Milrinone

證據等級: L5 | 預測適應症: 10


## 藥師評估報告

Milrinone 藥師筆記

一句話總結

Milrinone 是一種磷酸二酯酶抑制劑,TxGNN 預測其對禿髮症及頭痛障礙有潛力,其中頭痛障礙(特別是可逆性腦血管收縮症候群相關頭痛)已有病例報告支持動脈內 Milrinone 的療效。


快速總覽

項目 內容
藥物名稱 Milrinone(米力心)
DrugBank ID DB00235
台灣商品名 米力心注射劑0.2毫克/毫升
原核准適應症 充血性心衰竭的短期療法
預測新適應症 alopecia、hypotrichosis simplex of the scalp、congenital hypotrichosis milia、diffuse alopecia areata、headache disorder、congestive heart failure、migraine disorder、migraine with brainstem aura、trigeminal autonomic cephalalgia、acute pulmonary heart disease
最高預測分數 0.9991(禿髮症)
證據等級 L3(觀察性研究/病例報告 - 頭痛障礙)

預測適應症詳細分析

1. alopecia L5 99.91% 主要分析

為什麼這個預測合理?

### 藥理機轉分析

Milrinone 是選擇性磷酸二酯酶-3(PDE3)抑制劑,透過增加細胞內 cAMP 濃度發揮作用。其機轉與預測適應症的關聯:

  1. 禿髮症/毛髮稀疏症(TxGNN Score: 0.9991)
  • PDE 抑制劑(如 minoxidil)已知可促進毛髮生長
  • Milrinone 作為 PDE3 抑制劑理論上可能有類似作用
  • 但缺乏直接證據
  1. 頭痛障礙(TxGNN Score: 0.9946)
  • Milrinone 具有血管擴張作用
  • 已有病例報告顯示動脈內 Milrinone 可用於治療可逆性腦血管收縮症候群(RCVS)
  • 透過解除腦血管痙攣來緩解頭痛
  1. 充血性心衰竭(TxGNN Score: 0.9945)
  • 此為原核准適應症,有豐富臨床試驗證據

臨床試驗

目前無針對此特定適應症的臨床試驗登記。

2. hypotrichosis simplex of the scalp L5 99.90%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
3. congenital hypotrichosis milia L5 99.89%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
4. diffuse alopecia areata L5 99.88%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
5. headache disorder L3 99.46%

臨床試驗(1 項)

試驗編號階段狀態人數主要發現
NCT06205758N/AUNKNOWN1600Efficacy and Safety Prediction of Milrinone or Levosimendan as Initial Inotropic...

相關文獻(3 篇)

PMID年份類型期刊主要發現
347843432021ArticleThe American journal of case rReversible Cerebral Vasoconstriction Syndrome in a Background of Eclampsia Respo...
254403422015ArticleJournal of stroke and cerebrovA novel approach to diagnose reversible cerebral vasoconstriction syndrome: a ca...
186471812009ArticleHeadacheIntra-arterial milrinone for reversible cerebral vasoconstriction syndrome.
6. congestive heart failure L1 99.45%

臨床試驗(50 項)

