Dopexamine  Dopexamine is a synthetic analogue of dopamine that is administered intravenously in hospitals to reduce exacerbations of heart failure and to treat heart failure following cardiac surgery. It is not used often, as more established drugs like epinephrine, dopamine, dobutamine, norepinephrine, and levosimendan work as well. It works by stimulating beta-2 adrenergic receptors and peripheral dopamine receptor D1 and dopamine receptor D2. It also inhibits the neuronal re-uptake of norepinephrine. The most common adverse effects include fast heart beats and nausea. It was discovered by scientists at Fisons, which licensed it to Ipsen in 1993, and Ipsen in turn licensed it to Élan in 1999. Ipsen licensed rights in North America and Japan to Circassia in 2008; the drug had never been approved in those countries. Dopexamine went off-patent in 2010. Dopexamine is used in hospitals as an inotropic agent to reduce exacerbations of heart failure and to treat heart failure following cardiac surgery. It is administered intravenuously. As of 2010 dopexamine was not often administered in cardiac care because other, more well established drugs can accomplish the same effect, other such drugs include epinephrine, dopamine, dobutamine, norepinephrine, and levosimendan. It should not be used in people taking monoamine oxidase inhibitors, nor in people who have certain adrenal cancers, low platelet counts, or people with left ventricular outlet obstruction. It also should not be used in people with severe low blood pressure or reduced systemic vascular resistance. It should be used in caution in people with ischemic heart disease especially following heart attack or a recent episode of angina due to the risk of tachycardia. It should not be used in people with reduced blood volume. Safety in pregnant women has not been established. Very common (greater than 10%) adverse effects include fast heart beats and nausea. Common (between 1% and 10%) adverse effects include tremor, headache, transient low blood pressure, vomiting, increased sweating, sepsis, sinus and nodal slow heart beat, cardiac arrest, myocardial infarction, cardiac enzyme changes, non-specific ECG changes, high blood pressure, hemorrhage, respiratory failure, acute respiratory distress syndrome, pulmonary edema, pulmonary hypertension, and kidney failure. Like other ß2-agonists, dopexamine lowers potassium levels and raises glucose levels, so there is a risk of exacerbating hypokalaemia or hyperglycaemia.