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Milrinone Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 22, 2024.

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

Warning

A standardized concentration for this drug has been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. The drug is included in a standard concentration list which may apply to an IV or oral compounded liquid formulation. For additional information, see the ASHP website [Web].

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

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

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]

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. Product Information. Primacor (milrinone). Sanofi Winthrop Pharmaceuticals. 2001;PROD.

2. 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. 1997;80:61-4.

3. 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. 1999;84:894-9.

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

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

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. 1993;245:67-73.

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

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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.