milrinone at a glance
Medicine class
Phosphodiesterase-3 inhibitor; positive inotrope and vasodilator
Main role
Short-term hospital treatment of severe or acute heart failure
Administration
Given into a vein by healthcare professionals with continuous clinical monitoring
What is milrinone used for?
UK-licensed uses for the selected product are:
Short-term treatment of severe congestive heart failure that has not responded to conventional maintenance treatment.
Treatment of acute heart failure, including low cardiac-output states after cardiac surgery.
In children, short-term treatment of the same severe or acute heart-failure settings.
How does milrinone work?
Milrinone inhibits phosphodiesterase-3 in heart and vascular muscle, increasing intracellular cyclic AMP. This strengthens contraction, helps the heart relax between beats and widens blood vessels, reducing resistance to blood flow.
milrinone preparations and strengths
Injection
Route: Parenteral
Strengths: 1 mg/mL
How to take milrinone
Milrinone is not taken by mouth. It is prepared and administered into a vein by trained staff, with the solution and infusion site checked during treatment.
Food does not affect administration because milrinone is intravenous.
Tell staff promptly if the cannula site becomes painful, swollen, red or wet.
Do not handle, mix or adjust the infusion yourself.
milrinone side effects
Common or expected effects
- Headache, usually mild to moderate
- Low blood pressure, which may cause dizziness or faintness
- Abnormal heart rhythms, including extra beats or a rapid rhythm
Get urgent medical advice
- Severe allergic reaction or anaphylactic shock
- Serious ventricular heart rhythm disturbance
- Chest pain
- Bronchospasm with wheezing or breathing difficulty
- Kidney failure associated with low blood pressure
- Low platelets or haemoglobin; thrombocytopenia is reported more often in children
milrinone in pregnancy
Human pregnancy safety has not been established. Milrinone should be considered only when a specialist judges that the expected benefit outweighs the potential fetal risk.
milrinone while breastfeeding
It is not known adequately whether milrinone enters human milk. The clinical team should make an individual specialist assessment balancing breastfeeding benefits, infant factors and the mother's need for treatment.
milrinone interactions
Important issues mainly concern intravenous compatibility and factors that increase arrhythmia risk.
Furosemide or bumetanide
Do not administer through an intravenous line containing milrinone because a precipitate can form.
Sodium bicarbonate infusion
It must not be used to dilute milrinone because the preparations are incompatible.
Other intravenous medicines
They should not be mixed with milrinone unless compatibility has been established.
Diuretics and digoxin
Common questions about milrinone
Answers are fully visible for fast scanning and source review.
What is milrinone used for?
Milrinone provides short-term circulatory support in severe or acute heart failure, including low cardiac output after heart surgery.
Is milrinone only given in hospital?
Yes. The selected UK product is intravenous and requires close monitoring of blood pressure, heart rhythm, fluid balance and organ function.
Can milrinone be taken as a tablet?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.