Chemical formula: C₁₂H₉N₃O Molecular mass: 211.219 g/mol PubChem compound: 4197
Milrinone interacts in the following cases:
Furosemide or bumetanide should not be administered in intravenous lines containing milrinone lactate in order to avoid precipitation.
Milrinone should not be diluted in sodium bicarbonate intravenous infusion.
As milrinone produces a slight enhancement in A-V node conduction, there is a possibility of an increased ventricular response rate in patients with uncontrolled atrial flutter/fibrillation. Consideration should therefore be given to digitalisation or treatment with other agents to prolong A-V node conduction time prior to starting milrinone injection therapy, and to discontinuing the therapy if arrhythmias occur.
Supraventricular and ventricular arrhythmias have been observed in the high risk population treated with milrinone. In some patients, an increase in ventricular ectopy including non-sustained ventricular tachycardia has been observed which did not affect patient safety or outcome.
The potential for arrhythmia, present in heart failure itself, may be increased by many drugs or a combination of drugs. Patients receiving milrinone should be closely monitored during infusion and the infusion should be stopped if arrhythmias develop.
In patients with severe obstructive aortic or pulmonary valvular disease, or hypertrophic subaortic stenosis, milrinone should not be used in place of surgical relief of the obstruction. In these conditions it is possible that a drug with inotropic/vasodilator properties might aggravate outflow obstruction.
Although animal studies have not revealed evidence of drug-induced foetal damage or other deleterious effects on reproductive function, the safety of milrinone in human pregnancy has not yet been established. It should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.
There is insufficient information on the excretion of milrinone in human milk. A decision must be made whether to discontinue breast-feeding or to discontinue milrinone therapy taking into account the benefit of breast feeding for a child and the benefit of therapy for the woman.
No effects on male and female fertility were observed in 3-generation reproductive studies in rats.
No studies on the effect on the ability to drive and use machines have been performed.
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