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Adult doseing:
Acute decompensated heart failure (ADHF): IV: Initial: 6 to 12 mcg/kg infused over 10 minutes. Maintenance: 0.1 mcg/kg/minute by continuous infusion. Note: ESC heart failure guidelines recommend against administration of initial bolus dose in patients with systolic BP <90 mm Hg (Ponikowski 2016).
Dosage adjustments with concomitant medication (initial dose): Concomitant IV vasodilator or inotropic agents: Reduce initial infusion dose to 6 mcg/kg over 10 minutes.
Dosage adjustments (maintenance infusion):
If significant hypotension or tachycardia occur: Decrease infusion rate to 0.05 mcg/kg/minute or discontinue.
If inadequate response: May increase infusion up to 0.2 mcg/kg/minute.