Active substanceDobutamineDobutamine
Similar drugsTo uncover
  • Dobutamine Admeda
    solution d / infusion 
  • Dobutamine Hexal
    lyophilizate d / infusion 
    HEXAL AG     Germany
  • Dobutamine-MP
    concentrate d / infusion 
    Medresurs, OOO     Russia
  • Dosage form: & nbspLyophilizate for solution for infusion.
    Composition:1 vial of lyophilizate for the preparation of a solution for infusions contains:
    active substance:
    dobutamine hydrochloride 280 mg (equivalent to 250 mg dobutamine);
    Excipients:
    mannitol 250 mg.
    Description:Powder from white to slightly pink.
    Pharmacotherapeutic group:Cardiotonic means of non-glycosidic structure.
    ATX: & nbsp

    C.01.C.A.07   Dobutamine

    Pharmacodynamics:
    Dobutamine is a cardiotonic drug of a non-glycosidic nature, beta-1-adrenomimetic. It is a racemate, a synthetic sympathomimetic amine, akin to the structure of isoproterenol and dopamine. Has a positive inotropic effect on the myocardium; moderately increases the heart rate (heart rate), increases the stroke and minute volume of the heart, reduces the overall peripheral vascular resistance (OPSS) and vascular resistance in the small circulatory system. The system pressure does not change significantly.The drug causes a decrease in the filling pressure of the ventricles of the heart. Increases coronary blood flow and improves oxygen supply to the myocardium. An increase in cardiac output may cause an increase in renal perfusion and an increase in the excretion of sodium and liquid ions.
    In children, an increase in stroke volume, which is observed under the influence of dobutamine is accompanied by a less pronounced decrease in systemic vascular resistance and ventricular filling pressure; with a more pronounced increase in heart rate and an increase in blood pressure (BP). In children younger than 1 year, the pressure of wedging of the pulmonary artery may increase during the infusion of dobutamine. An increase in cardiac output begins with a dose of dobutamine below 1 μg / kg / min; an increase in blood pressure occurs at a dose of 2.5 μg / kg / min; increase in heart rate - with a dose of dobutamine 5.5 μg / kg / min. An increase in the infusion rate of dobutamine to 10-20 μg / kg / min is accompanied by a further increase in cardiac output. A test of "stress-echocardiography" with dobutamine.
    Diagnostic investigation of ischemia: due to a positive
    inotropic and chronotropic action in particular under a load of dobutamine increases myocardial oxygen demand (and substrate).In the case of stenosis of the coronary arteries, an insufficient increase in coronary blood flow leads to regional hypoperfusion and can be visualized by echocardiographic examination due to the appearance of a violation of local contractility in the affected segment. Diagnostic study of the "viability" of the myocardium: a "viable", but hypo- or akinetic myocardium resting on an echocardiogram (stunned, hibernating), has a functional reserve for contraction. This functional reserve is stimulated by a positive inotropic action caused by dobutamine loading at lower concentrations (5-20 μg / kg / min). On the echocardiogram, improvement of local contractility of the affected segment of the myocardium is recorded.
    Pharmacokinetics:
    The effect of the drug begins 1-2 minutes after the start of infusion, if the infusion rate is low - within 10 minutes; duration of action is less than 5 minutes. With continuous infusion, the equilibrium concentration in the blood plasma is reached after 10-12 minutes. The magnitude of the equilibrium concentration in the blood plasma increases linearly with increasing infusion rate.The half-life is 2-3 minutes, the volume of the distribution is about 0.2 l / kg of body weight, the plasma clearance is independent of the minute volume of the heart and is 2.4 l / min / m. Dobutamine it is metabolized mainly in tissues and liver. Metabolism is mainly due to conjugation with glucuronides, and also to the formation of pharmacologically inactive 3-O-methyl-dobutamine. The excretion of dobutamine occurs mainly with kidneys and with bile. More than 2/3 of the administered dose of the drug is excreted by the kidneys in the form of glucuronides and 3-O-methyl-dobutamine.
    Features of pharmacokinetics in children
    Most children have a log-linear relationship between plasma concentrations of dobutamine and the hemodynamic response. The clearance of dobutamine corresponds to the first-order kinetics in the dose range from 0.5 to 20 μg / kg / min. When using the drug at the same rate, the equilibrium plasma concentration of dobutamine can vary widely, differing by a factor of two. Therefore, it is necessary to evaluate hemodynamic effects and titrate the rate of administration of the drug individually.
    Indications:
