From the Guidelines
To calculate a dopamine drip, use the formula: dose (mcg/kg/min) × patient weight (kg) × 60 minutes ÷ concentration (mg/mL) = mL/hour infusion rate, as this is the most effective way to ensure accurate dosing and minimize potential adverse effects 1. When preparing the dopamine solution, a standard concentration can be achieved by adding 400 mg dopamine to 250 mL D5W or NS, resulting in a 1600 mcg/mL solution. The dosage of dopamine typically ranges from 2-20 mcg/kg/min, with different dose ranges having distinct effects on the body:
- Lower doses (1-5 mcg/kg/min) primarily affect dopaminergic receptors and may increase renal blood flow
- Medium doses (5-10 mcg/kg/min) stimulate beta-adrenergic receptors to increase cardiac output
- Higher doses (>10 mcg/kg/min) activate alpha-adrenergic receptors for vasoconstriction. For example, for a 70 kg patient receiving 5 mcg/kg/min using the standard concentration: 5 × 70 × 60 ÷ 1600 = 13.1 mL/hour. It is essential to always use an infusion pump for administration, monitor blood pressure and heart rate continuously, and titrate to the desired hemodynamic effect to ensure patient safety 1. Double-checking all calculations is crucial to prevent errors and potential harm to the patient. In clinical practice, it is vital to be aware that infusion rates >20 mcg/kg per minute may result in excessive vasoconstriction, and low-dose dopamine infusion has not been shown to provide benefits in maintaining renal blood flow or improving renal function 1.
From the FDA Drug Label
DOSAGE & ADMINISTRATION ... Begin infusion of dopamine hydrochloride solution at doses of 2 to 5 mcg/kg/min in adult or pediatric patients who are likely to respond to modest increments of heart force and renal perfusion In more seriously ill patients, begin infusion of dopamine hydrochloride at doses of 5 mcg/kg/min and increase gradually, using 5 to 10 mcg/kg/min increments, up to a rate of 20 to 50 mcg/kg/min as needed.
800 mcg/mL Dosing Chart for Dopamine (mL/hr) Infusion Rate 1600 mcg/mL Dosing Chart for Dopamine (mL/hr) Infusion Rate 3200 mcg/mL Dosing Chart for Dopamine (mL/hr) Infusion Rate
To calculate the dopamine drip, you need to know the desired dose in mcg/kg/min and the concentration of the dopamine solution. The formula to calculate the infusion rate in mL/hr is:
- Infusion rate (mL/hr) = (Desired dose (mcg/kg/min) x Weight (kg)) / Concentration (mcg/mL) Using the provided dosing charts for 800 mcg/mL, 1600 mcg/mL, and 3200 mcg/mL, you can determine the infusion rate based on the patient's weight and desired dose. For example, if the desired dose is 10 mcg/kg/min for a patient weighing 70 kg, using the 800 mcg/mL solution:
- Infusion rate (mL/hr) = (10 mcg/kg/min x 70 kg) / 800 mcg/mL = 8.75 mL/hr Always use an infusion pump to control the rate of infusion and monitor the patient's response to the dopamine infusion 2.
From the Research
Dopamine Drip Calculation
To calculate a dopamine drip, several factors must be considered, including the patient's weight, the desired dose, and the concentration of the dopamine solution.
- The standard concentration of dopamine is 200-400 mg in 100 mL of solution, but this can vary depending on the specific formulation and the patient's needs.
- The dose of dopamine is typically expressed in micrograms per kilogram per minute (mcg/kg/min).
- To calculate the dopamine drip rate, the following formula can be used: drip rate (mL/h) = (dose in mcg/kg/min x weight in kg x 60 min/h) / concentration in mcg/mL 3, 4.
Studies on Dopamine and Other Vasoactive Drugs
Several studies have compared the effects of dopamine with other vasoactive drugs, such as norepinephrine and dobutamine, in patients with septic shock.
- A study published in 1997 found that norepinephrine and dobutamine were more effective than epinephrine in improving gastric mucosal perfusion and tissue oxygen utilization in patients with septic shock 5.
- A study published in 2007 found that there was no significant difference in mortality rates between patients treated with epinephrine and those treated with norepinephrine plus dobutamine 6.
- A study published in 1995 found that dopamine was not superior to dobutamine or the combination of dobutamine and norepinephrine in improving oxygen delivery and uptake in patients with septic shock 3.
- A study published in 2021 found that norepinephrine was more effective than dopamine and dobutamine in improving hemodynamic indexes and reducing inflammatory factors in elderly patients with sepsis 7.
- A study published in 2002 found that norepinephrine plus dobutamine improved gastric mucosal perfusion and tissue oxygen utilization, while epinephrine and dopamine had deleterious effects on oxygen metabolism 4.