Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
December 2019
  • To increase cardiac output, blood pressure and improve renal blood flow in shock due to myocardial infarction, sepsis, trauma, acute renal failure, open heart surgery and chronic congestive heart failure
Reconstitution and Stability: 
  • Stable at room temperature. Protect from light
  • Solutions that are darker than slightly yellow should not be used as this indicates decomposition of the drug



-Solutions Compatible: dextrose up to D10W, 0.9% NaCl, dextrose-saline combinations, ringer's lactate, mannitol 20%

- Additives/Above Cassette Compatible: flumazenil

- Y-site Compatible: atracurium, dobutamine, epinephrine, fentanyl, hydromorphone, isoproterenol, KCl (up to 40 mmol/L), lidocaine, midazolam, milrinone, morphine, nitroglycerin, SMOF lipid 20%, TPN (amino acids/dextrose), vecuronium

Incompatible: alkaline solutions (ex: sodium bicarbonate, ampicillin), acyclovir, amphotericin, insulin, metronidazole,  thiopental


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct


IV Intermittent Infusion NO
IV Continuous Infusion

YES, Cardiac monitoring, continuous BP monitoring

Administer into a large vein
Standard concentration in ER/OR/PICU: 800 mcg/mL, 1600 mcg/mL  Central line only - 3200 mcg/mL

Click here to access SDC Drug Infusion Sheet


(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Individualized according to patient response


  • 1-20 mcg/kg/minute continuous IV infusion (Maximum: 50 mcg/kg/minute)
  • Titrate to effect.
    Renal Vasodilator:

    <5 mcg/kg/minute


    5-15 mcg/kg/minute


    >15 mcg/kg/minute


Potential hazards of parenteral administration: 
  • Cardiovascular: tachycardia, palpitation, ectopic beats, anginal pain, vasoconstriction, hypertension, ventricular arrhythmias
  • Gastrointestinal: nausea, vomiting
  • Miscellaneous: dyspnea, headache
  • Tissue necrosis may occur with extravasation - treatment:  remove canula from site of extravasation.  Elevate and splint limb.  If this is ineffective, subcutaneous infiltration of phentolamine may be used at the discretion of the physician (see phentolamine monograph). If extravasation occurs, click HERE for treatment guidelines.   
  • Peripheral vasoconstriction leading to stasis and gangrene of extremities
  • Before using dopamine, correct hypovolemia with an appropriate plasma expander
  • Patients require close monitoring (urine flow, cardiac output, ECG, heart rate, blood pressure)
  • Patients with pre-existing vascular disease are more prone to severe peripheral vascular constriction
  • DO NOT use in patients with pheochromocytoma
  • Patients who have been treated with MAO inhibitors will require substantially reduced dosage (reduce dose by at least 10%)
  • Use extreme caution in patients receiving cyclopropane or halogenated hydrocarbon anesthetics

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

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