    - acute heart failure with myocardial infarction, cardiogenic shock, open heart surgery, the consequences of surgical intervention on the heart;
    - acute decompensation of chronic heart failure;
    - as an adjuvant: temporary maintenance treatment of patients with chronic heart failure receiving standard therapy; acute cardiac insufficiency of non-cardiogenic genesis (incl. with septic shock); low minute volume of heart on the background of artificial ventilation with positive residual pressure on exhalation;
    - for sample "stress echo" as an alternative to functional exercise test (must only be carried out in specialized units with experience in these functional studies, ie. a. his conduct requires special precautions).
    Contraindications:
    For all indications
    - hypersensitivity to dobutamine or excipients;
    - hemodynamically significant obstacles filling and / or outflow from the ventricles of the heart (tamponade, constrictive pericarditis,hypertrophic obstructive cardiomyopathy, severe aortic stenosis);
    - hypovolemia;
    - simultaneous use of monoamine oxidase inhibitors (MAO).
    - pheochromocytoma;
    - ventricular arrhythmias, including ventricular fibrillation;
    - the period of breastfeeding.
    In addition, when conducting a "stress-echocardiography"
    - acute myocardial infarction (no earlier than 30 days after myocardial infarction);
    - unstable angina;
    - stenosis of the left coronary artery trunk;
    - hemodynamically significant damage to the heart valves;
    - severe heart failure (NYHA III and IV functional class);
    - predisposition to or presence in the anamnesis of clinically significant or chronic arrhythmias, including recurrent stable ventricular tachycardia;
    - marked conduction disturbance;
    - acute pericarditis, myocarditis, or endocarditis;
    - aortic aneurysm, aortic dissection;
    - poor ultrasonic "window";
    - untreated / uncontrolled arterial hypertension;
    - when using atropine (take into account contraindications to the use of atropine).
    Carefully:Metabolic acidosis, hypercapnia, hypoxia, tachyarrhythmia, atrial fibrillation,myocardial infarction (high doses of dobutamine may increase heart rate and myocardial contractility and, increasing myocardial oxygen demand, intensify ischemia), pulmonary hypertension, occlusive vascular diseases (arterial thromboembolism, atherosclerosis, thromboangiitis obliterans (Buerger's disease), cold trauma, including Frostbite, diabetes mellitus, diabetic endarteritis, Raynaud's disease, closed-angle glaucoma, pregnancy, age 18 years.
    Pregnancy and lactation:
    Use of the drug Dobutamine Hexal during pregnancy is only possible if the intended benefit to the mother exceeds the potential risk to the fetus and / or the child.
    If you need to use the drug during lactation, you should stop breastfeeding during therapy.
    Dosing and Administration:
    The drug Dobutamine Hexal is intended only for intravenous infusions after a preliminary dilution. Speed ​​and duration
    Introduction of the drug Dobutamine Hexal is set individually taking into account the patient's reaction and the dynamics of hemodynamic parameters.
    The drug Dobutamine Hexal, lyophilizate for the preparation of a solution for infusions,initially diluted in 10 ml of sterile water for injection, if the drug is not completely dissolved, add another 10 ml.
    If you need to further dilute the concentrate of the drug Dobutamine Hexal, you should use a 5% solution of dextrose (glucose), 0.9% sodium chloride solution, Ringer's solution or sodium-lactate solution. The prepared solutions are not intended for multiple selection of the preparation. Because of the short half-life of the drug Dobutamine Gexal should be continuous continuous infusion.
    The duration of intravenous infusion depends on the results of clinical efficacy. During the application of Dobutamine Hexal, constant heart rate, heart rate, blood pressure, volume of diuresis and infusion rate are needed. If possible, during treatment should also monitor the magnitude of the minute volume of the heart, central venous pressure and pressure in the pulmonary capillaries.
    Adults, in the absence of other prescriptions, the drug Dobutamine Hexal is recommended to be administered in doses of 2.5-10 μg per 1 kg of body weight per minute. In some cases, the dose is up to 40 μg / kg / min.
    Children are advised to use Dobutamine Hexal in doses from 2 to 20 μg per 1 kg of body weight per 1 min. When doses higher than or equal to 7.5 μg per kg body weight per minute, most side effects begin to appear (especially tachycardia). There is evidence that the lowest effective dose in childhood is higher than in adults and is 0.5-1 μg / kg / min. At the same time, the maximum tolerated dose in childhood is lower than in adults. Achieve the necessary doses in children should be done carefully because of the apparently lower therapeutic latitude in childhood!

