Milrinone
Milrinone is a phosphodiesterase III inhibitor classified as an inotropic agent used for short-term intravenous treatment of acute decompensated heart failure when other therapies prove inadequate. It works by increasing cyclic AMP levels in cardiac muscle and vascular smooth muscle, enhancing cardiac contractility while promoting vasodilation.
Milrinone is a short-term IV inotropic medication for acute heart failure that increases heart muscle contraction and promotes blood vessel dilation.
Key facts at a glance
- ATC
- C01CE02
- RxNorm
- 52769
- Generic
- Milrinone
- Class
- atc-c01
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
first trimesteravoid if possible
use only if potential benefits outweigh potential risks to fetus
regular fetal monitoring and echocardiography
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
use only if benefits outweigh risks, consider alternative therapy
close fetal monitoring, assess uterine activity
Use with caution and monitor for adverse effects.
lactation
breastfeedingdiscontinue breastfeeding or avoid
milrinone is excreted in breast milk, alternative feeding method recommended
monitor infant for adverse effects
Use with caution and monitor for adverse effects.
geriatric
elderlystart at lower end of dosing range
reduce initial loading dose and maintenance infusion, monitor renal function
monitor blood pressure, heart rate, renal function, and fluid status
Use with caution and monitor for adverse effects.
pediatric_age
neonatessignificant dose reduction required
use in pediatric patients with careful monitoring, dosing differs from adults
close hemodynamic monitoring, monitor for arrhythmias and hypotension
Use with caution and monitor for adverse effects.
pediatric_age
childrenweight-based dosing with adjustments
used for cardiac support in pediatric population with appropriate monitoring
monitor cardiac output, blood pressure, and renal function
Use with caution and monitor for adverse effects.
renal_impairment
mild renal impairmentreduce maintenance infusion rate by 25-50%
monitor renal function closely, adjust dose based on clinical response
frequent monitoring of serum creatinine and renal function
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentreduce maintenance infusion by 50-75%, avoid loading dose if possible
use with extreme caution, consider alternative therapy
intensive monitoring of renal function, drug levels if available
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate hepatic impairmentno major dose adjustment required
use with caution, monitor for increased effect
monitor hemodynamic parameters and liver function
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Milrinone belongs to the phosphodiesterase inhibitor class of cardiovascular drugs
Mechanism of action
Increases intracellular cAMP leading to increased cardiac contractility and vasodilation
Common uses
Primary therapeutic indications for Milrinone
FDA approval year
Original FDA approval date for Milrinone
Short-term intravenous treatment of acute decompensated heart failure, typically used when patients are not responding adequately to conventional therapies such as digoxin, diuretics, and vasodilators.
Milrinone inhibits phosphodiesterase III (PDE3), an enzyme that breaks down cyclic AMP (cAMP). By preventing cAMP degradation, it increases intracellular cAMP levels in cardiac myocytes and vascular smooth muscle, resulting in enhanced myocardial contractility and peripheral vasodilation.
Administered only by intravenous infusion due to lack of oral bioavailability. Associated with risks of arrhythmias, hypotension, and potential hepatotoxicity. Typically reserved for short-term use in critical care or acute settings. Contraindicated in severe obstructive aortic or pulmonic valvular disease.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy