Indications: short-term treatment of severe congestive heart failure unresponsive to conventional maintenance therapy (not immediately after myocardial infarction); acute heart failure, including low output states following heart surgery.

Cautions: heart failure associated with hypertrophic cardiomyopathy; stenotic or obstructive valvular disease; monitor blood pressure, heart rate, ECG, central venous pressure; fluid & electrolyte status; renal function; platelet count; hepatic enzymes; correct hypokalaemia, monitor renal function; renal impairment.

Side Effects: ectopic beats; less frequently ventricular tachycardia or supra ventricular arrhythmias; hypotension; headache; insomnia; nausea; vomiting; diarhhoea; chest pain, tremor, bronchospasm, anaphylaxis and rash.

Dose: by intravenous injection over 10 minutes, diluted before use, 50 mcg/kg followed by intravenous infusion at a rate of 375-750 nanograms/kg/minute, usually for up to 12 hours following surgery or for 48-72 hours in congestive heart failure; max. daily dose 1.13mg/kg.