Focus on fenoldopam: A dopaminergic agonist for severe hypertension

Fenoldopam mesylate is a parenteral post-synaptic dopamine₁ receptor agonist currently under FDA review for the treatment of severe hypertension. The agent markedly lowers blood pressure, augments renal blood flow secondary to a reduction in renal vascular resistance, and induces both a diuresis and natriuresis in severe hypertensive patients. Fenoldopam exhibits equivalent blood pressure control and dose-response to nitroprusside. Fenoldopam is relatively well tolerated, devoid of toxic metabolite formation, and requires no protection from light. In consideration of its physiological, clinical, and pharmaceutical advantages, fenoldopam would appear to be a useful addition to the antihypertensive armamentarium.