Milrinone

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Generic Name: Milrinone Brand Name(s): Generics only. No brands available.

Uses

What is Milrinone used for?

Milrinone is used for the short-term treatment of heart failure. It works by making your heart beat stronger and by relaxing certain blood vessels so that the amount of blood that is pumped from the heart is increased. This effect may help with symptoms of heart failure (such as shortness of breath, tiredness).

How should I take Milrinone?

This medication is given by injection into a vein as directed by your doctor. It is usually first given as a slow injection (over 10 minutes) and then given as a continuous infusion thereafter.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

Dosage is based on your medical condition, weight, and response to treatment.

How do I store Milrinone?

Store at 20° to 25°C (68° to 77°F). Avoid freezing. Exposure of pharmaceutical products to heat should be minimized. Avoid excessive heat.

If you need to store milrinone at home, talk with your doctor, nurse, or pharmacist about how to store it.

There may be different brands of Milrinone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Milrinone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Milrinone?

Before using milrinone, tell your doctor or pharmacist if you are allergic to it, or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart valve disease, kidney disease, mineral imbalance (low level of potassium in the blood), irregular heartbeat (such as atrial fibrillation).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Milrinone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Milrinone. Milrinone is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Milrinone?

Headaches may occur. If this effect persists or worsens, tell your doctor promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: pain/redness/swelling at the injection site, fast/irregular heartbeat, dizziness, fainting, chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Milrinone?

Some products have ingredients that could worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Milrinone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Milrinone?

Milrinone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Milrinone?

Milrinone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Milrinone.

What is the dose of Milrinone for an adult?

Usual Adult Dose for Congestive Heart Failure

Loading dose: 50 mcg/kg IV over 10 minutes.

Maintenance infusion: 0.375 to 0.75 mcg/kg/min.

Renal Dose Adjustments

CrCl 5 mL/min:Maintenance infusion: 0.2 mcg/kg/min.

CrCl 10 mL/min: Maintenance infusion: 0.23 mcg/kg/min.

CrCl 20 mL/min: Maintenance infusion: 0.28 mcg/kg/min.

CrCl 30 mL/min: Maintenance infusion: 0.33 mcg/kg/min.

CrCl 40 mL/min: Maintenance infusion: 0.38 mcg/kg/min.

CrCl 50 mL/min: Maintenance infusion: 0.43 mcg/kg/min.

Dose Adjustments

The maintenance infusion should be adjusted to the patient’s response.

Precautions

Patients should be monitored by telemetry when on milrinone infusions.

Infusion site reactions have been reported. The manufacturers recommends monitoring the infusion site to avoid extravasation.

Other Comments

The maximum recommended daily dose is 1.13 mg/kg.

Experience with infusions of milrinone for periods exceeding 48 hours has not been documented.

What is the dose of Milrinone for a child?

Usual Pediatric Dose for Congestive Heart Failure

less than 1 month:

Hemodynamic support: Full term neonates: Loading dose: 50 to 75 mcg/kg IV administered over 15 minutes followed by a continuous infusion of 0.5 mcg/kg/minute; titrate to effect; range: 0.25 to 0.75 mcg/kg/minute has been used by several centers. One report used a loading dose of 50 mcg/kg IV administered over 15 minutes, followed by a continuous infusion of 0.5 mcg/kg/minute for 30 minutes in 10 neonates (3 to 27 days old, median age: 5 days) with low cardiac output after cardiac surgery; results showed improved hemodynamic parameters and milrinone was well tolerated.

Prevention of postoperative low cardiac output syndrome (CHD corrective surgery): Full term neonates: Loading dose: 75 mcg/kg IV administered over 60 minutes followed by a continuous IV infusion of 0.75 mcg/kg/minute for 35 hours was used in a randomized, placebo controlled trial of 227 patients (age: 2 days to 6.9 years, median: 3 months) and showed 64% relative risk reduction for development of low cardiac output syndrome compared to placebo; a lower milrinone dose used in the study did not show a statistically significant relative risk reduction compared to placebo for the same endpoint.

1 month and older:

Loading dose: 50 mcg/kg IV over 15 minutes.

Maintenance infusion: 0.25-1 mcg/kg/min.

How is Milrinone available?

Milrinone is available in the following dosage forms and strengths:

  • Intravenous solution

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Milrinone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 29, 2018 | Last Modified: March 29, 2018

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