Fenoldopam (intravenous)

Fenoldopam is a medication that is used in a crisis situation to control severely elevated blood pressure quickly. Most likely used during a hospitalization, Fenoldopam is only administered by health care professionals as an injected or intravenous solution.

Overview

What is Fenoldopam

Fenoldopam is an injected drug that is used in emergency situations requiring a very fast way of reducing blood pressure. This medication, due to its aggressive and rapid activation, is only to be used by trained medical personnel in a hospital setting.

Typically, the use of Fenoldopam is only for severe cases of hypertensive activity or those cases of high blood pressure that are beginning to affect the other organs. After blood pressure is stabilized in the patient, they may be given another blood pressure regulatory medication to continue with.

How does Fenoldopam work

Fenoldopam activates a protein in the central nervous system called D1 dopamine receptor. By activating this receptor, Fenoldopam opens the blood vessels quickly and rapidly, thereby decreasing blood pressure.

Fenoldopam acts within four minutes of dosage and the effect lasts approximately ten minutes, no longer. Fenoldopam is also sold under the trade name Corlopam.

Conditions Treated

Type Of Medicine

  • Antihypertensive agent
  • Dopamine D1 receptor antagonist

Side Effects

This medication may cause adverse health effects that are unpleasant and sometimes severe, but not in all patients. Notify your health care professional if you show the following symptoms after being given Fenoldopam:

  • Convulsions
  • Urine amount has decreased
  • Pain or uncomfortable chest feeling
  • Neck veins are dilated
  • Fatigue
  • Mouth is dry
  • Rapid, irregular heart rhythm
  • Fever
  • Thirsty
  • Breathing is labored or irregular
  • No appetite
  • Mood swings
  • Cramps or pains in muscles
  • Vomiting
  • Nausea
  • Tingling or numb lips, feet or hands
  • Gasping for breath
  • Swollen lower legs, face, fingers or feet
  • Weak muscles
  • Gaining weight
  • Vision changes
  • Dizzy, faint feeling when rising
  • Sweating

The following health effects, while most likely temporary in nature, can still be bothersome and should be reported to your physician or nursing staff:

Headache
Anxiety
Feeling dizzy or lightheaded
Anxious demeanor
Muscles that spasm
Insomnia
Injection site bruising, bleeding, lumps, pain or rashes

You may experience other side effects than those listed here. If you have any health changes after receiving a dose of Fenoldopam, they should be reported immediately to your physician or medical staff.

Dosage

Your dosage of this medication will be predetermined and given to you by a health care professional such as a doctor, surgeon, EMT or nurse. The manufacturer has provided the following general information as patient information:

Adults receive 0.01 to 0.3 micrograms per kilogram of body weight every minute during intravenous transfusion. This dosage is the initial dose to see how the patient responds to the drug and may be increased in increments of 0.05 to 0.1 micrograms per kilogram per minute in 15 minute intervals until the blood pressure is at the target rate.

Pediatric patients typically receive an initial dose of 0.2 micrograms per kilogram of body weight every minute via intravenous transfusion. The maximum dose for children is 0.8 micrograms per kilogram of body weight per minute until the blood pressure is at a rate that the doctor is comfortable with.

Interactions

The list of medications, both prescription and non-prescription, that interact with Fenoldopam is quite extensive. Unfortunately, not all patients are able to communicate their medications to medical staff at the time they are administered this drug. Make certain that your medical records are up to date on the medications that you take. If you are diagnosed with a medical condition, make sure any identification such as a bracelet or card has your condition noted and is carried with you at all times. Loved ones should be aware and ready to communicate anything you are currently taking whether it is prescription, over-the-counter, vitamin or herbal in nature.

