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milrinone

Pronunciation

Generic Name: milrinone (MIL ri none)
Brand Name: Primacor, Primacor I.V.

What is milrinone?

Milrinone is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries.

Milrinone is used as a short-term treatment for treat life-threatening heart failure.

Milrinone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about milrinone?

You should not receive this medication if you are allergic to milrinone, or if you have recently had a heart attack.

If possible before you receive milrinone, tell your doctor if you have a heart rhythm disorder or low levels of potassium in your blood (hypokalemia), or if you are pregnant or breast-feeding.

In an emergency situation, it may not be possible before you are treated to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for you afterward knows that you have received this medication.

Tell your doctor about all other medications you use, especially digoxin (digitalis, Lanoxin, Lanoxicaps), or a diuretic (water pill).

While receiving milrinone, tell your caregivers at once if you have a serious side effect such as chest pain, feeling like you might pass out, wheezing or trouble breathing, confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, or muscle weakness.

What should I discuss with my healthcare provider before I receive milrinone?

You should not receive this medication if you are allergic to milrinone, or if you have recently had a heart attack.

If possible before you receive milrinone, tell your doctor if you have a heart rhythm disorder or low levels of potassium in your blood (hypokalemia).

FDA pregnancy category C. It is not known whether milrinone is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether milrinone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before you are treated with milrinone to tell your caregivers if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

How is milrinone given?

Milrinone is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. Milrinone is usually given around-the-clock for up to 48 hours.

Your heart rate and blood pressure will be constantly monitored while you are being treated with milrinone. Your kidney function and electrolytes may also need to be checked with blood tests.

What happens if I miss a dose?

Since milrinone is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Tell your caregivers right away if you think you have received too much of this medicine.

Overdose can cause severe dizziness or fainting.

What should I avoid after receiving milrinone?

Follow your doctor's instructions about any restrictions on food, beverages, or activity after your treatment with milrinone.

Milrinone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

  • chest pain;

  • feeling like you might pass out;

  • bronchospasm (wheezing, chest tightness, trouble breathing); or

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Less serious side effects may include:

  • headache;

  • tremors; or

  • easy bruising or bleeding.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Milrinone Dosing Information

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.

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.

What other drugs will affect milrinone?

Tell your doctor about all other medications you use, especially:

  • digoxin (digitalis, Lanoxin, Lanoxicaps); or

  • diuretic (water pill).

This list is not complete and there may be other drugs that can interact with milrinone. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about milrinone.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.04. Revision Date: 2010-12-15, 5:01:39 PM.

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