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a vasodilator used for short-term, inpatient management of severe hypertension, administered intravenously as the mesylate salt.


(fen-ole-doe-pam) ,


(trade name)


Therapeutic: antihypertensives
Pharmacologic: vasodilators
Pregnancy Category: B


Short-term (<48 hr), in-hospital management of hypertensive emergencies, including malignant hypertension with end-organ deterioration.


Acts as an agonist at dopamine d1-like receptors.
Also binds to alpha-adrenergic receptors.
Acts as a vasodilator.

Therapeutic effects

Rapid lowering of BP.


Absorption: IV administration results in complete bioavailability.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized by the liver; 90% of metabolites are excreted in urine, 10% in feces.
Half-life: 5–10 min.

Time/action profile (effect on BP)

IVrapid15 min1–4 hr


Contraindicated in: Hypersensitivity to fenoldopam or sulfites; Concurrent beta blocker therapy (will prevent reflex tachycardia).
Use Cautiously in: Glaucoma or intraocular hypertension; Obstetric / Pediatric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • headache (most frequent)
  • nervousness/anxiety
  • dizziness


  • hypotension (most frequent)
  • tachycardia (most frequent)
  • ECG changes
  • peripheral edema


  • nausea (most frequent)
  • abdominal pain
  • constipation
  • diarrhea
  • vomiting


  • flushing (most frequent)
  • sweating

Fluid and Electrolyte

  • hypokalemia


  • injection site reactions


  • back pain


Drug-Drug interaction

Concurrent use with beta blockers may result in excessive hypotension (concurrent use should be avoided).


Intravenous (Adults) 0.01–1.6 mcg/kg/min.


Concentrate for injection: 10 mg/mL in 1– and 2-mL single-use ampules (with sodium meta-bisulfite)

Nursing implications

Nursing assessment

  • Monitor BP, heart rate, and ECG frequently throughout therapy; continuous monitoring is preferred. Consult physician for parameters.
  • Lab Test Considerations: Monitor serum potassium concentrations every 6 hr during therapy. May cause hypokalemia. Treat with oral or IV potassium supplementation.

Potential Nursing Diagnoses

Ineffective tissue perfusion (Indications)


  • Intravenous Administration
  • pH: 2.8–3.8.
  • Administer via continuous infusion; do not use bolus doses. Avoid hypotension and rapid decreases in BP. Initial dose titration should occur no more frequently than every 15 min and less frequently as desired BP is reached. Increments of 0.05 to 0.1 mcg/kg/min are recommended for titration. Lower initial doses (0.03 to 0.1 mcg/kg/min) titrated slowly have been associated with less reflex tachycardia than higher initial doses.
    • Infusion can be abruptly discontinued or gradually tapered before discontinuation. Oral therapy with other antihypertensives can begin anytime after the BP is stable. Do not administer beta blockers concurrently with fenoldopam.
  • Continuous Infusion: Diluent: Dilute 4 mL (40 mg of drug) with 1000 mL, 2 mL (20 mg of drug) with 500 mL, or 1 mL (10 mg of drug) with 250 mL of 0.9% NaCl or D5W. Infusion is stable for 24 hr at room temperature. Concentration: 40 mcg/mL.
  • Rate: Based on patient's weight (see Route/Dosage section). Titrate to desired effect. Administer via infusion pump to ensure accurate dosage rate.
  • Y-Site Compatibility: alfentanil, amikacin, aminocaproic acid, amiodarone, ampicillin/sulbactam, argatroban, atracurium, atropine, azithromycin, aztreonam, butorphanol, calcium chloride, calcium gluconate, caspofungin, cefazolin, cefepime, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol, cimetidine, ciprofloxacin, cisatracurium, clindamycin, cyclosporine, daptomycin, dexmedetomidine, digoxin, diltiazem, diphenhydramine, dobutamine, dolasetron, dopamine, doxycycline, droperidol, enalaprilat, epinephrine, ertapenem, erythromycin, esmolol, famotidine, fentanyl, fluconazole, gentamicin, granisetron, haloperidol, heparin, hydralazine, hydrocortisone sodium succinate, hydromorphone, imipenem/cilastatin, insulin, isoproterenol, labetalol, levofloxacin, lidocaine, linezolid, lorazepam, magnesium sulfate, mannitol, meperidine, metoclopramide, metoprolol, metronidazole, micafungin, midazolam, milrinone, morphine, nafcillin, nalbuphine, naloxone, nicardipine, nitroglycerin, nitroprusside, norepinephrine, ondansetron, palonosetron, pancuronium, phenylephrine, piperacillin/tazobactam, potassium chloride, potassium phosphate, procainamide, promethazine, propofol, propranolol, quinupristin/dalfopristin, ranitidine, remifentanil, rocuronium, sufentanil, tacrolimus, theophylline, ticarcillin/clavulanate, tirofiban, tobramycin, trimethoprim/sulfamethoxazole, vancomycin, vasopressin, vecuronium, verapamil, voriconazole
  • Y-Site Incompatibility: acyclovir, aminophylline, amphotericin B, ampicillin, bumetanide, cefoxitin, dexamethasone sodium phosphate, diazepam, fosphenytoin, furosemide, ganciclovir, ketorolac, meropenem, methohexital, methylprednisolone sodium succinate, pantoprazole, pentobarbital, phenytoin, prochlorperazine, sodium bicarbonate, thiopental

