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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.

The Emergency Care Clinical Network recommends using the Critical Care Clinical Network guidance on inotropes and vasopressors

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

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

Page last updated: 18 Mar 2019

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