[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Vasopressors and inotropes](https://durgical.com/en/pharmacology/classes/vasopressors-and-inotropes/) › Dopamine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Vasopressors and inotropes](https://durgical.com/en/pharmacology/classes/vasopressors-and-inotropes/)

# Dopamine

A natural catecholamine given by intravenous infusion in shock. Its effects change with the dose: dopamine receptors first, then the heart, then the vessels.

Updated 2026-11-01

- Class: [Vasopressors and inotropes](https://durgical.com/en/pharmacology/classes/vasopressors-and-inotropes/)
- Receptor: Dopamine D1 receptor (also beta-1 and alpha-1 adrenergic receptors)
- ATC code: C01CA04
- WHO Model List of Essential Medicines

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

Also called: 3-hydroxytyramine

◎**Dopamine D1 receptor (also beta-1 and alpha-1 adrenergic receptors)**Dopamine

ⓘ The figure shows dopamine bound to the human dopamine D1 receptor in its active complex with a Gs protein.

**Target in 3D:** Dopamine D1 receptor (also beta-1 and alpha-1 adrenergic receptors). PDB structure 7F0T (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7F0T) · Drag to rotate · pinch to zoom

## Mechanism of action

Dopamine is the immediate precursor of norepinephrine. At low doses it acts mainly on dopamine receptors, dilating renal and splanchnic vessels; at moderate doses it stimulates cardiac beta-1 receptors, raising contractility and heart rate; at high doses alpha-1 stimulation constricts vessels. It also releases norepinephrine from nerve endings.

- Low doses: dopamine receptors dilate renal and splanchnic vessels
- Moderate doses: beta-1 stimulation increases contractility and heart rate
- High doses: alpha-1 stimulation constricts vessels and raises blood pressure

## Pharmacokinetics

**Metabolism**
Broken down by MAO and COMT; MAO inhibitors prolong and intensify its effect

**Half-life**
Very short: the effect fades within minutes of stopping the infusion

**Onset and duration**
Within minutes of starting the intravenous infusion

## Indications

- Shock with low cardiac output or distributive shock, to improve haemodynamics
- Septic shock (norepinephrine is usually preferred) [Sepsis and septic shock →](https://durgical.com/en/conditions/sepsis-and-septic-shock/)

## Adverse effects

### Common

- Tachycardia and palpitations
- Ectopic beats and other arrhythmias
- Nausea, vomiting and headache
- Angina
- Local vasoconstriction at the infusion site

### Serious (rare, important)

- Ventricular arrhythmias
- Tissue necrosis after extravasation
- Gangrene of the extremities with prolonged infusions or vascular disease
- Hypotension after abrupt discontinuation

## Contraindications

- Pheochromocytoma

## Key interactions

**MAO inhibitors**
Dopamine is not broken down: severe hypertension and arrhythmias

**Tricyclic antidepressants**
Stronger pressor response; blood pressure is watched

**Halogenated anaesthetics**
Sensitised myocardium: ventricular arrhythmias and hypertension

**Other vasopressors and oxytocic drugs**
Severe hypertension

## What is monitored

- Continuous blood pressure, heart rate and ECG
- Urine output and peripheral perfusion
- Infusion site for blanching or extravasation

## Administration and safety

- Always diluted and given by infusion pump into a large vein, preferably central, in an intensive care setting.
- Check the solution before use: do not use it if it is darker than slightly yellow or discoloured.
- Do not add other medicines to the dopamine infusion.
- Extravasation is an emergency: stop the infusion at that site and infiltrate phentolamine as early as possible.
- Dopamine and dobutamine have look-alike names: read the label twice.

## Nursing care

- Before: confirm that hypovolaemia, acidosis and hypoxia have been corrected.
- During: blood pressure, heart rate and rhythm continuously; urine output hourly.
- Check colour, temperature and capillary refill of the extremities and the infusion site often.
- Wean gradually while blood volume is maintained; abrupt stopping can cause marked hypotension.

## Pregnancy and breastfeeding

There are no human data; shock itself threatens the mother and the fetus, so treatment is not delayed. With oxytocic drugs it can cause severe maternal hypertension.

## Memory aid

Dopamine climbs a ladder: Dopamine receptors, then Beta-1, then Alpha-1 (D-B-A) as the dose goes up.

## Test yourself

Think of the answer, then tap the question to see it.

## In what order does dopamine activate receptors as its dose rises?

Dopamine receptors first (renal and splanchnic vasodilation), then cardiac beta-1 receptors, then vascular alpha-1 receptors (vasoconstriction).

## Which tumour is a contraindication to dopamine?

Pheochromocytoma: the tumour already releases catecholamines, and dopamine could trigger a hypertensive crisis.

## Why is a patient who recently took an MAO inhibitor at risk with dopamine?

MAO breaks dopamine down; with the enzyme blocked, its effect is prolonged and intensified, with severe hypertension and arrhythmias.

## What is done first if a dopamine infusion extravasates?

The infusion at that site is stopped and phentolamine is infiltrated into the area as early as possible to prevent necrosis.

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## Related drugs

- [Norepinephrine](https://durgical.com/en/pharmacology/norepinephrine/)
- [Dobutamine](https://durgical.com/en/pharmacology/dobutamine/)
- [Epinephrine](https://durgical.com/en/pharmacology/epinephrine/)

## Related conditions

- [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/)

[← Back to the class: Vasopressors and inotropes](https://durgical.com/en/pharmacology/classes/vasopressors-and-inotropes/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - DOPAMINE HYDROCHLORIDE injection, solution, concentrate](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1f306ad2-3606-4525-5a8a-ce78f426c1a2) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C01CA04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025); Farmacología básica y clínica (Katzung), cap. 9 (McGraw Hill, 2025).

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Representative model, for educational purposes only.

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