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Trade names | Aramine, Metaramin, Pressonex |
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Routes of administration | Intravenous, endotracheal |
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Pharmacokinetic data | |
Bioavailability | n/a |
Protein binding | ~45% |
Metabolism | Liver |
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Chemical and physical data | |
Formula | C9H13NO2 |
Molar mass | 167.208 g·mol−1 |
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Metaraminol, previously sold under the brand name Aramine among others and also known as metaradrine, is a stereoisomer of meta-hydroxynorephedrine (3,β-dihydroxyamphetamine), is a potent sympathomimetic amine used in the prevention and treatment of hypotension, particularly as a complication of anesthesia. It is an α1-adrenergic receptor agonist with some β-adrenergic effect.[2] It is currently sold in its generic form by Slayback Pharma.[3]
Metaraminol is given intravenously as either a bolus (often 0.5–1 mg doses) or as an infusion, usually via peripheral intravenous access. Metaraminol is commonly available as 10 mg in 1 mL, that requires dilution prior to administration (often made up to a 0.5 mg/mL solution), however pre-prepared syringes of metaraminol for bolus use for hypotension are also commonly available.[4][5]
The dominant mechanism for the vasopressor action of metaraminol is indirect,[6] with metaraminol displacing noradrenaline from neuronal vesicles in order for the noradrenaline to exert its vasopressor action.[7] Metaraminol at higher doses may have direct alpha-adrenergic agonist and β1 adrenergic agonist effects.[6] However at doses common in clinical practice, the indirect α1 adrenergic effects predominate, such that reflex bradycardia is a common side-effect.
Metaraminol is also used in the treatment of priapism.[8][9][10]