Levophed Vs. Dopamine
Levophed (norepinephrine) is a medication approved by the Food and Drug Adminsitration (FDA) for the treatment of low blood pressure (hypotension) and shock. Dopamine is approved by the FDA to treat oliguria (decreased urine output) and shock.
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Dosing
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Levophed is administered in a 2 to 4 mcg/min initial dose and can be increased to 12mcgs depending on the patient's response. Dopamine is typically given as an initial dose of 1 to 5mcg by intravenous administration. Dosing typically depends on the patient's response as well and can go up to 50mcgs.
Serious side effects
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According to drugs.com, the potential cardiovascular side effects from norepinephrine can be serious. It can cause vasoconstriction, hypertension (high blood pressure) which cause headaches, photophobia, severe chest pain, paleness, increased sweating and/vomiting. Patients with hyperthyroidism or taking other medications that interact with this drug, are at an increased risk for developing cardiac problems while taking this. Bradycardia and arrhythmias have also been noted. It is one-tenth as potent as dopamine, which has serious side effects of its own, including hypotension and heart arrhythmias.
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Warnings
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Levophed can cause tissue necrosis (death) and sloughing if administered intravenously. Administration in a larger vein is strongly recommended. Elderly patients appear to be an more risk for developing skin reactions when treated intravenously.
Dopamine also has the risk of causing severe skin reactions when administered intravenously. It has the same risk for necrosis and also gangrene. There have been cases of amputation from gangrene. According to PharmacyOneSource, dopamine should be administered via central venous catheter, especially in higher risk patients.
Levophed contraindications
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Hypotensive patients resulting from blood volume deficits should not take levophed, except in emergent situations. Patients with types of vascular thrombosis should not be given levophed unless it is for a life saving procedures. It is also contraindicated for cyclopropane and halothane anesthesia and in any patients with hypoxia (not enough oxygen reaching tissues) or hypercarbia (too much carbon dioxide in the blood).
Dopamine contraindications
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Patients with pheochromocytoma should not take dopamine nor should patients taking MAOIs (monoamine oxidase inhibitors).
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