    Dose recommendations for discontinuous infusion *

    1 vial for injections of 250 mg dobutamine in 50 ml of solvent

    Dose areas

    Body mass

    50 kg

    70 kg

    90 kg

    Low:

    ml / hour

    1,5

    2D

    2,7

    2.5 μg / kg / min

    (ml / min.)

    (0,025)

    (0,035)

    (0,045)

    Medium:

    ml / hour

    3,0

    4,2

    5,4

    5 μg / kg / min

    (ml / min.)

    (0,05)

    (0,07)

    (0,09)

    High:

    ml / hour

    6,0

    8,4

    10,8

    10 μg / kg / min

    (ml / min.)

    (0,10)

    (0,14)

    (0Д8)

    * At doubled concentration, i.e. at 2 x 250 mg dobutamine in 50 ml

    it is necessary to reduce the recommended dose by 2 times.


    Dose recommendations for continuous infusion *

    1 vial for injections of 250 mg dobutamine in 500 ml of solvent

    Dose areas

    Body mass

    50 kg

    70 kg

    90 kg

    Low:

    ml / hour

    15

    21

    27

    2.5 μg / kg / min

    (drops / min.)

    (5)

    (7)

    (9)

    Medium

    ml / hour

    30

    42

    54

    5 μg / kg / min

    (drops / min.)

    (10)

    (14)

    (18)

    High:

    ml / hour

    60

    84

    108

    10 μg / kg / min

    (drops / min.)

    (20)

    (28)

    (36)

    * At doubled concentration, i.e. at 2 x 250 mg dobutamine in 500 ml

    it is necessary to reduce the recommended dose by 2 times.

    Before drug cancellation it is necessary to gradually reduce its dose! The "stress-echocardiography" test with dobutamine is carried out by gradually increasing the dose of the drug. It is necessary to monitor the method and duration of administration of the drug.

    The most commonly used protocol is the "stress-echocardiography" sample with dobutamine.

    The most commonly used protocol for carrying out a stress-echocardiography test with dobutamine for determining the "viability" and myocardial ischemia: an initial infusion dose of dobutamine of 5 μg / kg / min increases every 3 minutes to 10, 20, 30, 40 μg / kg / min before the result. If the criteria for stopping the sample can not be reached for 3 minutes of the maximum dose, then in addition (to increase the heart rate) four times 0.25 mg of atropine sulfate is injected intravenously 4 minutes at the interval of 1 min against the background of continuing infusion of dobutamine at a dose of 40 μg / kg / min.

    Alternative dosing regimens are characterized by the maximum dose of Dobutamine Hexal (up to 50 μg / kg / min), the maximum dose of atropine (up to 2 mg) and the time of atropine administration.

