Inopin Special Precautions

Discontinuation of therapy: When discontinuing the infusion, it may be necessary to gradually decreases the dose of Dopamine while expanding blood volume with IV fluids, since sudden cessation may result in marked hypotension.
Cardiovascular effects: Ventricular arrhythmias: If an increased number of ectopic beats are observed, reduce the dose if possible.
Decreased pulse pressure: If a disproportionate rise in the diastolic pressure (i.e., a marked decrease in the pulse pressure) is observed in patients receiving Dopamine, decrease the infusion rate and carefully observe the patient for further evidence of predominant vasoconstrictor activity.
Hypotension: At lower infusion rates, if hypotension occurs, rapidly increase the infusion rate until adequate blood pressure is obtained. If hypotension persists, discontinue Dopamine and administer a more potent vasoconstrictor agent, such as norepinephrine.
Hypovolemia: Prior to treatment with Dopamine, ensure that hypovolemia is fully corrected, if possible, with either whole blood or plasma as indicated. Monitoring of central venous pressure or left ventricular filling pressure may be helpful in detecting and treating hypovolemia.
Hypoxia, hypercapnia, acidosis: These conditions, which may also reduce the effectiveness and/or increase the incidence of adverse reactions of Dopamine, must be identified and corrected prior to, or concurrently with administration of Dopamine.
Occlusive vascular disease: Closely monitor patients with a history of occlusive vascular disease (e.g., atherosclerosis, arterial embolism, Raynaud disease, cold injury [e.g., frostbite], diabetic endarteritis, Buerger disease) for any changes in color or temperature of the skin in the extremities. If a change in skin color or temperature occurs and is thought to be the result of compromised circulation to the extremities, weigh the benefits of continued Dopamine infusion against the risk of possible necrosis. This condition may be reversed by either decreasing the rate or discontinuing the infusion.
Extravasation: Infuse Dopamine into a large vein whenever possible to prevent the possibility of extravasation into tissue adjacent to the infusion site. Large veins of the antecubital fossa are preferred to veins in the dorsum of the hand or ankle. Administration into umbilical arterial catheter is not recommended. Only use less suitable infusion sites when larger veins are unavailable and if the patient's condition requires immediate attention. Switch to more suitable sites as rapidly as possible. Continuously monitor the infusion site for free flow. If extravasation occurs, infiltrate the area with diluted phentolamine (5 to 10 mg in 10 to 15 mL of saline) with a fine hypodermic needle. Phentolamine should be administered as soon as possible after extravasation is noted.
Sulfite sensitivity: INOPIN contains sodium metabisulfite, this sodium metabisulfite may cause allergic-type reactions, including anaphylactic symptoms, and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and is probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.