Milrinone Side Effects

Not all side effects for milrinone may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to milrinone: parenteral injection for iv infusion, parenteral injection for iv use

Side effects include:

Ventricular arrhythmias (e.g., ventricular ectopy, nonsustained ventricular tachycardia ), supraventricular arrhythmias, hypotension, headache.

For Healthcare Professionals

Applies to milrinone: intravenous solution

Cardiovascular

Cardiovascular side effects have included ventricular arrhythmias (12%), ventricular ectopic activity (8%), supraventricular arrhythmias (3.8%), sustained and nonsustained ventricular tachycardia (1% and 2.8%, respectively), ventricular fibrillation (0.2%), and atrial fibrillation. Hypotension (2.9%) and angina/chest pain (1.2%) have occurred. In addition, rare reports of torsades de pointes have been reported in postmarketing experience.[Ref]

Nervous system

Nervous system side effects have included headaches (2.9%) and tremor (0.4%). Dizziness is most often associated with hypotension.[Ref]

Hematologic

Hematologic side effects of reversible thrombocytopenia (0.4%), inhibition of platelet activity, and increased bleeding time have occurred. While these effects have been described in patients undergoing cardiac surgery who had received milrinone for 12 to 24 hours, they have not been associated with acute administration of milrinone. The hematologic side effects of milrinone may be important in some patients who are awaiting cardiac catheterization, transplant, or other significant invasive procedures.[Ref]

Milrinone has been shown to inhibit human platelet thromboxane A2 synthesis and calcium uptake.[Ref]

Gastrointestinal

General gastrointestinal complaints have been reported rarely.[Ref]

Hypersensitivity

Hypersensitivity reactions including rare instances of bronchospasm and anaphylactic shock have been reported in postmarketing experience.[Ref]

Hepatic

Hepatic side effects including liver function test abnormalities have been reported in postmarketing experience.[Ref]

Other

Other side effects including rash and skin reactions have been reported in postmarketing experience.[Ref]

Metabolic

Metabolic side effects have included rare reports of hypokalemia (0.6%).[Ref]

Respiratory

Respiratory side effects have been reported including isolated, spontaneous reports of bronchospasm.[Ref]

Dermatologic

Dermatologic side effects including rash has been reported in postmarketing experience.

Local

Local side effects including infusion site reaction has been reported in postmarketing experience.

References

1. Mehra MR, Ventura HO, Kapoor C, Stapleton DD, Zimmerman D, Smart FW "Safety and clinical utility of long-term intravenous Milrinone in advanced heart failure." Am J Cardiol 80 (1997): 61-4

2. "Product Information. Primacor (milrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.

3. Fleming GA, Murray KT, Yu C, et al. "Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery." Circulation 118 (2008): 1619-25

4. MilfredLaforest SK, Shubert J, Mendoza B, Flores I, Eisen HJ, Pina IL "Tolerability of extended duration intravenous milrinone in patients hospitalized for advanced heart failure and the usefulness of uptitration of oral angiotensin-converting enzyme inhibitors." Am J Cardiol 84 (1999): 894-9

5. Packer M, Carver JR, Rodeheffer RJ, et al "Effect of oral milrinone of mortality in severe chronic heart failure." N Engl J Med 325 (1991): 1468-75

6. Jeremy JY, Gill J, Mikhailidis D "Effect of milrinone on thromboxane A2 synthesis, cAMP phosphodiesterase and 45Ca2+ uptake by human platelets." Eur J Pharmacol 245 (1993): 67-73

7. Kikura M, Lee MK, Safon RA, Bailey JM, Levy JH "The effects of milrinone on platelets in patients undergoing cardiac surgery." Anesth Analg 81 (1995): 44-8

8. Hasegawa R "Milrinone, a new agent for the treatment of congestive heart failure." Clin Pharm 5 (1986): 201-5

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