    To stop the action of dobutamine, infusion solutions of beta-blockers are used.

    Criteria for stopping the "stress-echocardiography" sample with dobutamine:

    - achievement of maximum heart rate for a given age / sex, calculated by the formula {(220-age) x0.85};

    - decrease in systolic blood pressure by more than 20 mm Hg. Art. in comparison with the initial one;

    - a progressive increase in blood pressure (for example, systolic more than 220 mm Hg, diastolic - more than 120 mm Hg);

    - increasing symptoms of angina pectoris (pain in the chest, dyspnea, dizziness, impaired coordination of movements);

    - the development of abnormal repolarization of the myocardium on the ECG (horizontal or skewed depression of the ST segment, more than 0.2 mV in length of 80 (60) milliseconds after point J in comparison with the baseline level, progressive or monophasic ST segment elevations above 0.1 mV) patients without a history of myocardial infarction;

    - increasing arrhythmia (eg, bigeminy, group extrasystole);

    - increasing conduction disturbance;

    - development of undesirable phenomena;

    - violation of local myocardial contractility more than 1 segment (16-segment model of echocardiography);

    - the development of a global decline in contractility (including an increase in the terminal systolic volume of the left ventricle);

    - reaching the maximum dose of drugs used in the "stress-echocardiography" assay scheme.


