Active Ingredient: Isoprenaline
Mild or transient episodes of heart block that do not require electric shock or pacemaker therapy.
Serious episodes of heart block (except when caused by ventricular tachycardia of fibrillation).
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intracardiac, 0.02 milligrams isoprenaline, one dose.
For:
Subcutaneous, 0.2 milligrams isoprenaline, one dose. Afterwards, subcutaneous, between 0.15 milligrams isoprenaline and 0.2 milligrams isoprenaline, one dose.
Initial dose: 0.2 mg.
Subsequent administration dose range: 0.15 mg to 0.2 mg.
Subsequent dosage and method of administration depend on the ventricular rate and the rapidity with which the cardiac pacemaker can take over when the medicine is gradually withdrawn.
Isoprenaline should generally be started at the lowest recommended dose and the rate of administration gradually increased if necessary while carefully monitoring the patient.
Elderly patients may be more sensitive to the effects of sympathomimetics and lower doses may be required.
For:
Intramuscular, 0.2 milligrams isoprenaline, one dose. Afterwards, intramuscular, between 0.02 milligrams isoprenaline and 1 milligrams isoprenaline, one dose.
Initial dose: 0.2 mg.
Subsequent administration dose range: 0.02 mg to 1 mg.
Subsequent dosage and method of administration depend on the ventricular rate and the rapidity with which the cardiac pacemaker can take over when the medicine is gradually withdrawn.
Isoprenaline should generally be started at the lowest recommended dose and the rate of administration gradually increased if necessary while carefully monitoring the patient.
Elderly patients may be more sensitive to the effects of sympathomimetics and lower doses may be required.
For:
Regimen A: Intravenous, between 0.02 milligrams isoprenaline and 0.06 milligrams isoprenaline, one dose. Afterwards, intravenous, between 0.01 milligrams isoprenaline and 0.2 milligrams isoprenaline,.
Regimen B: Intravenous, 5 micrograms isoprenaline, once every minute.
| Route of Administration | Initial dose | Subsequent administration dose range* |
|---|---|---|
| Bolus intravenous injection | 0.02 mg to 0.06 mg | 0.01 mg to 0.2 mg |
| Intravenous infusion | 5 mcg/min |
* Subsequent dosage and method of administration depend on the ventricular rate and the rapidity with which the cardiac pacemaker can take over when the medicine is gradually withdrawn.
Isoprenaline should generally be started at the lowest recommended dose and the rate of administration gradually increased if necessary while carefully monitoring the patient.
Elderly patients may be more sensitive to the effects of sympathomimetics and lower doses may be required.
For:
Intravenous, 0.1 milligrams isoprenaline per kilogram of body weight, once every minute.
There are no well-controlled studies in children to establish appropriate dosing; however, the American Heart Association recommends an initial infusion rate of 0.1 mcg/kg/min, with the usual range being 0.1 mcg/kg/min to 1.0 mcg/kg/min.
Adequacy and safety of intravenous isoprenaline in children are not established. Based on published literature, the initial dose of intravenous isoprenaline used in children is not established. Based on published literature, the initial dose of intravenous isoprenaline used in children (age 7 to 19 years of age) ranges between 0.05 to 0.17 mcg/kg/min, which is increased gradually by 0.1 to 0.2 mcg/kg/min at intervals of 15 to 20 minutes, titrated to clinical response; a maximum dose ranging between 1.3 to 2.7 mcg/kg/min has been used. In children generally, post-operative cardiac patients with bradycardia require lower doses (0.029 ± 0.002 mcg/kg/min) of intravenous isoprenaline than asthma patients (0.5 ± 0.21 mcg/kg/min).
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