rapidly after discontinuation, the alpha-adrenergic antagonist phentolamine may be administered.
Available products
Formulations
- Concentrated solution for injection (40 mg/mL, 80 mg/mL, 160 mg/mL)
- Premixed injection solution in Dextrose 5% (0.8 mg/mL, 1.6 mg/mL, 3.2 mg/mL)
Human-labeled
- Dopamine HCl for Concentrated Solution for Injection: 40 mg/mL, 80 mg/mL and 160 mg/mL in 5 mL & 10 mL vials
- Dopamine HCl in Dextrose 5% Injection Solution: 200 mg/250 mL (0.8 mg/mL); 400 mg/500 mL (0.8 mg/mL); 400 mg/250 mL (1.6 mg/mL); 800 mg/500 mL (1.6 mg/mL); & 800 mg/250 mL (3.2 mg/mL) in premixed containers
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Protect from light. Store at room temperature (15-30°C). Solutions that are pink, yellow, brown, or purple indicate decomposition and must be discarded. After dilution in compatible IV fluids (e.g., normal saline, D5W, LRS), it is stable for at least 24 hours at room temperature, though it is recommended to dilute just prior to use. Most stable at pH < 5; oxidized at alkaline pH.
Client information
Dopamine is a critical care medication used exclusively in a hospital setting, typically in an Intensive Care Unit (ICU).
- Purpose: It is used to support your pet's blood pressure, heart function, and organ blood flow during life-threatening conditions like severe shock or heart failure.
- Administration: It is given as a continuous intravenous (IV) drip using a specialized pump to ensure exact dosing.
- Monitoring: While on this medication, your pet will be closely monitored by the veterinary team, including continuous heart rate, ECG, and blood pressure checks.
- Safety: The veterinary team will frequently check the IV catheter, as this medication can cause tissue damage if it leaks outside the vein.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.