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Milrinone for Heart Failure -- Primacor for Heart Failure

When Is Primacor (Milrinone) Used For Patients With Heart Failure?

By Marc Lallanilla

Updated December 19, 2008

(LifeWire) - Primacor (milrinone) is a medication used to treat heart failure. Milrinone belongs to a class of medications known as inotropes used to treat heart failure by helping the heart contract, which allows the heart to pump blood more effectively. Milrinone also widens blood vessels, making it easier for the heart to move the blood through the arteries. (There are also other inotropes, which include dobutamine and dopamine.)

Milrinone is given to patients orally and as an intravenous injection or continuous intravenous infusion. It is usually used in cases of acute heart failure, that is, heart failure that occurs in a matter of minutes or hours. Chronic heart failure, by contrast, is a long-term condition that is managed with different drugs. Milrinone is not recommended for long-term use. That is because according to several studies, it has been associated with hypotension (low blood pressure), arrhythmia (irregular heartbeat) and a higher incidence of hospitalization and death than was seen with other medications.

Patients with heart failure who are awaiting a heart transplant may also benefit from milrinone. These patients can be treated at home while waiting for a transplant operation when appropriate measures are taken, such as medication to prevent arrhythmia. There is some evidence that milrinone may be beneficial when combined with beta blockers for patients with advanced heart failure.

Side effects of milrinone may include hypotension, blurred vision, headache and diarrhea. A healthcare provider should be contacted immediately if any of the following conditions occur when taking milrinone: arrhythmia, fainting, dizziness, rash, chest pain or pressure, unusual bleeding or bruising or any signs of an allergic reaction, such as swelling, unusual skin color, fever, itching or wheezing.

In addition to its use in treating heart failure, milrinone has also been studied for its association with atrial fibrillation after heart surgery. Atrial fibrillation occurs when the two upper chambers of the heart (the atria) beat irregularly; it is a serious and potentially life-threatening condition. Milrinone has been shown to be a risk factor for atrial fibrillation when used after heart surgery.

Read more about treating heart failure here.

Sources:

Fleming, G.A., K.T. Murray, C. Yu, J.G. Byrne, J.P. Greelish, M.R. Petracek, S.J. Hoff, S.K. Ball, N.J. Brown, and M. Pretorius. "Milrinone Use is Associated With Postoperative Atrial Fibrillation After Cardiac Surgery." Circulation 118:16(2008): 1619-25. 11 Dec. 2000 <http://www.ncbi.nlm.nih.gov/sites/entrez/18824641?dopt=Abstract&holding=f1000,f1000m,isrctn%3E>.



Hobbs, Robert, and Andrew Boyle. "Heart Failure." clevelandclinicmeded.com. 28 Sep. 2004. Cleveland Clinic. 5 Dec. 2008 <http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/heartfailure/heartfailure.htm>.



Millane, T., G. Jackson, C.R. Gibbs, and G.Y.H. Lip. "ABC of Heart Failure: Acute and Chronic Management Strategies." British Medical Journal 320 (2000): 559-62. 5 Dec. 2008 <http://www.bmj.com/cgi/content/full/320/7234/559>.



"Milrinone." drugs.com. Jan. 2008. Drug Information Online. 5 Dec. 2008 <http://www.drugs.com/pro/milrinone.html>.



"Milrinone: Patient Drug Information." uptodate.com. 2008. 5 Dec. 2008 <http://www.uptodate.com/online/content/topic.do?topicKey=pat_drug/403013&selectedTitle=2~72&source=search_result>. (subscription)



Zewail, Aly M., Mohammad Nawar, Bojan Vrtovec, Cathy Eastwood, Biswajit Kar, and Reynolds M. Delgado, III. "Intravenous Milrinone in Treatment of Advanced Congestive Heart Failure." Texas Heart Institute Journal. 30:2(2003): 109-13. 5 Dec. 2008 <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=161895>.


LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Marc Lallanilla is a New York-based freelance writer and editor. He has written extensively on health, science, the environment, design, architecture, business, lifestyle and travel.

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