Milrinone

Milrinone is a prescription medication used for short-term treatment of acute decompensated heart failure (a specific type of heart problem). Milrinone belongs to a group of drugs called inotropes, which work by helping the heart pump more blood through the body.

This medication comes in an injectable form to be given directly into the vein (IV) by a healthcare professional.  It is usually given continuously (24 hours per day) in the vein (IV). 

Common side effects of milrinone include abnormal heart rhythm, and headache. Milrinone can also cause changes in blood pressure, which can cause dizziness or fainting. Do not drive or operate heavy machinery until you know how milrinone affects you. Get out of bed slowly to avoid dizziness or fainting.

Milrinone is a prescription medication used for short-term treatment of acute decompensated heart failure (a specific type of heart problem).  

Take milrinone exactly as prescribed by your doctor.

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your kidney function
• your liver function
• your weight

The recommended dose range for milrinone in adults is based on weight and start with a large dose (loading dose) followed by a lower continuous dose. The recommended loading dose is 50 mcg/kg given in the vein (IV) over 10 minutes. After the loading dose, the dose ranges from 0.375 to 0.75 mcg/kg/minute given in the vein (IV) continuously (24 hours per day).  

Serious side effects have been reported with milrinone including the following:

• hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:
  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing
  • fainting
  • rash
• congestive heart failure (CHF). Tell your healthcare provider right away if you experience any of the following symptoms of CHF:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing to use more pillows to go to sleep or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• abnormal heart rate or extra beats (arrhythmia). Your healthcare provider will be monitoring your heart while taking this medication. Report any feelings of rapid or racing heart rate immediately to your healthcare provider.   
• a decline in liver function. Tell your healthcare provider any signs or symptoms of liver damage, which include the following:
  • loss of appetite or start losing weight (anorexia)
  • nausea or vomiting
  • feel tired
  • stomach pain or tenderness
  • dark urine or light colored stools
  • yellowing of your skin or the whites of your eyes
  • fever or rash
• a decline in kidney function. Toxicity from milrinone may occur with kidney dysfunction. Your doctor may want to monitor your kidney function with certain blood tests as well. Tell your healthcare provider right away right away if you have any of the following symptoms of kidney dysfunction:
  • swelling of face, ankles, hands, or feet
  • fatigue
  • paleness of skin
  • decreased urination
  • shortness of breath
  • change in blood pressures
  • side effects as mentioned in this section or in the “Side Effects” section of this medication page
• loss of control of blood sugar. Milrinone is mixed with dextrose, a type of sugar, before it is given into the vein (IV).  This may result in low blood sugar episodes, high blood sugar episodes, or both. Tell your healthcare provider right away if you have some or all of the following symptoms of low blood sugar:
  • hunger
  • shakiness
  • dizziness
  • confusion
  • difficulty speaking
  • feeling anxious or weak

Tell your healthcare provider right away if you have some or all of the following symptoms of high blood sugar:

• convulsions
• confusion
• increased thirst
• fever
• frequent urination
• nausea
• lethargy
• weight loss
• weakness

Milrinone can cause drowsiness. Do not drive or operate heavy machinery until you know how this medication affects you.

Serious side effects have been reported with milrinone. See the “Drug Precautions” section.

• abnormal heart rhythm
• abnormal heart beats or extra heart beats
• increased heart rate
• headache
• dizziness or fainting
• abnormal liver function test results (measured in the blood)
• blood sugar problems in diabetic patients

This is not a complete list of milrinone side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• diuretic medications used to reduce swelling and extra water such as furosemide (Lasix), torsemide (Demadex), bumetanide (Bumex), or metolazone (Zaroxolyn)

This is not a complete list of milrinone drug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Milrinone can also cause changes in blood pressure, which can cause dizziness or fainting. Get out of bed slowly to avoid dizziness or fainting.

Milrinone is mixed with dextrose, a type of sugar, before it is given into the vein (IV).  This may result in low blood sugar episodes, high blood sugar episodes, or both.

Your healthcare provider will be monitoring your heart while taking this medication.  Report any feelings of rapid or racing heart rate immediately to your healthcare provider.