• Presentation 10mg/10mL (1000 microgram/mL) vial. Dosage / Interval
  • Term Infant Preterm Infant Maintenance NO Loading Dose
  • Followed by maintenance dose
  • Renal impairment (including hypoplastic left heart syndrome undergoing surgery)
  • Total cumulative Route
  • Preparation/Dilution Term Infants
  • Pre-term infants and renal impairment
  • Neonatal Intensive Care Drug Manual




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    Drug Type

    Inotrope and vasodilator.

    Trade Name

    Primacor, Milrinone GH, Milrinone-Baxter

    Presentation

    10mg/10mL (1000 microgram/mL) vial.

    Dosage / Interval





    Term Infant

    Preterm Infant

    Maintenance NO Loading Dose

    0.33 - 0.75 micrograms/kg/minute

    0.2 microgram/kg/minute

    OPTIONAL Loading dose

    Loading: 75 microgram/kg over 1 hour

    Loading: 45 microgram/kg over 1 hour

    Followed by maintenance dose

    0.33 - 0.75 microgram/kg/minute

    0.2 microgram/kg/minute

    Caution: Risk of hypotension with loading dose!

    Dose adjustment

    Renal impairment (including hypoplastic left heart syndrome undergoing surgery)

    0.2 −0.33 microgram/kg/minute IV infusion,




    Maximum dose

    Maximum IV Infusion rate for the maintenance dose is 1 microgram/kg/minute and 0.5

    microgram/kg/minute for term and preterm infants respectively – caution as risk of drug accumulation over time.




    Total cumulative




    Route



    IV infusion

    Preparation/Dilution

    Term Infants


    Infusion strength

    Prescribed amount

    1 mL/hour = 0.33 microgram/kg/minute

    1 mL/hour = 0.33 microgram/kg/minute

    Draw up 1mL/kg (1000 microgram/kg of milrinone) and add sodium chloride 0.9% or glucose 5% to make a final volume of 50mL. Infusing at a rate of 1mL/hour = 0.33 microgram/kg/minute


    OPTIONAL- Give a loading dose of 3.75 mL (75 microgram/kg) over 1 hour (Note: risk of hypotension with loading dose).

    For term infants ─ if loading is not given, higher maintenance infusion may be required to reach the steady drug range of 0.5−0.75 microgram/kg/minute.


    Pre-term infants and renal impairment,


    Infusion strength

    Prescribed amount

    1 mL/hour = 0.2 microgram/kg/minute

    0.6 mL/kg milrinone and make up to 50mL

    Draw up 0.6mL/kg (600 microgram/kg of milrinone) and add sodium chloride 0.9% or glucose 5% to make a final volume of 50mL. Infusing 1mL/hour = 0.2microgram/kg/minute.


    OPTIONAL - Give a loading dose of 3.75 mL (45 microgram/kg) over 1 hour (Note: risk of hypotension with loading dose).

    For preterm infants ─ if loading dose is not given, titrate the maximal infusion rate to 0.5 microgram/kg/minute if required. Avoid prolonged infusion > 0.2 microgram/kg/minute in very preterm infants




    Administration


    Continuous IV infusion preferably via central line. Change solution every 24 hours.

    Adjust infusion rate based on haemodynamic and clinical response.

    For Loading dose: IV infusion over ONE hour


    Monitoring


    Heart rate, ECG and blood pressure

    Urine output and peripheral perfusion frequently.

    Fluid and electrolytes.

    Liver function.

    Platelets



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    Neonatal Intensive Care Drug Manual

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