Patient/Family Teaching

  • Explain purpose of medication to patient.
  • Advise patient to report headache or pain at the injection site.

Evaluation/Desired Outcomes

  • Decrease in BP without the appearance of side effects.


/fe·nol·do·pam/ (fe-nol´do-pam) a vasodilator used for short-term, inpatient management of severe hypertension; used as the mesylate salt.


an antihypertensive.
indications It is used to treat hypertensive crisis when an urgent decrease of pressure is required, including malignant hypertension.
contraindications Known hypersensitivity to this drug and sulfite sensitivity prohibit its use.
adverse effects Life-threatening effects are hypotension, myocardial infarction, ischemic heart disease, and leukocytosis. Other adverse effects include anxiety, dizziness, ST-T wave changes, angina pectoris, palpitations, nausea, vomiting, constipation, diarrhea, bleeding, and increased levels of blood urea nitrogen, glucose, lactic dehydrogenase, creatinine, and hypokalemia. Headache is a common side effect.
References in periodicals archive ?
38) Controversy exists with regard to the usefulness of other medications to prevent acute kidney injury, such as sodium bicarbonate, N-acetylcysteine, fenoldopam, and theophylline.
Fenoldopam mesylate in early acute tubular necrosis: a randomized, double-blind, placebo-controlled clinical trial.
Dopamine and fenoldopam: Using a scale of 1 to 10, with 10 being extremely effective, surveyed nephrologists rated both dopamine and fenoldopam low with rating of 2.
Different pharmacological agents and procedures have been suggested to prevent radiocontrast nephropathy, including N-acetylcysteine, ascorbic acid, theophylline, fenoldopam, calcium antagonists and periprocedural haemofiltration with variable results (3).
The technique avoids the systemic hy-potension and other adverse effects that have curtailed attempts at prophylactic periprocedural intravenous administration of agents such as fenoldopam for the prevention of contrast-induced nephropathy (CIN) in patients at high risk--particularly those with preexisting renal insufficiency and diabetes, said Dr.
Physician-specified medications delivered intra-renally via TRT in the patients studied included fenoldopam (83.
Agents infused using TRT included: fenoldopam mesylate (92.
which offers most generic drugs available in its injectable portfolio, and Bedford Laboratories, which offers injectable fenoldopam.
Prospective randomized study of N-acetylcysteine, fenoldopam and saline for prevention of radiocontrast-induced nephropathy.
30 /PRNewswire/ -- Direct intra-renal drug delivery using the Benephit(TM) Infusion System can increase the beneficial effects of fenoldopam on the kidneys while minimizing systemic side effects in patients undergoing coronary procedures, according to important new clinical data reported today at the Cardiovascular Research Foundation's (CRF) Sixteenth Annual Scientific Symposium, Transcatheter Cardiovascular Therapeutics (TCT2004), in Washington, D.
Physician-specified agents used for TRT within the procedures included fenoldopam mesylate (93.
Use of a post-column immobilized [beta]-glucuronidase enzyme reactor for the determination of diastereomeric glucuronides of fenoldopam in plasma and urine by high-performance liquid chromatography with electrochemical detection.