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Key points

These guidelines are recommended for dosing, preparing and centrally administering inotropes and vasopressors in adults.

If central venous access is not possible, peripheral administration should be commenced in consultation with a critical care service, ARV or the tertiary referral hospital.

ARV 1300 368 661

Formal guidance about the peripheral administration of inotropes and vasopressors is currently being by developed by SCV and will be available soon.

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Prescribing guide

The table below is an easy-to-follow prescribing guide for emergency clinicians to use when managing patients who require inotropes and vasopressors.

Click on the links for more detailed information on each medication.

Inotrope and vasopressor guidelines

Medication

Prescribe

Make infusion using

Volume to be removed from bag

Suggested dosing range

Adrenaline (epinephrine)

1 mg/1 mL vials

(1:1000)

6 mg in 100 mL

12 mg in 200 mL

100 mL bag glucose 5%

250 mL bag glucose 5%

6 mL

62 mL

Starting dose:
1 - 4 microg/minute

Usual dose range:
1 – 20 microg/minute

Argipressin
(vasopressin)

20 units/1 mL vials

Via syringe driver:
20 units in 20 mL

40 units in 40 mL

Draw up 19 mL glucose 5%

Draw up 38 mL glucose 5%

N/A

N/A

Starting dose:
0.6 units/hour

Usual dose range:
0.6 – 2.4 Units/hour

Dobutamine

250 mg/ 20 mL vials

250 mg in 42 mL

500 mg in 83 mL

50 mL bag glucose 5%

100 mL bag glucose 5%

28 mL

57 mL

Starting dose:
100 – 400 microg/minute

Usual dose range:
100 – 1500 microg/minute

Dopamine

200 mg/ 5 mL vials

300 mg in 50 mL

600 mg in 100 mL

50 mL bag glucose 5%

100 mL bag glucose 5%

7.5 mL

15 mL

Starting dose:
100 – 400 microg/minute

Usual dose range:
100 – 1500 microg/minute

Isoprenaline

1 mg/ 5 mL vials

6 mg in 100 mL

100 mL bag glucose 5%

30 mL

Starting dose:
0.5 – 2 microg/minute

Usual dose range:
2 – 10 microg/minute

Levosimendan

12.5 mg/ 5 mL vials

12.5 mg in 250 mL

250 mL bag glucose 5%

5 mL

Usual dose range:
0.05 – 0.2 microg/kg/minute

Metaraminol

10 mg/ 1 mL vials

Incremental IV bolus:
10 mg in 20 mL

Via syringe driver:
20 mg in 40 mL

Draw up 19 mL glucose 5%

Draw up 38 mL glucose 5%

N/A

N/A

Usual dose range:
0.5 – 10 mg/hour

Milrinone

10 mg/ 10 mL vials

Via syringe driver:
10 mg in 50 mL

Via infusion pump:
20 mg in 100 mL

Draw up 40 mL glucose 5%

100 ml bag glucose 5%

N/A

20 mL

Starting dose:
0.1 microg/kg/minute

Usual dose range:
0.125 – 0.75 microgram/kg/minute

Noradrenaline
(norepinephrine)

 

2 mg/ 2 mL vials

4mg in 66mL

6mg in 100 mL

16 mg in 266 mL

100mL bag glucose 5%

100 mL bag glucose 5%

250 mL bag glucose 5%

38mL

6 mL

Nil

 

Starting dose:
2 – 10 microg/minute

Usual dose range:
0.5 - 30 microg/minute

Implement the guidelines in your health service

Download our change package

This document is designed to help you implement the above guidelines.

It contains strategies and resources to help you manage change at your service.

Watch our webinar to learn more.

Are you using the guidelines in your health service? Take our survey and share your feedback.

Test your knowledge

Download our learning package.

This package is for nurses, and junior medical and allied health staff who are transitioning to ICUs and CCUs.

It outlines actions, clinical effects, indications and clinical considerations. 

Background

Inotropes and vasopressors are vital medicines that are commonly used to treat the heart – mostly in our hospitals’ intensive care units (ICUs) or critical care units (CCUs).

Research shows the way they are used varies significantly between health services.

To help reduce medication errors and support consistent, high-quality care for all Victorian patients, we have released standardised guidelines on how centrally administered inotropes and vasopressors are prepared, dosed and administered.

Read more about this project

Page last updated: 12 Nov 2020

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