Skip to Content

Milrinone Disease Interactions

There are 6 disease interactions with milrinone:

Major

Milrinone (applies to milrinone) arrhythmias

Major Potential Hazard, Moderate plausibility.

The use of milrinone both intravenously and orally has been associated with increased frequency of ventricular arrhythmias, including nonsustained ventricular tachycardia. Long-term oral use has been associated with an increased risk of sudden death. Hence, patients receiving milrinone should be observed closely with the use of continuous electrocardiographic monitoring to allow the prompt detection and management of ventricular arrhythmias.

References

  1. Packer M, Medina N, Yushak M "Hemodynamic and clinical limitations of long-term inotropic therapy with amrinone in patients with severe chronic heart failure." Circulation 70 (1984): 1038-47
  2. Jelsema RD, Bhatia RK, Ganguly S "Use of intravenous amrinone in the short-term management of refractory heart failure in pregnancy." Obstet Gynecol 78 (1991): 935-6
  3. Hasegawa R "Milrinone, a new agent for the treatment of congestive heart failure." Clin Pharm 5 (1986): 201-5
  4. Silverman B, Merrill A, Gerber L "Clinical effects and side effects of amrinone. A study of 24 patients with chronic congestive heart failure." Arch Intern Med 145 (1985): 825-9
  5. DiBianco R, Shabetai R, Silverman BD, Leier CV, Benotti JR "Oral amrinone for the treatment of chronic congestive heart failure: results of a multicenter randomized double-blind and placebo- controlled withdrawal study." J Am Coll Cardiol 4 (1984): 855-66
  6. Ward A, Brogden RN, Heel RC, Speight TM, Avery GS "Amrinone: a preliminary review of its pharmacological properties and therapeutic use." Drugs 26 (1983): 468-502
  7. Mancini D, LeJemtel T, Sonnenblick E "Intravenous use of amrinone for the treatment of the failing heart." Am J Cardiol 56 (1985): b8-15
  8. "Product Information. Primacor (milrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  9. Bottorff MB, Rutledge DR, Pieper JA "Evaluation of intravenous amrinone: the first of a new class of positive inotropic agents with vasodilator properties." Pharmacotherapy 5 (1985): 227-37
View all 9 references
Major

Milrinone (applies to milrinone) heart valve disease

Major Potential Hazard, Moderate plausibility. Applicable conditions: Valvular Heart Disease

Milrinone should not be used in patients with severe obstructive aortic or pulmonic valvular disease in lieu of surgical relief of the obstruction. Like other inotropic agents, it may aggravate outflow tract obstruction in hypertrophic subaortic stenosis.

Major

Milrinone (applies to milrinone) myocardial infarction

Major Potential Hazard, Moderate plausibility.

No clinical studies have been conducted with milrinone in patients in the acute phase of post myocardial infarction. Until further clinical experience with this class of drugs is gained, milrinone is not recommended in these patients.

Moderate

Amrinone (applies to milrinone) liver disease

Moderate Potential Hazard, Moderate plausibility.

The use of inamrinone (former amrinone) has been associated with hepatotoxicity, manifested as marked alterations in liver function tests and clinical symptoms suggestive of idiosyncratic hypersensitivity. This especially after long-term use. Therapy with inamrinone should be administered cautiously if at all in patients with liver disease and discontinuation of the drug may be required if symptoms worsen. Monitoring of liver functions tests prior to and during therapy is recommended.

References

  1. Massie B, Bourassa M, DiBianco R, Hess M, Konstam M, Likoff M, Packer M "Long-term oral administration of amrinone for congestive heart failure: lack of efficacy in a multicenter controlled trial." Circulation 71 (1985): 963-71
  2. DiBianco R, Shabetai R, Silverman BD, Leier CV, Benotti JR "Oral amrinone for the treatment of chronic congestive heart failure: results of a multicenter randomized double-blind and placebo- controlled withdrawal study." J Am Coll Cardiol 4 (1984): 855-66
  3. Silverman B, Merrill A, Gerber L "Clinical effects and side effects of amrinone. A study of 24 patients with chronic congestive heart failure." Arch Intern Med 145 (1985): 825-9
  4. "Product Information. Inocor (inamrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  5. Wilsmhurst PT, Webb-Peploe MM "Side effects of amrinone therapy." Br Heart J 49 (1983): 447-51
  6. Bottorff MB, Rutledge DR, Pieper JA "Evaluation of intravenous amrinone: the first of a new class of positive inotropic agents with vasodilator properties." Pharmacotherapy 5 (1985): 227-37
  7. Dunkman WB, Wilen MM, Franciosa JA "Adverse effects of long-term amrinone administration in congestive heart failure." Am Heart J 105 (1983): 861-3
  8. Mancini D, LeJemtel T, Sonnenblick E "Intravenous use of amrinone for the treatment of the failing heart." Am J Cardiol 56 (1985): b8-15
  9. Gilman ME, Margolis SC "Amrinone-induced hepatotoxicity." Clin Pharm 3 (1984): 422-4
View all 9 references
Moderate

Amrinone/milrinone (applies to milrinone) hypotension

Moderate Potential Hazard, High plausibility.

