Dosing and uses of Corlopam (fenoldopam)
Adult dosage forms and strengths
injectable solution
- 10mg/mL
Severe/Malignant Hypertension, Hypertensive Emergencies
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
In hospital use only
Monitor
Continuously monitor BP (usually by means of an intra-arterial line) & heart rate
Other Indications & Uses
Short-term (No more than 48 hr adult, 4 hr Peds), in-hospital treatment of
- Severe or malignant hypertension
- Hypertensive emergencies
Pediatric dosage forms and strengths
injectable solution
- 10mg/mL
Severe/Malignant HTN, Hypertensive Emergencies
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
In hospital use only
Monitor
Continuously monitor BP (usually by means of an intra-arterial line) & heart rate
Corlopam (fenoldopam) adverse (side) effects
Frequency not defined
Angina
Cardiac dysrhythmia
Dizziness
Flushing
Heart failure
Hypotension
Myocardial infarction
Tachycardia
Headache
Nausea
Vomiting
Serum creatinine raised
Warnings
Contraindications
Hypersensitivity to fenoldopam and sulfite
Cautions
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
Pregnancy and lactation
Pregnancy category: B
Lactation: Excretion in milk unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Corlopam (fenoldopam)
Mechanism of action
D1-dopamine receptor agonist: rapid-acting vasodilator; decreases peripheral resistance and increases renal blood flow; has minimal adrenergic effects
Also diuretic, natriuretic
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%)
Administration
IV Incompatibilities
Y-site: aminophylline, amphotericin B, ampicillin, bumetanide, cefoxitin, dexamethasone sodium PO4, diazepam, fosphenytoin, furosemide, ketorolac, methohexital, methylprednisolone Na-succinate, pentobarbital, phenytoin, prochlorperazine, Na-bicarb, thiopentaL
IV Compatibilities
Solution: D5W, Ns
Y-site (partial list): alfentanil, atropine, cefazolin, cefepime, ciprofloxacin, cisatracurium, clindamycin, dalfopristin-quinupristin, digoxin, diltiazem, dobutamine, dopamine, epinephrine, erythromycin, esmolol, heparin, hydromorphone, hydroxyzine, linezolid, lorazepam, MgSO4, morphine SO4, mannitol, midazolam, nitroglycerin, KCl, propofol, propranolol, TMP-SMX, vancomycin, verapamiL
IV Preparation
Adult Infusion: dilute in NS or D5W to a final concentration of 40 mcg/mL; for each 1 mL (=10 mg) of drug use 250 mL diluent
Pediatric Infusion: dilute in NS or D5W to a final concentration of 60 mcg/mL; for each 1.5 mL (=15 mg) of drug use 250 mL diluent
IV Administration
Use diluted solution within 24 hr
Use continuous infusion pump