Fenoldopam is known to interact with the following medications, but both may be required to treat your condition. Your physician may choose to change the frequency or amount of your dosage before using Fenoldopam if you are currently taking:

  • Alprenolol
  • Acebutolol
  • Befunolol
  • Atenolol
  • Bevantolol
  • Betaxolol
  • Bopindolol
  • Bisoprolol
  • Carteolol
  • Bucindolol
  • Celiprolol
  • Carvedilol
  • Esmolol
  • Dilevalol
  • Landiolol
  • Labetalol
  • Mepindolol
  • Levobunolol
  • Metoprolol
  • Metipranolol
  • Nebivolol
  • Nadolol
  • Oxprenolol
  • Nipradilol
  • Pindolol
  • Penbutolol
  • Sotalol
  • Propranolol
  • Tertatolol
  • Talinolol
  • Xamoterol
  • Timolol

Use of Fenoldopam with food, tobacco products or alcoholic beverages may also cause unwanted and adverse reactions or loss of effectiveness. Alert your physician if you have recently used any of these substances before being given a dose of Fenoldopam.

If you have the following medical diagnoses, you may be at risk for worsening them after being given Fenoldopam. Notify the medical team if you have:

Warnings

If you have, in the past, been diagnosed as hypersensitive with regards to eating certain foods, being around certain animals or you have reacted to any additives, perfumes or dyes, alert your doctor right away. This is especially true for those patients who have shown signs of adverse effects after being given this or any other drug.

Pediatric patients have been studied for any elevated risk of using this drug and have not demonstrated any age-specific issues in that regard. It is generally understood that use of this medication in pediatric patients is safe.

Elderly patients, however, are more inclined to have liver, heart or kidney diseases that should prompt their physician to use caution with regard to prescribing a dosage of this medication. The effectiveness of the drug could be heightened and the duration with which it lingers in the body could be greater in this age group, which must be accounted for.

Controlled studies with regard to the use of Fenoldopam in women who are pregnant have not provided any data to prove the safety or effective use of this drug. Caution should be used if the patient is pregnant prior to deciding to use Fenoldopam. Women who breastfeed may pass on the effects of this drug to their children. For this reason, Fenoldopam use may prompt your physician to advise you to stop breastfeeding during this time and for a certain duration after use.

Fenoldopam is used to reduce blood pressure, which increases heart rhythm. This could potentially cause an extreme cardiac event or even death, though this is very rare. More commonly, patients experience headaches, flushed skin, low blood pressure or become nauseated. As patients who have been given Fenoldopam are constantly monitored by trained medical staff, these events typically are short in duration.

Potassium levels in your blood may drop very low after you are given a dose of Fenoldopam. Potassium is an electrolyte substance that helps your muscle and nerve cells function, which relates directly to your heart. If you have symptoms of low potassium or hypokalemia, notify your health care provider. These symptoms include a high thirst level or mouth that is dry, cramps in muscles, vomiting, nausea or a heart rhythm that is uneven.

Be alert for new hypertensive crises even after you have been discharged from the hospital. Seek emergency medical care if you experience swollen ankles, feet or hands, have a low output of urine, have chest pains or vision changes.

Don't take other medications unless they have been specifically approved by your physician or health care staff. This includes anything over-the-counter, vitamins, herbal supplements and holistic remedies.

Storage

As Fenoldopam is a medication that is given only during care in a medical setting by health professionals, storage is instructed directly to staff by the manufacturer. The manufacturer advises medical staff to store the ampules or vials of Fenoldopam between 36 and 86 degrees Fahrenheit and not to allow this drug to be exposed to light, heat or freezing temperatures.

Summary

Fenoldopam is an injected medication that is used during a hypertensive crisis situation to quickly reduce blood pressure. This medication can only be administered in a medical setting by trained staff such as a surgeon, a physician, a nurse or EMT. Use of this medication is typically safe on adults, children and in most geriatric patients.

As there may not be an opportunity to communicate to medical staff prior to being given this drug, it is advised that medical records be kept up-to-date with regard to any new diagnoses, any medications or treatments the patient is receiving. Fenoldopam typically gives patients a headache but could also make their skin appear flushed and make them nauseated as well. These symptoms usually go away after Fenoldopam has done its job and has been metabolized from the body. Should any lingering health effects continue, they should be reported immediately to your physician or you should seek emergency treatment from medical staff.

Signs of new hypertensive events, lowered levels of blood potassium and other adverse health effects may be experienced by some patients even after their treatment of Fenoldopam has passed. Report any symptoms of these conditions to your doctor right away. Fenoldopam should not be used on women who are pregnant or those who are breastfeeding. Let your doctor know if you are pregnant before being given Fenoldopam.