| MILRINONE LACTATE
Classifications: inotropic agent; vasodilator; Therapeutic: vasodilator; inotropic agent
Pregnancy Category: C
1 mg/mL, 200 mcg/mL injection
Member of a class of inotropic/vasodilator agents. Positive inotropic action and vasodilator, with little chronotropic activity;
mode of action and structure are different from digitalis and catecholamines as well as beta-adrenergic agonists. Inhibitory
action against cyclic-AMP phosphodiesterase in cardiac and smooth vascular muscle. Increases cardiac contractility.
Increases myocardial contractility. Therefore, increases cardiac output and decreases pulmonary wedge pressure and vascular
resistance, without increasing myocardial oxygen demand or significantly increasing heart rate.
Short-term management of CHF.
Short-term use to increase the cardiac index in patients with low cardiac output after surgery. To increase cardiac function
prior to heart transplantation.
Hypersensitivity to milrinone; valvular heart disease; acute MI; pregnancy (category C).
Older adult; atrial fibrillation, atrial flutter; renal disease; renal impairment, renal failure; lactation. Safety and
efficacy in children are not established.
Route & Dosage
Adult: IV Loading Dose 50 mcg/kg IV over 10 min IV Maintenance Dose 0.3750.75 mcg/kg/min
- Note: Correct preexisting hypokalemia before administering milrinone. See manufacturer's information for dosage reduction in the
presence of renal impairment.
PREPARE: Loading Dose: Give undiluted or dilute each 1 mg in 1 mL NS or 0.45% NaCl. IV Infusion: Dilute 20 mg of milrinone in D5W, NS, or 0.45% NaCl to yield: 100 mcg/mL with 180 mL diluent; 150 mcg/mL with 113 mL
diluent; 200 mcg/mL with 80 mL diluent.
ADMINISTER: Loading Dose: Give 50 mcg/kg over 10 min. IV Infusion: Give at a rate based on weight. Use a microdrip set and infusion pump.
INCOMPATIBILITIES Solution/additive: Furosemide, procainamide. Y-site: Furosemide, imipenem/cilastatin, procainamide.
- Store according to manufacturer's directions.
Adverse Effects (≥1%)CV:
Increased ectopic activity, PVCs, ventricular tachycardia, ventricular fibrillation, supraventricular arrhythmias; possible
increase in angina symptoms
may cause excessive hypotension.
2 min. Duration:
2 h. Distribution:
70% protein bound. Elimination:
8085% excreted unchanged in urine within 24 h. Active renal
tubular secretion is primary elimination pathway. Half-Life:
Assessment & Drug Effects
- Monitor cardiac status closely during and for several hours following infusion. Supraventricular and ventricular arrhythmias
- Monitor BP and promptly slow or stop infusion in presence of significant hypotension. Closely monitor those with recent aggressive
diuretic therapy for decreasing blood pressure.
- Monitor fluid and electrolyte status. Hypokalemia should be corrected whenever it occurs during administration.
Patient & Family Education
- Report immediately angina that occurs during infusion to physician.
- Be aware that drug may cause a headache, which can be treated with analgesics.