    A trial of "stress echocardiography" with dobutamine to identify "viability" and myocardial ischemia should be performed only by a physician with sufficient experience in conducting similar studies with resuscitation experience. During the study, continuous monitoring of myocardial contractility by echocardiography, changes in the electrocardiogram, and monitoring of blood pressure are necessary. When carrying out a stress-echocardiography test with dobutamine, medical and hardware resuscitation equipment (for example, a defibrillator, intravenous beta-blockers, nitrates, etc.) and personnel trained in resuscitation should be in close proximity to the patient. Symptoms of angina pectoris or threatening tachycardia may be suppressed by intravenous administration of beta-blockers short-acting,or other antiarrhythmic drugs (antiarrhythmic drugs of classes I and III should be excluded). It is possible to take nitroglycerin and / or beta-blockers under the tongue.
    Side effects:
    According to the World Health Organization (WHO), adverse reactions are classified according to their frequency of development as follows:
    Often (1/10),
    often (1/100, <1/10),
    infrequently (1/1000, <1/100),
    rarely (1/10000, <1/1000) and
    very rarely (<1/10000);
    frequency unknown - According to available data to establish the frequency of occurrence was not possible.
    On the part of the blood and lymphatic system
    often: eosinophilia, suppression of platelet aggregation (only with infusion for several days).
    From the side of metabolism and nutrition is very rare: hypokalemia.
    From the nervous system often: headache.
    From the side of the cardiovascular system
    very often: increased heart rate 30 beats / min; often: increased blood pressure 50 mm of mercury. Art. (in patients with arterial hypertension may have a higher increase in blood pressure), lowering of blood pressure, ventricular arrhythmia, a dose-dependent increase in the number of ventricular extrasystoles,an increase in the frequency of ventricular contractions in patients with atrial fibrillation (prior to the initiation of therapy with dobutamine, such patients need to be digitized), vasoconstriction (especially in patients who previously received beta-adrenergic blockers), angina, palpitations.
    Increased blood pressure by 10-20 mm Hg. Art. is observed in most patients.
    infrequently: ventricular tachycardia, ventricular fibrillation;
    very rarely: bradycardia, myocardial ischemia, myocardial infarction, stop
    heart;
    frequency unknown: decreased pressure in the pulmonary capillaries.
    From the immune system
    rarely: hypersensitivity reactions, bronchospasm.
    Children's population
    Adverse effects include increased systolic blood pressure, systemic hypertension or hypotension, tachycardia, headache and increased pulmonary wedge pressure, leading to congestion in the lungs and edema, as well as symptomatic complaints. A test of "stress echocardiography" with dobutamine
    From the nervous system
    often: headache;
    frequency unknown: paresthesia, tremor, myoclonic seizures.
    From the side of the cardiovascular system
    very often: chest discomfort, ventricular extrasystole with a frequency> 6 / min;
    often: supraventricular extrasystole, ventricular tachycardia; infrequently: ventricular fibrillation, myocardial infarction;
    rarely: atrioventricular block of the second degree, spasm
    coronary vessels, violation of blood pressure (hypertension / hypotension), occurrence of an intracavitary pressure gradient, a feeling of palpitations.
    frequency unknown: stress-induced cardiomyopathy, fatal heart rupture.
    On the part of the respiratory system, chest and mediastinum often:
    bronchospasm, shortness of breath.
    Mental disorders
    frequency is unknown: anxiety, sensation of heat and anxiety.
    From the gastrointestinal tract
    often: nausea.
    From the skin and subcutaneous tissues
    often: exanthema;
    very rarely: petechial bleeding.
    From the side of the musculoskeletal system and connective tissue
    often: chest pain.
    From the side of the kidneys and urinary tract
    often: mandatory urge to urinate.
    General disorders and disorders at the site of administration
    often: fever, phlebitis at the injection site, with insignificant
    paravenous infiltration possible the development of local inflammation;
    very rarely: cutaneous necrosis.
    Overdose:
    Signs and Symptoms:
    nausea, vomiting, loss of appetite, tremor, anxiety, palpitations, tachycardia, tachyarrhythmia, ventricular fibrillation, an excessive increase in blood pressure, myocardial ischemia, false angina, headache, shortness of breath, anginal and nonspecific chest pain, vasodilation symptoms, marked reduction in blood pressure.
    Treatment: discontinuation of injection, intubation of the trachea for
    providing ventilation and oxygenation of the blood. When excessive increase in blood pressure - in / administration of alpha-blockers short acting at ventricular tachyarrhythmia - propranolol or lidocaine.
    At casual reception inside - Activated carbon (more effective than washing the stomach and inducing vomiting).
    Hemo- and peritoneal dialysis, forced diuresis, hemosorption with the use of activated charcoal are ineffective.
