Amrinone

Name: Amrinone

Dosing & Uses

Dosage Forms & Strengths

injectable solution

  • 5mg/mL

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

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

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)

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.

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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