Posology : מינונים

4.2     Posology and method of administration
Just before administration Dobutamine concentrate for solution for infusion must be further diluted to at least 50 ml prior to administration in a container for intravenous use and according to the table below with one of the intravenous solutions listed in section 6.6.
The concentration used depends on the dosage and fluid requirements of the patient. The dilution should not be more concentrated than 5 mg/ml (5,000 µg/ml). Most patients will respond satisfactorily to doses from 2.5 to 10 µg/kg/min. Occasionally, however, a dose as low as 0.5 µg/kg/min will be effective. Rarely, a dose as high as 40 µg/kg/min has been required.

The table below is a directive for the rate of infusion:
Drug Delivery Rate                                       Infusion Delivery Rate (ml/kg/min)
(µg/kg/min)               250 µg/ml*            500 µg/ml**        1000 µg/ml***           5000 µg/ml**** 0.5                       0.002                 0.001              0.0005                  0.0001 1.0                       0.004                 0.002              0.0010                  0.0002 2.5                       0.010                 0.005              0.0025                  0.0005
5.0                       0.020                 0.010              0.0050                  0.0010 7.5                       0.030                 0.015              0.0075                  0.0015 10.0                      0.040                 0.020              0.0100                  0.0020 
12.5                           0.050                   0.025                      0.0125                      0.0025 15.0                           0.060                   0.030                      0.0150                      0.0030 * 250 mg of Dobutamine (1 vial) added to 1 liter of diluent.
** 500 mg of Dobutamine (2 vials) added to 1 liter of diluent or 250 mg (1 vial) added to 500 ml of diluent.
*** 1000 mg Dobutamine (4 vials) added to 1 liter of diluent or 250 mg (1 vial) added to 250 ml of diluent.
**** 250 mg of Dobutamine (1 vial) added to 50 ml of diluent. This dilution can be used in patients with restricted fluid intake.

The rate of administration and the duration of the therapy must be individualized to the patient's requirements and response as determined by heart rate, blood pressure, urine flow, and, whenever possible, measurement of cardiac output.
Because of the development of partial tolerance with continuous infusions of Dobutamine for 72 hours or more, higher doses may be required to maintain the same effects.
Rather than abruptly discontinuing the duration of therapy with Dobutamine, it is often advisable to decrease the dosage gradually.