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Milrinone

    Brands

    DEA Class; Rx

    Common Brand Names; Lanoxin

    • Inotropic Agents; 
    • Phosphodiesterase Enzyme Inhibitors
    Parenteral positive inotrope and vasodilator with phosphodiesterase inhibitor activity
    Used for short-term treatment of acute heart failure
    Minimal chronotropic activity
    Indicated for the short-term treatment of acute heart failure and other low cardiac output states (e.g., cardiogenic shock, low cardiac output syndrome (LCOS) after cardiac surgery).
    For the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
    For the short-term treatment of low cardiac output during septic shock or postresuscitation stabilization.
    For the treatment of persistent pulmonary hypertension of the newborn (PPHN) in patients with poor response to nitric oxide.

    Hypersensitivity to milrinone and inamrinone

    • Ventricular arrhythmias
    • Supraventricular arrhythmia (4%)
    • Headache (3%)
    • Hypotension (3%)
    • Angina/chest pain (1%)
    • Abnormal liver function test results
    • Anaphylaxis
    • Atrial fibrillation
    • Bronchospasm
    • Hypokalemia
    • Injection-site reaction
    • Rash
    • Thrombocytopenia
    • Torsades de pointes
    • Tremor
    • Ventricular premature complex

    Use caution in atrial fibrillation/flutter, hypertrophic subaortic stenosis, electrolyte abnormalities, hypotension, recent MI, severe aortic or pulmonic valvular disease, renal impairment

    Severe aortic or pulmonic obstruction, acute phase after myocardial infarction (MI)

    May increase risk of arrhythmias

    Ensure that ventricular rate is controlled in atrial fibrillation/flutter before initiating therapy; may increase ventricular response rate

    Concurrent use of disopyramide

    Discontinue therapy if symptoms of hepatotoxicity (eg., increased LFTs) occur; monitor liver function

    Monitor blood pressure/heart rate closely

    Short-term use only

    Pregnancy category: C

    Lactation: Unknown whether drug is excreted into breast milk; use with caution; nursing is not priority in situations where milrinone is used

    Adults

    0.75 mcg/kg/minute continuous IV infusion.

    Geriatric

    0.75 mcg/kg/minute continuous IV infusion.

    Adolescents

    Safety and efficacy have not been established; however, up to 1 mcg/kg/minute continuous IV infusion has been used.

    Children

    Safety and efficacy have not been established; however, up to 1 mcg/kg/minute continuous IV infusion has been used.

    Infants

    Safety and efficacy have not been established; however, up to 1 mcg/kg/minute continuous IV infusion has been used.

    Neonates

    Safety and efficacy have not been established; however, up to 1 mcg/kg/minute continuous IV infusion has been used.

    Milrinone lactate

    infusion solution, in D5W

    • 20mg/100mL
    • 40mg/200mL

    injectable solution

    • 1mg/mL