Adult Dosing
CHF
- 0.375-0.75 mcg/kg/min IV
- Start: 50 mcg/kg IV x 1 dose; Max: 0.75 mcg/kg/min IV
- Dose should be titrated to desired effect. Do not exceed infusions >48 hrs as they are not shown to be safe or effective
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Calcium Channel Blocker Overdose [Non-FDA Approved]
- 50 mcg/kg IV bolus over 10 min followed by 0.5 to 1 mcg/kg/min IV infusion
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 50 mL/min: Start 0.43 mcg/kg/min IV
- 40 mL/min: Start 0.38 mcg/kg/min IV
- 30 mL/min: Start 0.33 mcg/kg/min IV
- 20 mL/min: Start 0.28 mcg/kg/min IV
- 10 mL/min: Start 0.23 mcg/kg/min IV
- 5 mL/min: Start 0.20 mcg/kg/min IV
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Do not exceed infusions >48 hrs as they are not shown to be safe or effective
- Therapy is associated with increased frequency of ventricular arrhythmias, including nonsustained ventricular tachycardia.
- Closely observe patients receiving milrinone with continuous ECG monitoring to allow the prompt detection and management of ventricular arrhythmias
- Do not use therapy in patients with severe obstructive aortic or pulmonic valvular disease in lieu of surgical relief of the obstruction because it may aggravate outflow tract obstruction in hypertrophic subaortic stenosis
- Shortening of AV node conduction time has been reported with milrinone indicating a potential for an increased ventricular response rate in patients with atrial flutter/fibrillation which is not controlled with digitalis therapy
- Monitor blood pressure and heart rate during therapy with milrinone, the rate of infusion slowed or stopped in patients showing excessive decreases in blood pressure
- Infusion site reaction may occur with the therapy. Careful monitoring of the infusion site should be maintained to avoid possible extravasation
- Milrinone is not recommended in Acute Myocardial Infarction
Cautions: Use cautiously in
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution when milrinone is administered to nursing women.