    When using the usual "stress-echocardiography" assays, it is unlikely to achieve toxic doses of dobutamine. If severe complications occurred during the study, the use of the drug
    should immediately stop and ensure adequate ventilation and oxygen supply. If angina occurs and / or clinically significant rhythm disturbances, short-acting beta-blockers should be injected intravenously (for example, esmolol), as well as short-acting nitrates are sublingually. Do not use antiarrhythmic drugs I and III class.
    Interaction:
    With the simultaneous use of blockers beta-adrenergic receptors, due to competitive inhibition of the receptors catecholaminergic effects of dobutamine may be weakened. The predominant alpha-adrenergic effects contribute to peripheral vasoconstriction with a subsequent increase in blood pressure. With simultaneous blockade of alpha-adrenergic receptors, the predominant beta-mimetic effects (stimulating beta-adrenoceptors) in this case can cause tachycardia and peripheral vasodilation.
    Simultaneous use of nitroglycerin or sodium nitroprusside, especially in patients with ischemic heart disease, contributes to an increase in the minute volume of the heart and a decrease in systemic vascular resistance and ventricular filling pressure.The heart rate and blood pressure increase slightly or do not change.
    Reduces the hypotensive effect of diuretics and hypotensive drugs (including alkaloids rauvolfii).
    The use of dobutamine in patients with diabetes mellitus may cause a higher need for insulin. Therefore, in patients with diabetes at the beginning of treatment, changing the rate of infusion and stopping the use of the drug should monitor the concentration of glucose in the blood plasma.
    Simultaneous use of angiotensin-converting enzyme (ACE) inhibitors and high doses of dobutamine can lead to an increase in the minute volume of the heart caused by increased consumption of oxygen by the heart muscle. This can lead to pain in the heart and arrhythmias.
    In combination with dopamine usually there is no additional increase in the minute volume of the heart, which is possible with a separate application of dobutamine. However, this combination increases systemic blood pressure, increases renal blood flow, excretion of sodium and diuresis, and also prevents an increase in the filling pressure of the ventricles. Contraindicated concomitant use of MAO inhibitors,since in this case development of life-threatening side effects (hypertensive crisis, collapse, heart rhythm disturbance and intracranial hemorrhages) is possible.
    Tricyclic antidepressants, maprotiline, cocaine, doxapram, guanadrel, guanethidine, increase the pressor effect and the risk of cardiotoxic side effects.
    Ergometrine, ergotamine, methylergomethrin, oxytocin increase the vasoconstrictor effect and the risk of occurrence of ischemia and gangrene, as well as severe arterial hypertension, up to intracranial hemorrhage.
    Levodopa increases the risk of arrhythmias (requires a reduction in the dose of sympathomimetics).
    Thyroid hormones increase (mutually) the effect and the associated risk of coronary insufficiency (especially in coronary atherosclerosis). There are no clear indications of the interaction of dobutamine with preparations of cardiac glycosides, furosemide, spironolactone, lidocaine, isosorbide dinitrate, morphine, atropine, heparin, protamine sulfate, potassium chloride, folic acid and paracetamol.
    Dobutamine can react with the HPLC analysis method, which uses chloramphenicol.
    Pharmaceutical incompatibility
    You can not mix a solution of dobutamine with alkaline solutions (for example, 5% sodium bicarbonate solution), solutions containing both sodium bisulfate, and ethanol, with acyclovir, aminophylline, brethil tosylate, calcium chloride, calcium gluconate, cefamandol formate, cefalothin sodium salt, cefazolin sodium salt, diazepam, digoxin, ethacrynic acid (sodium salt), furosemide, heparin sodium, hydrocortisone sodium succinate, insulin, potassium chloride , magnesium sulfate, penicillin, phenytoin, streptokinase, verapamil. Inhalation anesthetics - derivatives of hydrocarbons (including chloroform, enflurane, halothane, isoflurane, methoxyflurane) increase the risk of severe atrial or ventricular arrhythmias (increase myocardial sensitivity to sympathomimetics).
    12 hours before the sample "stress-echocardiography" with dobutamine the use of beta-adrenoreceptor blockers, as well as other antianginal drugs that reduce heart rate, is recommended to be stopped in order to avoid the absence of the effect of dobutamine test.
    When the "stress-echocardiography" test is extended, the use of high doses dobutamine with simultaneous introduction atropine may increase the risk of developing adverse events.
    Special instructions:
    Diluted in sterile water for injection, the lyophilisate of the preparation Dobutamine Hexal should be stored at a temperature of 2 ° to 8 ° C for a maximum of 24 hours before further dilution, and for a maximum of 6 hours at a temperature of no higher than 25 ° C. Further dilution should be carried out immediately before application of the drug. The prepared solution must be used within 24 hours, after which the solution is not to be used.
    Solutions containing Dobutamine Hexal can give a pink color, the intensity of which will eventually increase (due to its
