|Drug Name:||Milrinone Lactate|
To OpenTear outer wrap at notch and remove solution container. Some opacity of the plastic due to moisture absorption during the sterilization process may be observed.
This is normal and does not affect the solution quality or safety.
The opacity will diminish gradually.Preparation for Administration(Use aseptic technique)Close flow control clamp of administration set.Remove cover from outlet port at bottom of container.Insert piercing pin of administration set into port with a twisting motion until the set is firmly seated.
NOTE: See full directions on administration set carton.Suspend container from hanger.Squeeze and release drip chamber to establish proper fluid level in chamber.Open flow control clamp and clear air from set.
Close clamp.Attach set to venipuncture device.
If device is not indwelling, prime and make venipuncture.Regulate rate of administration with flow control clamp.WARNING: Do not use flexible container in series connections.
Such use could result in air embolism due to residual air being drawn from the primary container before administration of the fluid from the secondary container is complete.
Intravenous drug products should be inspected visually and should not be used if particulate matter or discoloration is present.Dosage Adjustment in Renally Impaired PatientsData obtained from patients with severe renal impairment (creatinine clearance = 0 to 30 mL/min) but without congestive heart failure have demonstrated that the presence of renal impairment significantly increases the terminal elimination half-life of milrinone.
Reductions in infusion rate may be necessary in patients with renal impairment.For patients with clinical evidence of renal impairment, the recommended infusion rate can be obtained from the following table: Creatinine Clearance( mL/min/1.73 m2)Infusion Rate(mcg/kg/min) 50.20 100.23 200.28 300.33 400.38 500.43
Milrinone lactate injection is indicated for the short-term intravenous treatment of patients with acute decompensated heart failure.
Patients receiving milrinone should be observed closely with appropriate electrocardiographic equipment.
The facility for immediate treatment of potential cardiac events, which may include life threatening ventricular arrhythmias, must be available.
The majority of experience with milrinone has been in patients receiving digoxin and diuretics.There is no experience in controlled trials with infusions of milrinone for periods exceeding 48 hours.
Whether given orally or by continuous or intermittent intravenous infusion, milrinone has not been shown to be safe or effective in the longer (greater than 48 hours) treatment of patients with heart failure.
In a multicenter trial of 1088 patients with Class III and IV heart failure, long-term oral treatment with milrinone was associated with no improvement in symptoms and an increased risk of hospitalization and death.
In this study, patients with Class IV symptoms appeared to be at particular risk of life-threatening cardiovascular reactions.
There is no evidence that milrinone given by long-term continuous or intermittent infusion does not carry a similar risk.The use of milrinone both intravenously and orally has been associated with increased frequency of ventricular arrhythmias, including nonsustained ventricular tachycardia.Long-term oral use has been associated with an increased risk of sudden death.Hence, patients receiving milrinone should be observed closely with the use of continuous electrocardiographic monitoring to allow the prompt detection and management of ventricular arrhythmias.