Dobutaminum Solvey

General characteristics. Structure:

Active agent: Dobutaminum a hydrochloride of 280 mg, (that corresponds to 250 mg of Dobutaminum)  

Excipients: Hydrochloride L-cysteine hydrate; citric acid monohydrate; sodium chloride, sodium hydroxide, water for injections.

Pharmacological properties:

Pharmacological action - cardiotonic, hypertensive.
Stimulates myocardium beta1-adrenoceptors. Has moderate positive chronotropic effect. Increases shock and minute volumes of heart, reduces OPSS and pulmonary vascular resistance.

Indications to use:

Heart failure (acute, an aggravation of chronic), inotropic therapy at the heart failure which is followed by low cordial emission against the background of a myocardial infarction; at open heart operations, a cardiomyopathy, septic shock, cardiogenic shock.

Route of administration and doses:

In / century. The dose is selected individually. The recommended dose for adults — 2,5–10 mkg/kg/min., in some cases — to 40 mkg/kg/min.; for children — 1–15 mkg/kg/min. (there are data that minimum effective dose at children is higher, than at adults); at use of high doses care since at the same time there are data that the most tolerable dose for children is lower, than for adults is necessary. At doses, big or equal 7,5 mkg/kg/min., the greatest number of by-effects was observed (especially tachycardia).

Tables for definition of intravenous dosages at different types of injections and at different initial concentration:

Dosage for the infusional pump 1 ampoule containing 250 mg of Dobutaminum on the volume of solution of 50 ml
Range of doses	Speed of infusion, ml/h (ml/min.) * at the body weight of the patient
	50 kg	70 kg	90 kg
Low — 2,5 mkg/kg/min.	1,5 (0,025)	2,1 (0,035)	2,7 (0,045)
Average — 5 mkg/kg/min.	3,0 (0,05)	4,2 (0,07)	5,4 (0,09)
High — 10 mkg/kg/min.	6,0 (0,10)	8,4 (0,14)	10,8 (0,18)
* at the doubled concentration, i.e. at 2х250 mg of Dobutaminum on the volume of solution of 50 ml, rate of administering has to be twice more slowly

Dosage for an infusional dropper 1 ampoule containing 250 mg of Dobutaminum on the volume of solution of 500 ml
Range of doses	Speed of infusion, ml/hour (drop/min.) * at the body weight of the patient
	50 kg	70 kg	90 kg
Low — 2,5 mkg/kg/min.	15 (5)	21 (7)	27 (9)
Average — 5 mkg/kg/min.	30 (10)	42 (14)	54 (18)
High — 10 mkg/ml/min.	60 (20)	84 (28)	108 (36)
* at the doubled concentration, i.e. at 2х250 mg of Dobutaminum on the volume of solution of 500 ml or 250 mg on the volume of solution of 250 ml, rate of administering has to be twice more slowly

Before drug withdrawal it is necessary to reduce its dose gradually!

Instructions on preparation of infusion solution: Dobutaminum Solvey in the form of solution for in/in introductions in ampoules with a capacity of 50 ml is applied in an undiluted look in infusional droppers. As an alternative drug it is possible to dilute previously 5% with glucose solution, normal saline solution, Ringer-laktat solution.

To apply only for in/in introductions.

Because of the short period of removal the drug should be administered in/in continuously.

During introduction of Dobutaminum Solvey it is necessary to control a cordial rhythm, the ABP, volume of the emitted urine, volume of infusion and rate of administering. If it is possible, during infusion it is necessary to control the size of minute volume of heart, the central venous pressure and pressure in pulmonary capillaries.

Duration in/in introductions depends on clinical symptoms and is defined by the doctor.

At continuous use of drug more than 72 h tolerance can develop that does necessary increase in a dosage of drug.

Features of use:

During treatment control of ChSS, minute volume of heart, the ABP, venous pressure and pressure in pulmonary capillaries, amounts of the emitted urine is obligatory. At patients with a diabetes mellitus in an initiation of treatment with Dobutaminum, at change of speed of infusion and at the termination of injection it is necessary to control glucose level in blood.

Side effects:

Tachycardias (including ventricular), a ciliary arrhythmia, heartbeat, pains in heart and a breast, an asthma, increase in the ABP or hypotension, a headache, nausea, a hypopotassemia, petekhialny bleedings, phlebitis, allergic reactions (skin rash, fever, a bronchospasm, an eosinophilia, etc.), a skin necrosis (in an injection site) at hit under skin.

Interaction with other medicines:

Beta adrenoblockers reduce a positive inotropic effect. MAO inhibitors are not predicted increase adrenomimetichesky activity (risk of development of hypertensive crisis, disturbance of a cordial rhythm). Venous vazodilatator (nitrates, Sodium nitroprussidum) at the combined use with Dobutaminum strengthen increase in minute volume of heart, the expressed decrease in OPSS and filling pressure of ventricles of heart. The concomitant use of APF inhibitors (including captopril) and high doses of Dobutaminum leads to increase in minute volume of heart, consumption by a cardiac muscle of oxygen increases (perhaps emergence of heartaches and disturbance of a cordial rhythm).

In combination with a dopamine Dobutaminum causes – depending on a dopamine dose the expressed increase in the ABP.

Contraindications:

Hypersensitivity, idiopathic hypertrophic subaortal stenosis, cardiac tamponade, pericardis, hypertrophic subaortic stenosis, heavy stenosis of an aorta, hypovolemia, reception of MAO inhibitors.

Use at pregnancy and feeding by a breast
It is possible if the expected effect of therapy exceeds potential risk for a fruit. For the period of treatment it is necessary to stop breastfeeding.

Overdose:

There are no data.

Storage conditions:

In the dry, protected from light place, at the room temperature not above 25 °C. Not to freeze.
To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

In ampoules on 51 ml; in a box 1 ampoule.