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Milrinone - Primacor ® - Renal dosing

Usual Dosing (Adults)

Inotropic/vasodilator
Give loading dose of 50 mcg/kg slowly over 10 minutes, then start maintenance: 0.375 to 0.75 mcg/kg/min. 


DOSAGE AND ADMINISTRATION
PRIMACOR (milrinone lactate) should be administered with a loading dose followed by a continuous infusion (maintenance dose) according to the following guidelines:

LOADING DOSE
50 mcg/kg: Administer slowly over 10 minutes

Note: PRIMACOR Flexible Containers (200 mcg/mL in 5% Dextrose Injection) are for intravenous infusion only and should not be used for a loading dose. Dosage recommendations using a 1mg/mL concentration of milrinone are included for informational purposes only. The loading dose should be administered using a milrinone 1mg/mL vial.

The table below shows the loading dose in milliliters (mL) of milrinone (1mg/mL) by patient body weight (kg).
Loading Dose (mL) Using 1 mg/mL Concentration
Patient Body Weight (kg)
kg 30 40 50 60 70 80 90 100 110 120
mL 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0

MAINTENANCE DOSE

Infusion Rate Total Daily Dose
(24 Hours)
Minimum 0.375 mcg/kg/min 0.59 mg/kg Administer as a
Standard 0.50 mcg/kg/min 0.77 mg/kg continuous
Maximum 0.75 mcg/kg/min 1.13 mg/kg intravenous infusion

The infusion rate should be adjusted according to hemodynamic and clinical response. Patients should be closely monitored. In controlled clinical studies, most patients showed an improvement in hemodynamic status as evidenced by increases in cardiac output and reductions in pulmonary capillary wedge pressure.

Renal Dosing

dialysis Recommended infusion rates (mcg/kg/min) per manufacturer:  
CRCL -  mL/min/1.73 m2 

[CRCL > 50]: No change
[50]: 0.43 mcg/kg/min
[40]: 0.38 mcg/kg/min
[30]: 0.33 mcg/kg/min
[20]: 0.28 mcg/kg/min
[10]: 0.23 mcg/kg/min
[5]: 0.2 mcg/kg/min

Hemodialysis

dialysis Hemodialysis:
Specific guidelines for hemodialysis are not mentioned by the manufacturer. See renal adjustments in the previous section.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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