Clinical safety of intravenous amrinone--a review

Clinical trials of intravenous amrinone were performed in 462 patients severely ill with congestive heart failure. All were monitored invasively. Adverse reactions were complicated by underlying disease severity and concomitant drug therapy. No consistent pattern of arrhythmias emerged in relation to intravenous amrinone administration. Thrombocytopenia was noted in 2.4% of patients, but it was asymptomatic with no demonstrable bone marrow depression or antiplatelet antibodies. Gastrointestinal adverse effects, hypotension and fever were rare, each occurring in fewer than 2% of patients. Liver enzyme alterations were seen in 1 patient, but it could not be determined whether these changes were related to intravenous use of the drug. Chest pain and irritation at the site of injection were noted in 1 patient each. Spontaneous anecdotal postapproval reports cited tachycardia, liver enzyme elevation, thrombocytopenia, intravenous site irritation, failure to respond and anaphylactoid response as adverse effects or possible adverse effects; each was mentioned in 3 or fewer reports. Drugs contraindicated for concomitant use with intravenous amrinone are listed, and chemical interactions with glucose solutions and intravenous furosemide are discussed.