Milrinone


Full Generic Medicine Info
Dosage/Direction for Use

Intravenous
Short-term management of severe heart failure, Acutely decompensated heart failure
Adult: For patients unresponsive to conventional standard therapy or with low cardiac output post-cardiac surgery: Initially, a loading dose of 50 mcg/kg by slow inj over 10 minutes followed by continuous maintenance infusion of 0.375-0.75 mcg/kg/min. Adjust according to haemodynamics and clinical response. Max total dose: 1.13 mg/kg daily.
Renal impairment: Reductions in infusion rate may be necessary. Refer to individual product information for detailed recommendations.
Contraindications
Severe obstructive aortic or pulmonary valvular disease or hypertrophic subaortic stenosis in lieu of surgical relief of obstruction; severe hypovolaemia.
Special Precautions
Patients with CV disease, electrolyte imbalance (e.g. hypokalaemia). Not recommended for use in patients with acute MI. Renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor blood pressure, heart rate, ECG, electrolyte level (e.g. K, Mg) and fluid balance, renal function (e.g. serum creatinine), platelet count. Assess for signs of decreasing cardiac function (e.g. arrhythmia, hypotension).
Adverse Reactions
Significant: Ventricular arrhythmias (e.g. nonsustained ventricular tachycardia, sustained ventricular tachycardia, ventricular ectopy, ventricular fibrillation, supraventricular arrhythmias, supraventricular tachycardia), hypotension. Blood and lymphatic system disorders: Thrombocytopenia, anaemia. Cardiac disorders: Angina pectoris, atrial fibrillation, torsades de pointes. General disorders and administration site conditions: Injection site reaction. Investigations: Abnormal LFT. Metabolism and nutrition disorders: Hypokalaemia. Nervous system disorders: Headache, tremors. Respiratory, thoracic and mediastinal disorders: Bronchospasm. Skin and subcutaneous tissue disorders: Rash.
Potentially Fatal: Very rarely, anaphylactic shock.
Overdosage
Symptoms: Hypotension, cardiac arrhythmia. Management: General supportive treatment.
Drug Interactions
Adverse effects may be enhanced when given concomitantly with anagrelide. May increase the hypotensive effect of riociguat.
Action
Milrinone is a selective phosphodiesterase III inhibitor with positive inotropic and vasodilator activity but has minimal chronotropic activity. It acts on the cardiac and vascular muscles by selectively inhibiting the cyclic adenosine monophosphate (cAMP) phosphodiesterase activity resulting in an increased intracellular concentration of cAMP which produces increased myocardial contractility and vascular muscle relaxation.
Onset: 5-15 minutes.
Distribution: Volume of distribution: Approx 0.38-0.45 L/kg. Plasma protein binding: Approx 70%.
Excretion: Via urine (approx 83% as unchanged drug, 12% as 0-glucuronide metabolite). Elimination half-life: Approx 2.3-2.4 hours.
Storage
Intravenous: Store below 25°C. Protect from excessive heat.
CIMS Class
Cardiac Drugs
ATC Classification
C01CE02 - milrinone ; Belongs to the class of phosphodiesterase inhibitors. Used in the treatment of heart failure.
Disclaimer: This information is independently developed by CIMS based on milrinone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 CIMS. All rights reserved. Powered by CIMSAsia.com
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