Applies to milrinone: parenteral injection for iv infusion, parenteral injection for iv use.
Warning
Special Alerts:
A standardized concentration for this drug has been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. The drug is included in a standard concentration list which may apply to an IV or oral compounded liquid formulation. For additional information, see the ASHP website [Web].
Side effects include:
Ventricular arrhythmias (e.g., ventricular ectopy, nonsustained ventricular tachycardia ), supraventricular arrhythmias, hypotension, headache.
For Healthcare Professionals
Applies to milrinone: intravenous solution.
Cardiovascular
Cardiovascular side effects have included ventricular arrhythmias (12%), ventricular ectopic activity (8%), supraventricular arrhythmias (3.8%), sustained and nonsustained ventricular tachycardia (1% and 2.8%, respectively), ventricular fibrillation (0.2%), and atrial fibrillation. Hypotension (2.9%) and angina/chest pain (1.2%) have occurred. In addition, rare reports of torsades de pointes have been reported in postmarketing experience.[Ref]
Nervous system
Nervous system side effects have included headaches (2.9%) and tremor (0.4%). Dizziness is most often associated with hypotension.[Ref]
Hematologic
Milrinone has been shown to inhibit human platelet thromboxane A2 synthesis and calcium uptake.[Ref]
Hematologic side effects of reversible thrombocytopenia (0.4%), inhibition of platelet activity, and increased bleeding time have occurred. While these effects have been described in patients undergoing cardiac surgery who had received milrinone for 12 to 24 hours, they have not been associated with acute administration of milrinone. The hematologic side effects of milrinone may be important in some patients who are awaiting cardiac catheterization, transplant, or other significant invasive procedures.[Ref]
Gastrointestinal
General gastrointestinal complaints have been reported rarely.[Ref]
Hypersensitivity
Hypersensitivity reactions including rare instances of bronchospasm and anaphylactic shock have been reported in postmarketing experience.[Ref]
Hepatic
Hepatic side effects including liver function test abnormalities have been reported in postmarketing experience.[Ref]
Other
Other side effects including rash and skin reactions have been reported in postmarketing experience.[Ref]
Metabolic
Metabolic side effects have included rare reports of hypokalemia (0.6%).[Ref]
Respiratory
Respiratory side effects have been reported including isolated, spontaneous reports of bronchospasm.[Ref]
Dermatologic
Dermatologic side effects including rash has been reported in postmarketing experience.
Local
Local side effects including infusion site reaction has been reported in postmarketing experience.
