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inamrinone (Rx)Brand and Other Names:amrinone

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 5mg/mL
more...

Congestive Heart Failure

Load: 0.75 mg/kg IV bolus over 2-3 minutes, THEN

5-10 mcg/kg/min IV 

Total daily dose (including loading dose) should not exceed 10 mg/kg/day

Therapeutic dosage range: 0.5-7 mcg/mL

Renal Impairment

CrCl <10 mL/min: Administer 50-75% of the dose

CrCl ≥10 mL/min: Dosage adjustment not required

Dosage Forms & Strengths

injectable solution

  • 5mg/mL
more...

Congestive Heart Failure

<28 days old

  • Load as in adults, 0.75 mg/kg IV over 3-5 minutes, THEN
  • 3-5 mcg/kg/min IV maintenance infusion 
  • Bolus dose may need to be repeated after 30 minutes
  • Total daily dose should not exceed 10 mg/kg/day
  • Therapeutic dosage range: 0.5-7 mcg/mL

>28 days old

  • Load as in adults, 0.75 mg/kg IV over 3-5 minutes, THEN
  • 5-15 mcg/kg/min IV 
  • Not to exceed 10 mg/kg/day
  • Therapeutic dosage range: 0.5-7 mcg/mL

Renal Impairment

CrCl ≥30 mL/min: Dose adjustment not necessary

CrCl 10-29 mL/min: Administer 50% of dose

CrCl <10 mL/min: Administer 25% of dose

Congestive Heart Failure

Load: 0.75 mg/kg IV bolus over 2-3 minutes, THEN

5-10 mcg/kg/min IV 

Total daily dose (including loading dose) should not exceed 10 mg/kg/day

Therapeutic dosage range: 0.5-7 mcg/mL

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Interactions

Interaction Checker

inamrinone and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Arrhythmia (3%)

            Thrombocytopenia (2.4%)

            Nausea (1.7%)

            Hypotension (1.3%)

            <1%

            Fever (0.9%)

            Vomiting (0.9%)

            Abdominal pain (0.4%)

            Anorexia (0.4%)

            Chest pain (0.2%)

            Injections site pain (0.2%)

            Hepatotoxicity (rare)

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            Warnings

            Contraindications

            Hypersensitivity to inamrinone, milrinone and bisulfites

            Cautions

            Recent MI

            Electrolyte abnormalities

            Hypotension

            Proarrhythmic effects

            Insufficient cardiac filling pressure

            Severe aortic or pulmonic valvular diseas

            Renal impairment

            Concurrent use of disopyramide (may cause hypotension)

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Positive inotrope with direct pulmonary vasodilator (decrease both preload & afterload) activity, which increases cardiac output; these effects result from increases in cellular levels of cAMP as inamrinone inhibits myocardial cAMP phosphodiesterase

            Pharmacokinetics

            Half-Life: 3.6-5.8 hr (longer in CHF)

            Onset: 5-10 min (initial effect); within 10 min (max effect)

            Duration: 0.5-2 hr, duration depends on dose, mutiple doses: 8 hr

            Protein Bound: 10-49%

            Vd: 1.2 L/kg

            Metabolism: In the liver, main metabolic pathway is conjugation

            Metabolites: N-glycolate, N-acetate, N-glucuronide, O-glucuronide (inactive)

            Excretion: Urine 10-40%, feces 18%

            Dialyzable: No (HD or PD)

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            Administration

            IV Incompatibilities

            Solution: D5W

            Additive: furosemide

            Y-site: procainamide(?), Na bicarb

            IV Compatibilities

            Solution: 1/2NS

            Additive: propafenone

            Syringe: propranolol, verapamil

            Y-site (partial list): atropine, CaCl2, digoxin, dobutamine, dopamine, epinephrine, hydrocortisone, isoproterenol, methylprednisolone, nitroglycerin, norepinephrine, phenylephrine, KCl, propofol, propranolol, verapamil

            IV Preparation

            Dilute inamrinone with 1/2NS or NS to 1-2 mg/mL concentration for IV infusion

            Use within 24 hr

            IV Administration

            IV injection

            • May administer undiluted
            • Use only for initial loading & additional bolus doses
            • Over 2-3 min

            IV infusion

            • Use for maintenance doses
            • Infuse continuously at 5-15 mcg/kg/min

            Storage

            Store intact vials at room temp; protect from light

            Use diluted soln within 24 hr

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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