試驗編號階段狀態人數主要發現
NCT01301313PHASE2TERMINATED116Phase II Study to Evaluate the Efficacy and Safety of Levosimendan in Severe Acu...
NCT02098629PHASE2COMPLETED25Concomitant Milrinone and Esmolol Treatment in Patients with Acute Myocardial In...
NCT04369573PHASE4TERMINATED100Early Intra-aortic Balloon Pump Placement in Acute Decompensated Heart Failure C...
NCT06522594PHASE2RECRUITING20Randomized Embedded Multifactorial Adaptive Platform in ExtraCorporeal Membrane ...
NCT03071835N/ACOMPLETED47A Comparative Study of Subjects tHree to Thirteen Years Past thEiR fInal Follow-...
NCT05202938N/AUNKNOWN32Energy MEtabolism of Septic Heart.
NCT04092855N/ARECRUITING112Early Identification and Prediction of Right Ventricular Dysfunction and Failure...
NCT04573049PHASE4UNKNOWN124A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Effectivene...
NCT01576094PHASE1, PHASE2COMPLETED20Phase I Study of Two Inodilators in Neonates Undergoing Cardiovascular Surgery
NCT01971944N/ACOMPLETED50The Influence of Beta Blocker Therapy on the Hemodynamic Response to Inotrope In...
NCT04694092NAUNKNOWN40Landiolol for Rate Control in Decompensated Heart Failure Due to Atrial Fibrilla...
NCT03836482NANOT_YET_RECRUITING20Feasibility Study to Assess the Safety and Efficacy of a Selective Cytopheretic ...
NCT01616069PHASE4COMPLETED81Assessment and Hemodynamic Response in CABG After Cardiopulmonary Bypass Using I...
NCT01364636N/ATERMINATED180Accuracy of Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Predict...
NCT03574311PHASE4UNKNOWN210A Phase IV Double-blind, Randomised, Parallel Group Comparison of the Efficacy a...
NCT07186062N/ACOMPLETED60Clinical Outcomes of Levosimendan Versus Dobutamine Versus Milrinone in Cases Wi...
NCT05700617EARLY_PHASE1RECRUITING5Myocardial Reserve in Advanced Heart Failure Patients
NCT06595264N/ACOMPLETED19Patients With Aneurysms of the Vein of Galen, H.U.B Experience; a Retrospective ...
NCT03631654PHASE4WITHDRAWN0Ivabradine in Stage D Heart Failure Patients on Chronic Inotropes: A Pilot Study
NCT04718350NACOMPLETED40Comparison of Intravenous Levosimendan and Inhalational Milrinone in High Risk C...
NCT06205758N/AUNKNOWN1600Efficacy and Safety Prediction of Milrinone or Levosimendan as Initial Inotropic...
NCT05999487NAUNKNOWN40Dobutamine Versus Milrinone in Management of Critically Ill Low Cardiac Output P...
NCT04014010N/ACOMPLETED35000Machine Learning Modeling of Intraoperative Hemodynamic Predictors of 30-day Mor...
NCT03180450PHASE1, PHASE2SUSPENDED60The Study of Heart Failure With Human Umbilical Cord Mesenchymal Stem Cells (hUC...
NCT05063370PHASE2UNKNOWN40Perioperative Use of Levosimendan in Patients With Impaired Right Ventricular Fu...
NCT02606253PHASE4COMPLETED60Comparison of Oral Thiazides vs Intravenous Thiazides vs Tolvaptan in Combinatio...
NCT04682483N/ARECRUITING5000Cardiogenic Shock Working Group Registry
NCT03160846N/ACOMPLETED129Inotrope, Evaluation and Research (INTERPRET) Patient Registry Program
NCT04184674NACOMPLETED50Impact of the Transpulmonary Pressure on Right Ventricle Function in Acute Respi...
NCT04458103NATERMINATED161Percutaneous RVAD to Preemptively Treat Right Heart Failure Post-LVAD
NCT04015973NAUNKNOWN116A Randomised Controlled Trial of a Pre-operative High Energy Diet for the Preven...
NCT00338455PHASE2TERMINATED16Investigation of the Use of Natrecor (Nesiritide) in Transplant-Eligible Managem...
NCT04782154N/ACOMPLETED136Paceport Swan-Ganz Data Collection Study
NCT02728128N/ACOMPLETED53Platelet and Tissue cAMP: Novel Biomarkers of Milrinone Efficacy in Children
NCT01571037PHASE1COMPLETED10Inhaled Milrinone Use in Patients Receiving HeartMate II LVAD: A Pilot Study
NCT06800716N/ARECRUITING50A Prospective Study of Recovery Mechanisms in Heart Transplant Eligible Patients...
NCT05450328PHASE2NOT_YET_RECRUITING141Inhaled Milrinone and Epoprostenol for the Prevention of Difficult Cardiac Pulmo...
NCT00060840PHASE2COMPLETED150The Effects of Nitric Oxide for Inhalation During Left Ventricular Assist Device...
NCT02644057PHASE2WITHDRAWN0Comparison of Dobutamine Versus Milrinone for Renal Recovery in Patients With Ca...
NCT04586764N/AUNKNOWN500ST Elevation Myocardial Infarction Hemodynamic OutComes: Role of Non-Invasive Ca...
NCT04278404N/ARECRUITING5000Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs
NCT02077010PHASE1COMPLETED10Nebulized Inhaled Milrinone in a Hospitalized Advanced Heart Failure Population
NCT07175948N/ANOT_YET_RECRUITING100Outcome of Different Clinical Phenotypes of Myocarditis in Children Admitted to ...
NCT07019987NANOT_YET_RECRUITING80Imaging the Respiratory Effects of Truncal Adiposity in Acute Hypoxemic Respirat...
NCT01956006PHASE1, PHASE2COMPLETED26Pilot Study of Slow Release Oral Milrinone in Patients With Advanced Heart Failu...
NCT05064202NANOT_YET_RECRUITING456Use of mechaNical Left ventricuLar unlOading in Acute decompensateD Heart Failur...
NCT05801224NASUSPENDED70Regional Vascular Recruitment With Inhaled Nitric Oxide in Patients With ARDS
NCT02408003NACOMPLETED30What Are the Changes in Cardiac Deformation Variables and Hemodynamic Parameters...
NCT04298229PHASE3COMPLETED240A Randomized, Open-label Study of Dapagliflozin in Patients With or Without Type...
NCT01849094PHASE1, PHASE2COMPLETED9Evaluating the Safety, Pharmacokinetics and Haemodynamic Effect of a Slow Releas...

