Milrinone

It is a relatively selective inhibitor of peak III cyclic AMP phosphodiesterase isozyme in cardiac and vascular muscle. In patients with CHF it produces dose related and plasma drug concentration related increase in the maximum rate of left ventricular pressure. Milrinone has a direct inotropic and direct arterial vasodilator activity.

Indications

Short term management of CCF in patients unresponsive to digitalis, diuretics or vasodilators.

Dosage

Adults : Administer by i.v. infusion over 10 mins., diluted before use. Initiate therapy with 0.50 mg/kg followed by intravenous infusion at a rate of 375-750 nanograms/kg/min., usually for upto 12 hours following surgery or 48-72 hours in CHF. Max. daily dose 1.13 mg/kg.

Contra-Indications

Hypersensitivity to the drug.

Special Precautions

Monitor fluid and electrolyte changes, blood pressure and heart rate. Do not use in patients with severe obstructive aortic or pulmonic valvular disease.

Side Effects

Headache hypokalemia, tremors. Ventricular arrhythmias (including ventricular ectopic activity), hypotension nonsustained/sustained ventricular tachycardia, angina, ventricular fibrillation.

Drug Interactions

Tell your doctor about all your current medicines and any you start or stop using, especially: digoxin (digitalis, Lanoxin, Lanoxicaps); or diuretic (water pill).