Brands, Medical Use, Clinical Data
- Vasodilator Agents
- Cardiotonic Agents
Brands / Synonyms
Corotrop; Corotrope; Milrila; Milrinone; Milrinone IN Dextrose; Milrinone Lactate; Milrinone Lactose in 5% Dextrose; Primacor; Primacor
Indicated for the treatment of congestive heart failure.
Milrinone, a synthetic dimethylxanthine derivative structurally related to theophylline and caffeine, is used in the treatment of peripheral vascular diseases and in the management of cerebrovascular insufficiency, sickle cell disease, and diabetic neuropathy.
Mechanism of Action
Milrinone inhibits erythrocyte phosphodiesterase, resulting in an increase in erythrocyte cAMP activity. Subsequently, the erythrocyte membrane becomes more resistant to deformity. Along with erythrocyte activity, Milrinone also decreases blood viscosity by reducing plasma fibrinogen concentrations and increasing fibrinolytic activity.
Milrinone is rapidly and almost completely absorbed after oral administration. Bioavailability is 92% (in healthy volunteers).
LD50 = 0.3 mg/L in rats
Biotrnasformation / Drug Metabolism
There are five metabolites but the O-glucuronide represents the major pathway of biotransformation.
PRIMACOR is contraindicated in patients who are hypersensitive to it.
No untoward clinical manifestations have been observed in limited experience with patients in whom PRIMACOR was
used concurrently with the following drugs: digitalis glycosides; lidocaine, quinidine; hydralazine, prazosin;
isosorbide dinitrate, nitroglycerin; chlorthalidone, furosemide, hydrochlorothiazide, spironolactone; captopril;
heparin, warfarin, diazepam, insulin; and potassium supplements.
There is an immediate chemical interaction which is evidenced by the formation of a precipitate when furosemide is
injected into an intravenous line of an infusion of PRIMACOR. Therefore, furosemide should not be administered in
intravenous lines containing PRIMACOR.