相關文獻(20 篇)

PMID年份類型期刊主要發現
355451812023ArticleCurrent problems in cardiologyMeta-analysis Comparing the Efficacy of Dobutamine Versus Milrinone in Acute Dec...
30122261986ArticleThe Medical clinics of North ACongestive heart failure.
318654332020ArticleHeart and vesselsComparing the effects of milrinone and olprinone in patients with congestive hea...
361228162022ArticleJournal of cardiac failurePalliative Inotropes in Advanced Heart Failure: Comparing Outcomes Between Milri...
226645862012ArticleCirculation journal : officialCombination of β-blocker and milrinone for acute heart failure.
352436582022ArticleClinical cardiologyRepetitive milrinone therapy in ambulatory advanced heart failure patients.
325522212020ArticleJournal of the American Heart Old Drug, New Trick? Oral Milrinone for Heart Failure With Preserved Ejection Fr...
381471292024ArticleEuropean journal of pediatricsMilrinone in pediatric heart failure and pulmonary hypertension: Is meta-analyse...
378914902023ArticleBMC pediatricsMilrinone for the treatment of heart failure caused by severe Pneumonia in child...
385475242024ArticleJournal of cardiovascular pharComparative Effectiveness and Safety of Intermittent, Repeated, or Continuous Us...
40507071985ArticleThe American journal of cardioPharmacokinetics and pharmacodynamics of milrinone in chronic congestive heart f...
236203102014ArticleAngiologyMilrinone in advanced heart failure: dose and therapeutic monitor outside intens...
373228272023ArticleESC heart failureImproved mortality and haemodynamics with milrinone in cardiogenic shock due to ...
364179452023ArticleJournal of pain and symptom maHome Milrinone in Pediatric Hospice Care of Children with Heart Failure.
19494991991ArticleThe Veterinary clinics of NortThe efficacy and safety of milrinone for treating heart failure in dogs.
379094422024ArticleCurrent medicinal chemistryCurrent Targets and Future Directions of Positive Inotropes for Heart Failure.
26583771989ArticleDICP : the annals of pharmacotRole of milrinone in the management of congestive heart failure.
353843692022ArticleESC heart failureMilrinone or dobutamine in patients with heart failure: evidence from meta-analy...
362292992022ArticleHeart, lung & circulationLong-Term Ambulatory Intravenous Milrinone Therapy in Advanced Heart Failure.
379997642024ArticleEuropean journal of pediatricsReassessing the role of milrinone in the treatment of heart failure and pulmonar...
7. migraine disorder L5 99.45%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
8. migraine with brainstem aura L5 99.38%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
9. trigeminal autonomic cephalalgia L5 99.25%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果,需進一步驗證。
10. acute pulmonary heart disease L1 99.19%

臨床試驗(27 項)