The use of amrinone or milrinone is associated with a fall in blood pressure. Some patients have required correction by intravenous infusion of plasma. Therapy with amrinone or milrinone should be administered cautiously in hypotensive patients. Monitoring fluid and electrolyte status, renal function, blood pressure, and heart rate is recommended.

References

  1. Mancini D, LeJemtel T, Sonnenblick E "Intravenous use of amrinone for the treatment of the failing heart." Am J Cardiol 56 (1985): b8-15
  2. 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
  3. Bottorff MB, Rutledge DR, Pieper JA "Evaluation of intravenous amrinone: the first of a new class of positive inotropic agents with vasodilator properties." Pharmacotherapy 5 (1985): 227-37
  4. Burns P, Ondrejicka JS "Criteria for use of amrinone lactate in hospitalized adult patients." Clin Pharm 9 (1990): 882-4
  5. Hasegawa R "Milrinone, a new agent for the treatment of congestive heart failure." Clin Pharm 5 (1986): 201-5
  6. Larsson R, Liedholm H, Andersson KE, Keane MA, Henry G "Pharmacokinetics and effects on blood pressure of a single oral dose of milrinone in healthy subjects and in patients with renal impairment." Eur J Clin Pharmacol 29 (1986): 549-53
  7. Wilsmhurst PT, Webb-Peploe MM "Side effects of amrinone therapy." Br Heart J 49 (1983): 447-51
  8. "Product Information. Inocor (inamrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 8 references
Moderate

Amrinone/milrinone (applies to milrinone) thrombocytopenia

Moderate Potential Hazard, Low plausibility.

The use of amrinone, and infrequently, milrinone, can cause thrombocytopenia. This appears to be dose-dependent and usually occurs during prolonged therapy. Therapy with amrinone and milrinone should be administered cautiously in patients with thrombocytopenia. The dosage may need to be reduced or the drug discontinued if platelet count falls below 150,000/mm3 or if symptoms develop. Platelet counts prior and during therapy are recommended.

References

  1. Rubin SA, Lee S, O'Connor L, Hubenette A, Tober J, Swan HJ "Thrombocytopenia and fever in a patient taking amrinone." N Engl J Med 301 (1979): 1185
  2. Wilmshurst PT, Al-Hasani SF, Semple MJ, Hamblin AS, Kioy PG, Lucas GF, Savidge GF, Webb-Peploe MM "The effects of amrinone on platelet count, survival and function in patients with congestive cardiac failure." Br J Clin Pharmacol 17 (1984): 317-24
  3. Brandt JT, Miller L, Hermiller J, Unverferth DV, Leier CV "Effect of oral amrinone on platelet function and survival." Clin Pharmacol Ther 36 (1984): 260-4
  4. Wilsmhurst PT, Webb-Peploe MM "Side effects of amrinone therapy." Br Heart J 49 (1983): 447-51
  5. 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
  6. Ansell J, Tiarks C, McCue J, Parrilla N, Benotti J "Amrinone-induced thrombocytopenia." Arch Intern Med 144 (1984): 949-52
  7. Mancini D, LeJemtel T, Sonnenblick E "Intravenous use of amrinone for the treatment of the failing heart." Am J Cardiol 56 (1985): b8-15
  8. Packer M, Medina N, Yushak M "Comparative immediate hemodynamic and hormonal effects of amrinone and captopril in patients with severe chronic heart failure." Am J Med Sci 291 (1986): 8-15
  9. Deeb GM, Bolling SF, Guynn TP, Nicklas JM "Amrinone versus conventional therapy in pulmonary hypertensive patients awaiting cardiac transplantation." Ann Thorac Surg 48 (1989): 665-9
  10. "Product Information. Primacor (milrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  11. Bottorff MB, Rutledge DR, Pieper JA "Evaluation of intravenous amrinone: the first of a new class of positive inotropic agents with vasodilator properties." Pharmacotherapy 5 (1985): 227-37
  12. Burns P, Ondrejicka JS "Criteria for use of amrinone lactate in hospitalized adult patients." Clin Pharm 9 (1990): 882-4
  13. 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
  14. "Product Information. Inocor (inamrinone)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  15. Silverman B, Merrill A, Gerber L "Clinical effects and side effects of amrinone. A study of 24 patients with chronic congestive heart failure." Arch Intern Med 145 (1985): 825-9
  16. DiBianco R, Shabetai R, Silverman BD, Leier CV, Benotti JR "Oral amrinone for the treatment of chronic congestive heart failure: results of a multicenter randomized double-blind and placebo- controlled withdrawal study." J Am Coll Cardiol 4 (1984): 855-66
  17. Massie B, Bourassa M, DiBianco R, Hess M, Konstam M, Likoff M, Packer M "Long-term oral administration of amrinone for congestive heart failure: lack of efficacy in a multicenter controlled trial." Circulation 71 (1985): 963-71
  18. Ward A, Brogden RN, Heel RC, Speight TM, Avery GS "Amrinone: a preliminary review of its pharmacological properties and therapeutic use." Drugs 26 (1983): 468-502
View all 18 references

Milrinone drug interactions

There are 18 drug interactions with milrinone

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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