Drug information of Fenoldopam

Fenoldopam

Drug group: vasodilators

A dopamine D1 receptor agonist that is used as an antihypertensive agent. It lowers blood pressure through arteriolar vasodilation.

Mechanism of effect

Fenoldopam is a rapid-acting vasodilator. It is an agonist for D1-like dopamine receptors and binds with moderate affinity to α2-adrenoceptors. Fenoldopam is a racemic mixture with the R-isomer responsible for the biological activity.

The R-isomer has approximately 250-fold higher affinity for D1-like receptors than does the S-isomer. Fenoldopam may increase norepinephrine plasma concentration.

Pharmacodynamic

Fenoldopam is an agonist at D1-like dopamine receptors, binds to α2-adrenoceptors, increasing renal blood flow.

Pharmacokinetics

  • Half-Life: 5 min
  • Duration: 1-4 hr post infusion
  • Onset: initial effect: 10 min, max effect: 30-120 min
  • Vd: 0.6 L/kg
  • Metabolism: in the liver to a variety of sulfate, glucuronide, & methoxy metabolites
  • Metabolite: fenoldopam-8-sulfate, fenoldopam-7-sulfate, fenoldopam glucuronide conjugates, and other minor metabolites
  • Excretion: Urine (90%), feces (10%)

Drug indications

Hypertension

Dosage

Severe/Malignant Hypertension, Hypertensive Emergencies

In hospital use only

Adult

Initiate dosing at 0.01 to 0.3 mcg/kg/min by continuous IV infusion 

Titrate by 0.05-0.1 mcg/kg/min q15min or longer until target blood pressure reached; up to 1.6 mcg/kg/min used in clinical trials; may continue maintenance infusion for up to 48 hr

Pediatric

Initial 0.2 mcg/kg/min continuous IV infusion pump for <4 hr 

Titrate q20-30min up to 0.3-0.5 mcg/kg/min; not to exceed 0.8 mcg/kg/min

Drug contraindications

hypersensitivity to this drug

Alerts

Causes a dose-related tachycardia, particularly with infusion rates above 0.1 mcg/kg/min

Monitor potassium levels

Increased intraocular pressure in patients with glaucoma or intraocular hypertension

Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms in susceptible patients

Points of recommendation

Have blood work checked as you have been told by the doctor. Talk with the doctor.

If you are allergic to sulfites, talk with your doctor. Some products have sulfites.

Pregnancy level

B


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