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Discussion

Max dose on drips

Im new to CCU and im trying to get used to the max doses on certain drip. Ive seen that the max dose for levophed is 30 mcg/min and that's what we use at our hospital as well. My question to you all is what is the max dose on neosynephrine (phenylephrine). I was told 350 mcg/min but when I look online at references the highest I find is 180 mcg/min so Im a little confused.

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Im new to CCU and im trying to get used to the max doses on certain drip. Ive seen that the max dose for levophed is 30 mcg/min and that's what we use at our hospital as well. My question to you all is what is the max dose on neosynephrine (phenylephrine). I was told 350 mcg/min but when I look online at references the highest I find is 180 mcg/min so Im a little confused.

Every hospital will have their own policy, but there is truly no max dose on vasopressors. Here's what we use at my hospital

Levophed: 30 mcg/min

Neosynephrine: 200 mcg/min

Dopmanine: 20 mcg/kg/min

Vasopressin: .04 units/min

Epinephrine: 10 mcg/min

Dobutamine (Inotrope): 20 mcg/kg/min

These are the max doses we can use on our own, we've gone much higher with an MD order in place.

When I started in the CVICU they gave me a nifty little badge card with all the titrating ranges for drugs like eli, levi, vaso and neo etc. In my whopping three months as an ICU nurse I have seen epinephrine and levophed at 20 and 20, faso at .06 and neo at 300. These were all on patients that were trying really REALLY hard to die.

The max dose for neo in my facility is 180 mcg/min. Docs will typically allow up to 200 mcg/min though.

My current facility is 200 on neo but my last facility was 300. Go by your facilities max dose.

Weight based dosing for levophed goes to 1mcg/kg/min which is higher than 30mcg/min for most adults. Pharmacist told me that 200mcg/min may be acceptable for some patients over the short term. Hey, but that is more a sepsis thing ya know. Otherwise 30mcg/min. Then again, we have pumps set for 20mcg/min maximum and I've seen it over 30mcg/min in a post-op ARDS pt.

The max for neo at my facility is 360.

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