Emergency and Critical Care

Dobutamine Dosing Calculator (mcg/kg/min to mL/h)

Converts dobutamine dose (mcg/kg/min) to infusion rate (mL/h) for cardiogenic shock.

Primary source: Российские КР по ХСН (Минздрав РФ, 2023). ESC HF 2021.

Aleksandr A. Aulov, MD, internal medicine Last clinical review: April 28, 2026

Online calculation

Patient weight

Body weight

Dobutamine dose

Therapeutic range 2-20 mcg/kg/min

mcg/kg/min

Drug amount in solution

Standard vial: 250 mg

Solution volume

Standard: 250 mg in 50 mL (concentrated) or in 250 mL

About this score

Dobutamine is a selective β1-agonist, the primary inotrope for cardiogenic shock and decompensated heart failure with low cardiac output. The calculator converts a dose in mcg/kg/min into an infusion rate in mL/h.

The therapeutic range is 2-20 mcg/kg/min. Starting dose is 2.5-5 mcg/kg/min, titrated every 10-15 minutes based on cardiac output, heart rate, and lactate. Doses above 10 mcg/kg/min increase the risk of tachyarrhythmias and myocardial ischemia. Unlike dopamine and norepinephrine, dobutamine has no significant vasopressor effect; in hypotensive patients it is usually combined with norepinephrine.

Standard dilutions: 250 mg (1 vial) in 50 mL (concentration 5 mg/mL = 5000 mcg/mL) for a syringe pump, or in 250 mL (1 mg/mL) for a volumetric infusion pump at stable high doses. ESC HF 2021 guidelines recommend dobutamine for acute decompensation with signs of hypoperfusion.

When to use

Cardiogenic shock with preserved or moderately reduced blood pressure.
Acute decompensated heart failure with signs of hypoperfusion (cold extremities, elevated lactate, rising creatinine).
Pharmacologic stress echocardiography (dobutamine stress test).
Low cardiac output after cardiac surgery.

Clinical example

Case

70-kg female patient with acute decompensated heart failure (LVEF 20%), BP 95/60, lactate 3.5 mmol/L, cold extremities. Dobutamine 5 mcg/kg/min prescribed. Prepared dilution: 250 mg in 50 mL.

Calculation

Concentration: 250×1000/50 = 5000 mcg/mL. Rate: 5×70×60/5000 = 4.2 mL/h.

Interpretation and management

Therapeutic inotropic dose. Goal: lactate < 2, warm extremities, urine output ≥ 0.5 mL/kg/h. Monitor heart rate (target < 100), rhythm, continuous ECG. If hypotension persists, add low-dose norepinephrine.

Limitations and cautions

Not a vasopressor; as monotherapy in hypotensive patients it is often ineffective.
Tachyphylaxis with prolonged use (> 72 h): reduced effect at the same dose.
High incidence of tachyarrhythmias and ischemia at doses > 10 mcg/kg/min.
Contraindicated in HCM with LVOT obstruction; worsens the gradient.

Frequently asked questions

Dobutamine vs milrinone?

Dobutamine is a β1-agonist with fast onset (minutes) and a short half-life (2 min). Milrinone is a phosphodiesterase inhibitor acting through cAMP, with a half-life of 2 h. Milrinone is preferred in patients on β-blockers.

Can it be given peripherally?

Yes, dobutamine does not cause significant vasoconstriction, so extravasation is clinically less significant. For prolonged infusion, central access is preferred.

When should it be discontinued?

Once hemodynamic stability is achieved (warm extremities, normal lactate, adequate urine output, CVP ≤ 12), transition to oral therapy. Taper by 2-3 mcg/kg/min every 6-12 hours.

Is it safe in coronary artery disease?

Use with caution: it increases myocardial oxygen demand. In CAD with active ischemia, the choice is straightforward as a bridge to revascularization; outside the acute setting, monitor ECG and troponin.

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Aleksandr A. Aulov Physician, internal medicine, Sechenov School — independent medical education platform. Calculators are compiled from the original publications and current clinical guidelines. Interpretation thresholds follow the source study unless stated otherwise.

This calculator is intended for healthcare professionals. Do not use it for self-diagnosis or self-treatment. Management decisions are made by the treating clinician based on the full clinical picture of the individual patient.