Fenoldopam

Abstract

Fenoldopam is a dopamine agonist that causes peripheral vasodilation via stimulation of dopamine 1 (D1) receptors. The efficacy of an intravenous infusion of fenoldopam in decreasing blood pressure in patients with a hypertensive urgency, including patients who developed hypertension after coronary artery bypass graft surgery, and in a small number of patients with hypertensive emergency, is similar to that of sodium nitroprusside. However, unlike sodium nitroprusside, fenoldopam also increases renal blood flow and causes diuresis and natriuresis. There is no evidence of rebound hypertension after stopping the infusion. As the tolerability profile of fenoldopam is generally similar to that of sodium nitroprusside, fenoldopam appears to be an effective alternative to sodium nitroprusside in the immediate treatment of patients who develop severe hypertension and in whom oral treatment is not practical. Fenoldopam may be particularly useful in patients who develop hypertension after coronary artery bypass graft surgery, but further studies are required to confirm its role in hypertensive emergency.

Fenoldopam Mesylate: A Narrative Review of Its Use in Acute Kidney Injury

“…Although FM can be administered orally or intravenously, the preferred route of administration is the latter, since the bioavailability of the drug after oral administration is reduced and influenced by food intake [12]. The drug can be infused intravenously at a dosage between 0.01-1.6 μg/Kg/min, reaching a steady state concentration proportional to the infusion rate.…”

“…Once in the bloodstream, 88% of FM is bound to plasma proteins [12] and is metabolized in the liver by phase II reactions, without the intervention of cytochrome P-450 enzymes. Lastly, 10% of the drug is eliminated in the feces and 90% in the urine, of which 4% is excreted unchanged [13].…”