AdultPediatricGeriatricDosage 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 requiredDosage 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 doseCongestive 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/mLInteraction CheckerEnter a drug name and inamrinoneNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (2)ozanimodozanimod increases toxicity of inamrinone by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.ponesimodponesimod, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.Monitor Closely (2)anagrelideanagrelide, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.milrinonemilrinone, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.Minor (1)digoxininamrinone, digoxin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.anagrelideMonitor Closely (1)anagrelide, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.digoxinMinor (1)inamrinone, digoxin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.milrinoneMonitor Closely (1)milrinone, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of inamrinone by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.ponesimodSerious - Use Alternative (1)ponesimod, inamrinone. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients. 1-10% Arrhythmia (3%) Thrombocytopenia (2.4%) Nausea (1.7%) Hypotension (1.3%) <1% Fever (0.9%) Vomiting (0.9%) Abdominal pain (0.4%) Anorexia (0.4%) Chest pain (0.2%) Injections site pain (0.2%) Hepatotoxicity (rare) 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 Category: C Lactation: excretion in milk unknown; use with cautionPregnancy 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. 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 Pharmacokinetics 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) 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 No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. 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