FENOLDOPAM MESYLATE

Medical Diagnosis and Drugs, Medications

FENOLDOPAM MESYLATE
(fen-ol'do-pam mes'y-late)
Corlopam
Classifications: non-nitrate vasodilator; dopamine agonist agent; antihypertensive;
Therapeutic: non-nitrate vasodilator; antihypertensive
Pregnancy Category: B

Availability

10 mg/mL injection

Action

Rapid-acting vasodilator that is a dopamine D₁-like receptor agonist. Exerts hypotensive effects by decreasing peripheral vascular resistance while increasing renal blood flow, diuresis, and natriuresis.

Therapeutic Effect

Indicated by rapid reduction in BP. Decreases both systolic and diastolic pressures.

Uses

Short-term (up to 48 h) management of severe hypertension.

Contraindications

Hypersensitivity to fenoldopam. Avoid concomitant use with beta blockers.

Cautious Use

Asthmatic patients; hepatic cirrhosis, portal hypertension, or variceal bleeding; arrhythmias, tachycardia, or angina, particularly unstable angina; elevated IOP; angular-closure glaucoma; hypotension; hypokalemia; acute cerebral infarct or hemorrhage; pregnancy (category B), lactation.

Route & Dosage

Severe Hypertension
Adult: IV 0.1–0.3 mcg/kg/min by continuous infusion for up to 48 h, may increase by 0.05–0.1 mcg/kg/min q15min (dosage range: 0.01–1.6 mcg/kg/min)
Child: IV 0.2 mcg/kg/min, may increase to 0.3–0.5 mcg/kg/min

Administration

Intravenous

PREPARE: Continuous for Adult: Dilute to a final concentration of 40 mcg/mL by adding 1 mL (10 mg), 2 mL (20 mg), or 3 mL (30 mg) of fenoldopam to 250, 500, or 1000 mL, respectively, of NS or D5W. Continuous for Child: Dilute to a final concentration of 60 mcg/mL by adding 0.6 mL (6 mg), 1.5 mL (15 mg) or 3 mL (3 mg) of fenoldopam to 100, 250, or 500 mL, respectively, of NS or D5W.

ADMINISTER: Continuous for Adult/Child: Give only by continuous infusion; never give a direct or bolus dose. Titrate initial dose up or down no more frequently than q15min.

INCOMPATIBILITIES Y-site: Aminophylline, ampicillin, amphotericin B, bumetanide, cefoxitin, dexamethasone, diazepam, fosphenytoin, furosemide, ketorolac, methohexital, methylprednisolone, pentobarbital, phenytoin, prochlorperazine, sodium bicarbonate, thiopental.

Note: Diluted solution is stable under normal room temperature and light for 24 h. Discard any unused solution after 24 h.
Store at 15°–30° C (59°–86° F) in a tightly closed container and protect from light.

Adverse Effects (≥1%)

Body as a Whole: Injection site reaction, pyrexia, nonspecific chest pain. CNS: Headache, nervousness, anxiety, insomnia, dizziness. CV: Hypotension, tachycardia, T-wave inversion, flushing, postural hypotension, extrasystoles, palpitations, bradycardia, heart failure, ischemic heart disease, MI, angina. GI: Nausea, vomiting, abdominal pain or fullness, constipation, diarrhea. Metabolic: Increased creatinine, BUN, glucose, transaminases, LDH; hypokalemia. Respiratory: Nasal congestion, dyspnea, upper respiratory disorder. Skin: Sweating. Other: UTI, leukocytosis, bleeding.

Interactions

Use with beta-blockers increases risk of hypotension.

Pharmacokinetics

Onset: 5 min. Peak: 15 min. Duration: 15–30 min. Distribution: Crosses placenta. Metabolism: Conjugated in liver. Elimination: 90% in urine, 10% in feces. Half-Life: 5 min.

Nursing Implications

Assessment & Drug Effects

Monitor BP and HR carefully at least q15min or more often as warranted; expect dose-related tachycardia.
Lab tests: Carefully monitor serum electrolytes (especially serum potassium), BUN and creatinine, liver enzymes, and blood glucose and HbA_1C.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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