Dosing & Uses
Dosage Forms & Strengths
Congestive Heart Failure
Load: 0.75 mg/kg IV bolus over 2-3 minutes, THEN
Total daily dose (including loading dose) should not exceed 10 mg/kg/day
Therapeutic dosage range: 0.5-7 mcg/mL
CrCl <10 mL/min: Administer 50-75% of the dose
CrCl ≥10 mL/min: Dosage adjustment not required
Dosage Forms & Strengths
Congestive Heart Failure
<28 days old
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
Serious - Use Alternative
Significant - Monitor Closely
Abdominal pain (0.4%)
Chest pain (0.2%)
Injections site pain (0.2%)
Hypersensitivity to inamrinone, milrinone and bisulfites
Insufficient cardiac filling pressure
Severe aortic or pulmonic valvular diseas
Concurrent use of disopyramide (may cause hypotension)
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
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.
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
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)
Y-site: procainamide(?), Na bicarb
Syringe: propranolol, verapamil
Y-site (partial list): atropine, CaCl2, digoxin, dobutamine, dopamine, epinephrine, hydrocortisone, isoproterenol, methylprednisolone, nitroglycerin, norepinephrine, phenylephrine, KCl, propofol, propranolol, verapamil
Dilute inamrinone with 1/2NS or NS to 1-2 mg/mL concentration for IV infusion
Use within 24 hr
- May administer undiluted
- Use only for initial loading & additional bolus doses
- Over 2-3 min
- Use for maintenance doses
- Infuse continuously at 5-15 mcg/kg/min
Store intact vials at room temp; protect from light
Use diluted soln within 24 hr
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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