Fenoldopam
Corlopam
The only antihypertensive that increases renal perfusion while blood pressure falls. A selective D1 agonist without alpha or beta effects, with onset within minutes and duration under one hour — theoretically attractive in hypertensive crisis with renal involvement, but without documented hard-endpoint benefit.
Raises intraocular pressure — avoid in glaucoma and raised intracranial pressure. Causes dose-dependent hypokalaemia.
Dosing in adults
| Indication | Regimen | Comment |
|---|---|---|
| Hypertensive crisis | Starting dose 0,1 μg/kg/min iv | no bolus dose |
| Titration | Increase by 0,05–0,1 μg/kg/min every 15 minutes | more frequent titration causes reflex tachycardia |
| Maximum dose | 1,6 μg/kg/min iv | rarely required |
| Hypertensive crisis with renal failure | 0,1–0,3 μg/kg/min iv | maintains or increases renal perfusion |
No dose adjustment. Renal perfusion and natriuresis increase during treatment.
No established adjustment; titrate to effect.
0,2–0,8 μg/kg/min iv. Children often require higher doses per kilogram than adults.
Avoid in glaucoma, raised intracranial pressure, and in patients who are already hypokalaemic. The drug lacks documented advantage over nicardipine or clevidipine on patient-relevant outcomes.
Pharmacokinetics
- ONSET
- 5–10 minutes
- STEADY STATE
- 20 minutes
- DURATION
- 30–60 minutes
- t½
- 5 minutes
- PROTEIN BINDING
- 88 %
- METABOLISM
- Conjugation (methylation, glucuronidation)
- EXCRETION
- Renal 90 %, faecal 10 %
- FIRST-PASS
- Extensive — intravenous use only