試驗編號階段狀態人數主要發現
NCT05049590PHASE3COMPLETED63Acute Normovolemic Hemodilution (ANH) in Complex Cardiac Surgery
NCT05194514NACOMPLETED20Randomized Trial to Compare the SherpaPak™ Device vs Cold Storage of Donor Heart...
NCT04092855N/ARECRUITING112Early Identification and Prediction of Right Ventricular Dysfunction and Failure...
NCT01971944N/ACOMPLETED50The Influence of Beta Blocker Therapy on the Hemodynamic Response to Inotrope In...
NCT04694092NAUNKNOWN40Landiolol for Rate Control in Decompensated Heart Failure Due to Atrial Fibrilla...
NCT04182945NATERMINATED20Fever Algorithm Development of a Non-invasive Wearable Core Body Temperature Sen...
NCT03836482NANOT_YET_RECRUITING20Feasibility Study to Assess the Safety and Efficacy of a Selective Cytopheretic ...
NCT06361420NARECRUITING43The Efficacy of Driving Pressure-guided Lung Protective Ventilation in Surgical ...
NCT02549066NACOMPLETED18Impact of CArdiopulmonary Bypass Flow on Renal Blood Flow, Function and OXygenat...
NCT05253209PHASE3TERMINATED64A Phase III Double-Blind, Randomized, Placebo Controlled, Multi Center Clinical ...
NCT03335865N/ACOMPLETED100Noninvasive Measurements of Renal Perfusion During Cardiac Surgery
NCT07231107NACOMPLETED90Comparative Study Between Airway Pressure Release Ventilation and Pressure Regul...
NCT04014010N/ACOMPLETED35000Machine Learning Modeling of Intraoperative Hemodynamic Predictors of 30-day Mor...
NCT04184674NACOMPLETED50Impact of the Transpulmonary Pressure on Right Ventricle Function in Acute Respi...
NCT04015973NAUNKNOWN116A Randomised Controlled Trial of a Pre-operative High Energy Diet for the Preven...
NCT04782154N/ACOMPLETED136Paceport Swan-Ganz Data Collection Study
NCT05757557PHASE1, PHASE2COMPLETED136Perioperative Nitric oxiDE-conditioning, Produced by Plasma-chemical Synthesis T...
NCT06800716N/ARECRUITING50A Prospective Study of Recovery Mechanisms in Heart Transplant Eligible Patients...
NCT03207165PHASE4COMPLETED192Comparison of Milrinone Versus Dobutamine in a Heterogeneous Population of Criti...
NCT01864252PHASE3COMPLETED192The Effect of Remote Ischaemic Preconditioning and Glyceryl Trinitrate on Peri-o...
NCT04586764N/AUNKNOWN500ST Elevation Myocardial Infarction Hemodynamic OutComes: Role of Non-Invasive Ca...
NCT05740397NARECRUITING900Mean Arterial Pressure (MAP) Trial: Study Protocol for a Multicenter, Randomized...
NCT07019987NANOT_YET_RECRUITING80Imaging the Respiratory Effects of Truncal Adiposity in Acute Hypoxemic Respirat...
NCT02280239PHASE4TERMINATED10Safety and Antipyretic Efficacy of Acetaminophen in the Febrile Intensive Care U...
NCT02836899PHASE3ACTIVE_NOT_RECRUITING250Prevention of Acute Kidney Injury by Nitric Oxide in Prolonged Cardiopulmonary B...
NCT02891837PHASE3COMPLETED189A Phase III Double-Blind, Randomized, Placebo Controlled, Multi-Center Clinical ...
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相關文獻(20 篇)

PMID年份類型期刊主要發現
86595561996ArticleThe American journal of the meMilrinone: basic and clinical pharmacology and acute and chronic management.
110964921999ArticleCurrent treatment options in cAcute Pulmonary Edema.
165825442006ArticleCardiologyMedical and ventilatory treatment of acute heart failure: new insights.
165411662006ArticleTidsskrift for den Norske laeg[Medical and ventilatory treatment of acute heart failure].
216787082011ArticlePrescrire internationalAcute heart failure with dyspnoea: initial treatment. Furosemide and trinitrine,...
117923002001ArticleRevista espanola de anestesiol[The pulmonary vasodilatory effect of inhaled prostacyclin and milrinone in hear...
200564392010ArticleJournal of cardiothoracic and Inhaled nitroglycerin versus inhaled milrinone in children with congenital heart...
287938222017ArticleJournal of cardiovascular pharDose-Response Head-to-Head Comparison of Inodilators Dobutamine, Milrinone, and ...
335613072021ArticlePediatric pulmonologyIntensive care management of right ventricular failure and pulmonary hypertensio...
77287861995ArticleCardiologyHemodynamic effects and pharmacokinetics of oral milrinone for short-term suppor...
89035341996ArticleClinical cardiologyComparative efficacy of short-term intravenous infusions of milrinone and dobuta...
183035262008ArticleCurrent opinion in cardiologyNew therapies in acute decompensated heart failure.
224811002012ArticleCirculation journal : officialLow-dose β-blocker in combination with milrinone safely improves cardiac functio...
87976201996ArticleCritical care medicineMulticenter, double-blind study of intravenous milrinone for patients with acute...
96738321998ArticleClinical pharmacokineticsClinical pharmacokinetics of vasodilators. Part II.
20354271991ArticleAmerican heart journalHemodynamic and clinical benefits with intravenous milrinone in severe chronic h...
39533541986ArticleAmerican heart journalOccurrence of ventricular arrhythmias in patients receiving acute and chronic in...
379802532023ArticleTransplantation proceedingsRevisiting Pulmonary Hypertension in the Era of Temporary Mechanical Circulatory...
204976112010ArticleCritical care (London, EnglandClinical review: practical recommendations on the management of perioperative he...
39765171985ArticleThe American journal of cardioAcute dose range study of milrinone in congestive heart failure.

