High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error.
Short-term treatment of HF unresponsive to conventional therapy with digoxin, diuretics, and vasodilators.
Increased cardiac output (inotropic effect).
Absorption: IV administration results in complete bioavailability.
Metabolism and Excretion: 80–90% excreted unchanged by the kidneys.
Half-life: 2.3 hr (↑ in renal impairment).
TIME/ACTION PROFILE (hemodynamic effects)
|IV||5–15 min||unknown||3–6 hr|
Use Cautiously in:
CNS: headache, tremor
CV: VENTRICULAR ARRHYTHMIAS, angina pectoris, chest pain, hypotension, supraventricular arrhythmias
CV: skin rash
GI: ↑ liver enzymes
F and E: hypokalemia
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
IV (Adults) Loading dose–50 mcg/kg followed by continuous infusion at 0.5 mcg/kg/min (range 0.375–0.75 mcg/kg/min).
IV (Infants and Children) Loading dose–50 mcg/kg over 10 min followed by continuous infusion at 0.5 mcg/kg/min (range 0.25–0.75 mcg/kg/min).
Injection: 1 mg/mL
Premixed infusion: 20 mg/100 mL, 40 mg/200 mL
Lab Test Considerations: Monitor electrolytes and renal function frequently during administration. Correct hypokalemia prior to administration to decrease the risk of arrhythmias.
High Alert: Overdose manifests as hypotension. Dose should be decreased or discontinued. Supportive measures may be necessary.
Inform patient and family of reasons for administration. Milrinone is not a cure but is a temporary measure to control the symptoms of HF.
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