Dopamine Hydrochloride Injection Shortage

• • Dopamine Hydrochloride in 5% Dextrose injection, Baxter, 200 mg/250 mL, Viaflex Plus Plastic container 18 count, NDC 00338-1005-02
  • Dopamine Hydrochloride in 5% Dextrose injection, Baxter, 400 mg/250 mL, Viaflex Plus Plastic container 18 count, NDC 00338-1007-02
  • Dopamine Hydrochloride in 5% Dextrose injection, Baxter, 400 mg/500 mL, Viaflex Plus Plastic container 12 count, NDC 00338-1005-03
  • Dopamine Hydrochloride in 5% Dextrose injection, Baxter, 800 mg/250 mL, Viaflex Plus Plastic container 18 count, NDC 00338-1009-02
  • Dopamine Hydrochloride in 5% Dextrose injection, Baxter, 800 mg/500 mL, Viaflex Plus Plastic container 12 count, NDC 00338-1007-03
  • Dopamine Hydrochloride in 5% Dextrose injection, Pfizer, 400 mg/250 mL, LifeCare flexible container 12 count, NDC 00409-7809-22
  • Dopamine Hydrochloride in 5% Dextrose injection, Pfizer, 800 mg/250 mL, LifeCare flexible container 12 count, NDC 00409-7810-22
  • Dopamine Hydrochloride in 5% Dextrose injection, Pfizer, 800 mg/500 mL, LifeCare flexible container 12 count, NDC 00409-7809-24

• • Baxter has dopamine on a protective allocation due to potential for increased demand.
  • Hikma has dopamine injection available.
  • Pfizer has dopamine on shortage due to manufacturing delays.

• • Dopamine Hydrochloride injection, Hikma, 40 mg/mL, 10 mL vial, 25 count, NDC 00143-9254-25
  • Dopamine Hydrochloride injection, Hikma, 40 mg/mL, 5 mL vial, 25 count, NDC 00143-9252-25
  • Dopamine Hydrochloride injection, Pfizer, 40 mg/mL, 10 mL vial, 25 count, NDC 00409-9104-20
  • Dopamine Hydrochloride injection, Pfizer, 40 mg/mL, 5 mL vial, 25 count, NDC 00409-5820-01

Estimated Resupply Dates

• • Baxter has all presentations on a protective allocation.
  • Hikma has short-dated dopamine 40 mg/mL 10 mL vials available with an expiration date of March 2025.
  • Pfizer has dopamine 400 mg/250 mL premixed bags and 800 mg/250 mL premixed bags on back order and the company estimates a release date of July 2024. The 800 mg/500 mL premixed bags are on back order and the company estimates a release date of June 2024.

Implications for Patient Care

• • Dopamine is a natural catecholamine that at higher doses (5-15 mcg/kg/min) exhibits inotropic effects and increased cardiac output for patients hemodynamically unstable (eg, cardiogenic shock).[1-3]

Safety

• • Premixed bags and vial strength may differ than our standard concentrations. Ensure proper dosing/rate of administration if non-standard concentration is used.¯¯

Alternative Agents & Management

• • For states of hemodynamic instability, use alternative catecholamine or non-catecholamine inotropes and vasopressors.[4]
  • Information on assessing the management of different types of cardiogenic shock can be found at https://www.ahajournals.org/doi/10.1161/CIR.0000000000000525#d1e1478. Table 5 serves as a good reference for which vasoactive agents to use in specific causes/presentations of cardiogenic shock.[4]
  • The American College of Cardiology created a guidance of recommendations for the DOBUTamine shortage (another inotropic agent). Table 1 provides a summary of pharmacological properties of all vasopressors and inotropes that can also be utilized to assess alterative agents for DOPamine. This information can be found here: https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/02/12/42/What-You-Need-to-Know-Guidance-For-Clinicians-on-Dobutamine-Shortage

References

• 1. Dopamine HCl in 5% Dextorse injection [prescribing information]. Mukilteo, WA: HF Acquisition Co LLC; February 2023.
  2. Dopamine HCL injection [prescribing information]. Lake Forest, IL: Hospira Inc; September 2023.
  3. Dopamine. Lexicomp Online, Lexi-Drugs. UpToDate, Inc, Waltham, MA; 2023.¯
  4. van Diepen S, Katz JN, Albert NM, et al. Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association. Circulation. 2017;136(16):e232-e268. doi:10.1161/CIR.0000000000000525