Olprinone is used primarily in the management of acute heart failure due to its potent inotropic and vasodilatory effects. It functions as a phosphodiesterase III inhibitor, leading to increased intracellular cyclic AMP levels in cardiac and vascular smooth muscle cells. This results in enhanced myocardial contractility and relaxation of vascular smooth muscle, reducing both preload and afterload on the heart.

Clinically, olprinone improves cardiac output and alleviates symptoms such as dyspnea and pulmonary congestion in patients with acute decompensated heart failure. It is particularly beneficial in cases where conventional therapies like catecholamines may pose higher risks of arrhythmias or excessive vasoconstriction. Because it does not significantly increase myocardial oxygen demand, olprinone offers a favorable hemodynamic profile.

It is administered intravenously and often used in hospital settings for short-term support. Its rapid onset of action and relatively short half-life allow for quick titration and discontinuation as the patient's condition stabilizes. Olprinone may also have bronchodilatory effects, which can be advantageous in patients with concomitant respiratory issues.

Due to its pharmacological profile, it is considered an alternative inotropic agent, especially in patients who do not respond adequately to or cannot tolerate other inotropic drugs.