台灣上市資訊

許可證字號 商品名 劑型 許可證持有者 狀態
(待確認) 米力心注射劑0.2毫克/毫升 注射劑 (待確認) 有效

適應症:充血性心衰竭的短期療法。需在有適當心電圖監測設備的環境下使用。


安全性考量

使用注意事項

  1. 心律不整風險
    • 可能引起危及生命的室性心律不整
    • 需持續心電圖監測
  2. 使用限制
    • 目前無使用超過 48 小時的對照試驗經驗
    • 建議僅作為短期療法
  3. 藥物交互作用
    • 常與 digoxin 和利尿劑併用
    • 與其他強心藥物併用時需謹慎

給藥途徑考量

  • 靜脈注射:心衰竭標準給藥方式
  • 動脈內注射:RCVS 治療的研究給藥方式,需專業介入設備
  • 吸入給藥:肺高壓治療的研究給藥方式

藥物-疾病注意事項 (DDSI)

資料來源:DDInter 2.0(原文內容請參閱該網站)

肝臟疾病 🟡 Moderate

  • 需定期監測。風險包括:肝毒性。

低血壓 🟡 Moderate

  • 需定期監測。

Thrombocytopenia 🟡 Moderate

  • 風險包括:血栓。出現症狀時應考慮停藥。

Arrhythmias, Cardiac 🟢 Minor

  • 需密切監測。風險包括:心律不整。可能有致命風險。

Heart Valve Diseases 🟢 Minor

  • 不應使用本藥物。可能有嚴重不良反應。

Myocardial Infarction 🟢 Minor

  • 不建議使用本藥物。

結論與下一步

評估結論

預測適應症 證據等級 臨床轉譯可行性 建議優先順序
頭痛障礙(RCVS) L3 中等 建議進一步研究
禿髮症 L5 不建議優先開發
心衰竭 L1 高(已核准) 不適用

建議

  1. 可逆性腦血管收縮症候群(RCVS)
    • 目前已有多篇病例報告支持動脈內 Milrinone 的療效
    • 建議設計前瞻性研究評估安全性和有效性
    • 可考慮作為鈣離子通道阻斷劑無效時的救援治療
  2. 禿髮症
    • 雖然 PDE 抑制劑理論上可能有效
    • 但 Milrinone 為注射劑型,不適合局部外用治療禿髮
    • 不建議進一步開發

後續行動

  • 確認頭痛障礙文獻證據(已有 3 篇病例報告)
  • 監測 RCVS 治療的新臨床試驗
  • 評估是否有可能開發局部外用劑型用於禿髮(可行性低)

報告產生日期:2026-02-11 資料來源:TxGNN 預測、ClinicalTrials.gov、PubMed、台灣 FDA


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引用本報告

如需引用本報告,請使用以下格式:

APA 格式:

TwTxGNN. (2026). Milrinone老藥新用驗證報告. https://twtxgnn.yao.care/drugs/milrinone/

BibTeX 格式:

@misc{twtxgnn_milrinone,
  title = {Milrinone老藥新用驗證報告},
  author = {TwTxGNN Team},
  year = {2026},
  url = {https://twtxgnn.yao.care/drugs/milrinone/}
}

免責聲明
本報告僅供學術研究參考,不構成醫療建議。藥物使用請遵循醫師指示,切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。

最後審核:2026-02-20 | 審核者:TwTxGNN Research Team

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