A drip that helps the heart pump in severe heart failure
Milrinone
A hospital drip used to help the heart pump more strongly in severe heart failure.
What is Milrinone?
Milrinone is a hospital medicine given as a drip into a vein to help the heart pump more strongly and to relax blood vessels in people with severe, short-term heart failure. It is used in intensive care or coronary care under close monitoring. The main risks are abnormal heart rhythms and a drop in blood pressure, so the heart rhythm and blood pressure are watched continuously. It is a short-term treatment used while the heart recovers or while other treatments take effect.
Education and reference only. This is a plain-language guide to Milrinone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Milrinone is an inotrope, a medicine that strengthens the heart's pumping action. It belongs to a group called phosphodiesterase inhibitors. It is used in hospital, usually in intensive care or coronary care, for people with severe, short-term heart failure whose heart is not pumping well enough — for example after heart surgery or during a serious flare of heart failure. It is given as a controlled drip into a vein with continuous monitoring. It is a short-term support treatment, not a long-term medicine taken at home.
How it works
Milrinone helps the heart in two ways at once: it makes the heart muscle contract more strongly so it pumps more blood, and it relaxes and widens blood vessels so the heart has less resistance to push against. Together these improve the amount of blood the heart can move around the body. Because it both strengthens the beat and lowers the resistance, it can also lower blood pressure and, like other inotropes, can trigger abnormal heart rhythms, which is why it is given only with continuous heart and blood-pressure monitoring.
Company & origin
Originated / developed by: Hospital manufacturers.
A hospital medicine used in the UK to support the heart's pumping in people with severe, short-term heart failure.
Practical use
How to take Milrinone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given in hospital as a controlled drip into a vein by trained staff, never by yourself.
- Your heart rhythm and blood pressure are monitored continuously while it is being given.
- The drip rate is adjusted carefully against how your heart and blood pressure respond.
- It is used for short-term support, so it is stopped once your heart improves or other treatments take over.
- Tell the team about kidney problems, as the medicine can build up and may need the dose adjusting.
Weighing it up
Advantages & disadvantages of Milrinone
Advantages
- Helps the heart pump more strongly in severe, short-term heart failure.
- Also relaxes blood vessels, easing the work the heart has to do.
- A useful short-term support while the heart recovers or other treatments take effect.
Disadvantages
- Can trigger abnormal heart rhythms, which need close monitoring.
- Can lower blood pressure, sometimes too much.
- Used only in hospital with continuous monitoring, and can build up if the kidneys are not working well.
Practical use
Good to know
The key thing to know about milrinone is that it is a powerful hospital medicine used only with continuous monitoring of the heart's rhythm and blood pressure, because its two most important risks are abnormal heart rhythms and a drop in blood pressure. It is used for short-term support while the heart recovers or while other treatments take effect, rather than as a lasting treatment. The team adjusts the drip carefully against how the heart and blood pressure are responding. It is used with extra care in people with very low blood pressure, certain heart-valve problems or reduced kidney function, where it may build up. Because it can cause the heart to race or beat irregularly, any change in rhythm is taken seriously and acted on quickly.
Who should not take it / use with caution
- People who have had a serious allergic reaction to milrinone should not be given it.
- It is used with great care, or avoided, in certain heart-valve problems and in very low blood pressure.
- It is used cautiously and with dose adjustment in people with reduced kidney function.
Monitoring
- Continuous monitoring of heart rhythm and blood pressure throughout treatment.
- Adjusting the drip rate against how the heart and blood pressure respond.
- Checking kidney function and blood tests, especially with longer use.
Side effects
- Abnormal heart rhythms, including a fast or irregular heartbeat.
- A drop in blood pressure, sometimes causing light-headedness.
- Headache and, less commonly, changes in blood tests such as platelet levels with longer use.
Key interactions
- Care is needed alongside other medicines that lower blood pressure, as the effect can add up.
- It is used cautiously with other medicines that affect the heart's rhythm.
- Tell the team about all your medicines, as several can interact with milrinone.
Available as: A solution for a drip into a vein, given in hospital.
Answers
Milrinone: frequently asked questions
What is milrinone used for?
It is a hospital drip used to help the heart pump more strongly and relax blood vessels in people with severe, short-term heart failure.
Why does it need such close monitoring?
Its main risks are abnormal heart rhythms and a drop in blood pressure, so the heart rhythm and blood pressure are watched continuously while it is given.
Is it a long-term medicine?
No. It is a short-term support treatment used in hospital while the heart recovers or while other treatments take effect, not something taken at home.
Can it affect my kidneys?
The medicine can build up if the kidneys are not working well, so the team checks kidney function and may adjust the amount given.
How does it help the heart?
It makes the heart muscle pump more strongly and relaxes blood vessels so the heart has less resistance to push against, improving the blood it can move.
Authoritative sources
- BNF
- NICE CKS
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