    oxidation, however, there is no significant loss of activity and no increase in toxicity).
    Constant blood pressure control, ventricular filling pressure, central venous pressure, pulmonary arterial pressure, heart rate, ECG, body temperature and diuresis, and potassium in the blood serum are mandatory.
    When conducting treatment, the regional increase or decrease in the coronaryblood flow (blood flow in the coronary vessels of the heart), since this may change the need for cardiac muscle in oxygen. The speed and duration of administration of the drug Dobutamine Hexal is determined according to the patient's response, which is determined by the hemodynamic parameters (heart rate, heart rate, BP) and, if possible, by the minute volume of the heart, ventricular filling pressure (central venous, intracapillary pressure in the small circulation and pressure in the left atrium), as well as signs of changes in blood supply in the pulmonary artery and organ blood flow (diuresis, skin temperature and mental state). If tachycardia occurs, a rhythm disturbance, a significant increase in systolic blood pressure, the dose of Dobutamine Hexal should be reduced or the drug should be discontinued.
    The use of the drug Dobutamine Hexal may provoke or aggravate ventricular ectopic activity, which in rare cases can cause ventricular tachycardia or fibrillation. Because the Dobutamine Gexal facilitates atrioventricular conduction, in patients with flutter or atrial fibrillation, an increase in the frequency of ventricular contractions is possible.
    Particular caution is required when using the drug Dobutamine Hexal in patients with acute myocardial infarction, t. an increase in heart rate or excessive increase in blood pressure can increase ischemia and cause angina pectoris, elevation of the ST segment to the ECG.
    In cases where the average blood pressure is less than 70 mm Hg. and of course, diastolic pressure of the left ventricle is not increased, hypovolemia may be present, which must be corrected before using Dobutamine Hexal. If the blood pressure remains low or continues to decrease during the administration of the drug, despite the adequate magnitude of the end-diastolic pressure and the minute volume of blood, it is necessary to consider the possibility of using dopamine or norepinephrine. Dobutamine Hexal is not recommended as an adjuvant for hypovolemic shock.
    Continuous infusion of 72 hours or more may result in the development of tolerance, so higher doses may be needed to maintain the initial effect.
    In some cases with chronic heart failure in the stage of decompensation, along with the drug Dobutamine Hexal, the use of peripheral vasodilators (including sodium nitroprusside, nitroglycerin) is shown.
    The question of using the drug Dobutamine Hexal in patients with coronary heart disease should be addressed individually.
    The rupture of the cardiac muscle is a potential complication of myocardial infarction. The risk of rupture of the myocardium (interventricular septum and free wall) may depend on various factors including localization and time from the onset of the infarction. There are isolated reports of the onset of an acute cardiac rupture during a stress-echocardiography trial with Dobutamine Hexal for 4-12 days in patients after a previous myocardial infarction. It is recommended that patients be carefully selected for this study.
    Dobutamine Hexal is used in children with hypoperfusion due to low cardiac output as a result of decompensation of heart failure, heart surgery, cardiogenic and septic shock. Some hemodynamic effects of the drug Dobutamine Hexal may be
    quantitatively or qualitatively different in children and adults. The increase in heart rate and blood pressure is more frequent and pronounced in children. In children with the use of the drug Dobutamine Hexal, both a reduction and an increase in the wedging pressure in the pulmonary capillaries are possible.The cardiovascular system of the newborn is less sensitive to the drug Dobutamine Hexal and hypotensive effect, it is observed more often in adult patients than in young children. Accordingly, when using Dobutamine Hexal in children, these pharmacodynamic characteristics should be carefully taken into account.
    Effect on the ability to drive transp. cf. and fur:Not applicable, taking into account indications for use and a short half-life of the drug.
    Form release / dosage:Lyophilizate for the preparation of a solution for infusions 250 mg.
    Packaging:At 530 mg in a glass bottle with a capacity of 20 ml of neutral glass, closed with a rubber stopper, a metal cap and a plastic lid; 1 bottle per pack together with instructions for use.
    Storage conditions:
    In the dark place at a temperature of no higher than 25 ° C. After dissolution, it can be stored for 24 hours at a temperature of 2 to 8 ° C or for 6 hours at a temperature of no higher than 25 ° C.
    Keep out of the reach of children!
    Shelf life:
    3 years.
    Do not use the drug after the expiration date.
    Terms of leave from pharmacies:On prescription
    Registration number:П N012726 / 01
    Date of registration:21.04.2008
    The owner of the registration certificate:HEXAL AG HEXAL AG Germany
    Manufacturer: & nbsp
    Representation: & nbspSANDOZ SANDOZ Switzerland
    Information update date: & nbsp21.01.2016
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