Severe congestive heart failure

Active Ingredient: Milrinone

Indication for Milrinone

Population group: only children (1 year - 12 years old) , adolescents (12 years - 18 years old)

Milrinone is indicated for the short-term treatment of severe congestive heart failure unresponsive to conventional maintenance therapy, and for the treatment of patients with acute heart failure, including low output states following cardiac surgery.

For this indication, competent medicine agencies globally authorize below treatments:

0.05-1.13 mg/kg/min

Route of admnistration

Intravenous

Defined daily dose

50 - 75 ug per kg of body weight

Dosage regimen

From 50 To 75 ug per kg of body weight once every day

Loading dose

50 ug per kg of body weight

Detailed description

In published studies selected doses for infants and children were:

  • Intravenous loading dose: 50 to 75 μg/kg administered over 30 to 60 minutes.
  • Intravenous continuous infusion: To be initiated on the basis of hemodynamic response and the possible onset of undesirable effects between 0.25 to 0.75 μg/kg/min for a period up to 35 hours.

In clinical studies on low cardiac output syndrome in infants and children under 6 years of age after corrective surgery for congenital heart disease 75 μg/kg loading dose over 60 minutes followed by a 0.75 μg/kg/min infusion for 35 hours significantly reduced the risk of development of low cardiac output syndrome.

Results of pharmacokinetic studies have to be taken into consideration.

Active ingredient

Milrinone

Milrinone is a positive inotrope and vasodilator, with little chronotropic activity. It also improves left ventricular diastolic relaxation. It is a selective inhibitor of peak III phosphodiesterase isoenzyme in cardiac and vascular muscle. It produces slight enhancement of A-V node conduction, but no other significant electrophysiological effects.

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