Inoen Dobutamine Premix 200 mg Injection

Adult administration

Adults should receive a continuous intravenous infusion of 2.5-10 µg/kg/min of dobutamine. If necessary, the infusion rate can be adjusted up to 40 µg/kg/min. For patients with rapid heart rates associated with atrial fibrillation before treatment, digitalis preparations should be used. The infusion rate and duration of treatment should be determined based on the patient's heart rate, motion displacement, blood pressure, urine output, measurements of central venous pressure or closure pressure, and cardiac output; the final dosage will depend on the patient's response.

This drug should not be used in patients with idiopathic hypertrophic aortic stenosis or those who are hypersensitive to this drug, nor in patients with constrictive pericarditis or cardiac tamponade. Patients allergic to corn or corn products should not be administered the infused solutions containing dextrose present in this drug. Dosing should be performed cautiously in patients with increased heart rate or blood pressure, particularly hypertensive patients, as their blood pressure may worsen. Careful use is required for patients with severe coronary artery disease, as there is a risk of uneven cardiac blood flow and worsened myocardial ischemia. In patients with atrial fibrillation, there can be increased ventricular response, therefore their condition should be closely monitored during administration. Note that while it may induce or worsen ventricular motion displacement, it rarely causes ventricular tachycardia. Caution should be exercised when using it in patients with severe hypotension due to cardiogenic shock. This drug contains sodium bisulfite, which can cause life-threatening allergic reactions or asthma attacks in patients allergic to sulfites or asthmatics, necessitating careful observation. Infusing dextrose-containing solutions together with blood or similar fluid sets can cause agglutination reactions or hemolysis, thus they should not be used together. Intravenous infusion of solutions may cause fluid overload, resulting in dilution of plasma electrolyte concentrations, excess fluids, congestive states, and pulmonary edema, so caution is required. The risk of dilution varies depending on the electrolyte concentration of the infusion solution, which should be considered alongside the risk of solute overload that induces congestive states. Excessive infusion of solutions containing no potassium can lead to hypokalemia; hence, caution is necessary. During the administration of this drug, blood pressure, heart rate, electrocardiogram, and urine output should be monitored continuously, and if possible, the closure pressure and cardiac output should also be measured to closely assess the patient's condition. Acute circulatory insufficiency patients do not exhibit peripheral vasoconstriction, so appropriate measures such as administering peripheral vasoconstrictors should be undertaken as needed. Patients with decreased blood volume should first receive treatment to increase their blood volume before the administration of this drug. Patients taking beta-blockers or who have recently taken them should be cautious, as the effects of this drug may be reduced. Patients with severe aortic stenosis or severe flow obstruction may not show therapeutic effects from this drug. The safety of this drug in acute myocardial infarction patients has not been established, and it could worsen myocardial ischemia, hence it should be administered cautiously. If excessive increases in heart rate or systolic blood pressure occur, appropriate measures such as adjusting or discontinuing the drug dosage may be necessary. If administered continuously for more than 72 hours, tolerance may develop, and an increased dosage may be required. Dextrose-containing solutions should be used cautiously in diabetic patients or those suspected of diabetes. This drug shows minimal interaction when combined with certain other medications; however, caution is required when used in conjunction with specific vasodilators, MAO inhibitors, ACE inhibitors, and beta-blockers. Pregnant women or those who may become pregnant should only use this drug when the benefits outweigh the risks, and if breastfeeding, should avoid use or discontinue breastfeeding if unavoidable. Safety and efficacy in children have not been established; hence, caution is necessary. Elderly patients have decreased physiological functions, so treatment should start at lower doses and be closely monitored. This drug should only be administered through an intravenous drip, and care should be taken to prevent injection into the tissue as it can lead to redness, swelling, and tissue necrosis at the injection site. It should not be mixed with specific diluents, and intravenous solutions should be used within 24 hours of preparation. In the event of overdose, blood pressure changes or tachycardia may occur, necessitating a reduction in dosage or temporary cessation of administration until the patient's condition stabilizes. This drug has a short action time, so additional treatment is generally not required.

Serious side effects

Shortness of breath → respiratory problems

Mild side effects

• Rarely: rash
• fever
• eosinophilia
• bronchospasm
• tachycardia
• extrasystoles
• excessive blood pressure rise
• angina
• precordial warmth
• chest discomfort

This medication should be stored in a sealed container protected from air and moisture, ideally at a cool temperature below 25 degrees Celsius. Proper storage can help maintain the drug's efficacy for a longer duration and prevent degradation.

Appearance

A transparent solution injected into a colorless or pale yellow transparent plastic container for infusion.

Package unit

250 milliliters