milrinone

High Alert

Short-term treatment of HF unresponsive to conventional therapy with digoxin, diuretics, and vasodilators.

Contraindicated in:

Hypersensitivity;
Severe aortic or pulmonic valvular heart disease;
Hypertrophic subaortic stenosis (may ↑ outflow tract obstruction).

Use Cautiously in:

History of arrhythmias, electrolyte abnormalities, abnormal digoxin levels, or insertion of vascular catheters (↑ risk of ventricular arrhythmias);
Renal impairment (↓ infusion rate if CCr is <50 mL/min);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding.

CV: angina pectoris, chest pain, hypotension, supraventricular arrhythmias, VENTRICULAR ARRHYTHMIAS

Derm: rash

GI: ↑liver enzymes

Hemat: thrombocytopenia

Neuro: headache, tremor

Drug-drug:

None reported.

(Generic available)

Solution for injection: 1 mg/mL
Premixed infusion: 20 mg/100 mL; 40 mg/200 mL

IV (Adults ): Loading dose: 50 mcg/kg followed by Continuous infusion at 0.5 mcg/kg/min (range 0.375–0.75 mcg/kg/min).
IV (Infants and Children): Loading dose: 50 mcg/kg over 10 min followed by Continuous infusion at 0.5 mcg/kg/min (range 0.25–0.75 mcg/kg/min).

Increases myocardial contractility.
Decreases preload and afterload by a direct dilating effect on vascular smooth muscle.

Therapeutic effects:

Increased cardiac output (inotropic effect).

Therapeutic Classification: inotropics

Absorption: IV administration results in complete bioavailability.

Distribution: Moderately distributed to tissues.

Metabolism/Excretion: 80–90% excreted unchanged by the kidneys.

Half-Life: 2.3 hr (↑ in renal impairment).

(hemodynamic effects)

ROUTE	ONSET	PEAK	DURATION
IV	5–15 min	unknown	3–6 hr

Inform patient and family of reasons for administration. Milrinone is not a cure but is a temporary measure to control the symptoms of HF.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

NDC Code

0143- West-Ward Pharmaceuticals Corp
- 0143-9326- Milrinone Lactate
  - 0143-9326-10- 10 VIAL in 1 CARTON (0143-9326-10) > 20 mL in 1 VIAL (0143-9326-01)

0143- West-Ward Pharmaceuticals Corp
- 0143-9708- Milrinone Lactate
  - 0143-9708-10- 10 VIAL in 1 BOX (0143-9708-10) > 50 mL in 1 VIAL (0143-9708-01)

0143- West-Ward Pharmaceuticals Corp
- 0143-9709- Milrinone Lactate
  - 0143-9709-10- 20 mL in 1 VIAL (0143-9709-10)

0143- West-Ward Pharmaceuticals Corp
- 0143-9710- Milrinone Lactate
  - 0143-9710-25- 25 VIAL in 1 BOX (0143-9710-25) > 10 mL in 1 VIAL (0143-9710-10)

0338- Baxter Healthcare Corporation
- 0338-6010- Milrinone Lactate in Dextrose
  - 0338-6010-48- 10 BAG in 1 CARTON (0338-6010-48) > 100 mL in 1 BAG

0338- Baxter Healthcare Corporation
- 0338-6011- Milrinone Lactate in Dextrose
  - 0338-6011-37- 10 BAG in 1 CARTON (0338-6011-37) > 200 mL in 1 BAG

0409- Hospira, Inc.
- 0409-0212- MILRINONE LACTATE
  - 0409-0212-01- 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-0212-01) > 10 mL in 1 VIAL, SINGLE-DOSE (0409-0212-10)

0409- Hospira, Inc.
- 0409-0212- MILRINONE LACTATE
  - 0409-0212-02- 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-0212-02) > 20 mL in 1 VIAL, SINGLE-DOSE (0409-0212-11)

0409- Hospira, Inc.
- 0409-0212- MILRINONE LACTATE
  - 0409-0212-03- 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-0212-03) > 50 mL in 1 VIAL, SINGLE-DOSE

0409- Hospira, Inc.
- 0409-2776- Milrinone Lactate
  - 0409-2776-02- 10 BAG in 1 CASE (0409-2776-02) > 200 mL in 1 BAG

0409- Hospira, Inc.
- 0409-2776- Milrinone Lactate
  - 0409-2776-23- 10 BAG in 1 CASE (0409-2776-23) > 100 mL in 1 BAG

63323- Fresenius Kabi USA, LLC
- 63323-617- Milrinone Lactate
  - 63323-617-10- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-617-10) > 10 mL in 1 VIAL, SINGLE-DOSE

63323- Fresenius Kabi USA, LLC
- 63323-617- Milrinone Lactate
  - 63323-617-20- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-617-20) > 20 mL in 1 VIAL, SINGLE-DOSE

63323- Fresenius Kabi USA, LLC
- 63323-617- Milrinone Lactate
  - 63323-617-50- 1 VIAL, SINGLE-DOSE in 1 CARTON (63323-617-50) > 50 mL in 1 VIAL, SINGLE-DOSE

68083- Gland Pharma Limited
- 68083-318- Milrinone Lactate
  - 68083-318-10- 10 SYRINGE in 1 CARTON (68083-318-10) > 5 mL in 1 SYRINGE (68083-318-01)

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