Levosimendan


Concise Prescribing Info
Indications/Uses
CHF.
Dosage/Direction for Use
Adult : IV Loading dose: 6-24 mcg/kg over 10 min, then 0.05-0.2 mcg/kg/min continuous infusion.
Dosage Details
Intravenous
Congestive heart failure
Adult: Loading dose: 6-24 mcg/kg over 10 min followed by 0.05-0.2 mcg/kg/min continuous infusion, adjust according to response.
Renal Impairment
Severe: Contraindicated.
Hepatic Impairment
Severe: Contraindicated.
Contraindications
History of torsade de pointes. Severe renal and hepatic impairment.
Special Precautions
Patient w/ severe hypotension, tachycardia or w/ mechanical obstruction affecting ventricular filling or outflow; ongoing coronary ischaemic or long QTc interval. Renal and hepatic impairment.
Adverse Reactions
Headache, dizziness, hypotension, ventricular tachycardia, extrasystoles, AF, hypokalaemia, insomnia, GI disturbances and anaemia.
Potentially Fatal: Arrhythmias, tachycardia, AF w/ rapid ventricular response.
MonitoringParameters
Closely monitor ECG, serum K concentration. Monitor haemodynamic effects for several days after the end of infusion as they may be prolonged.
Action
Description: Levosimendan is a cardiac inotrope and vasodilator w/ Ca-sensitising properties. It is dependent on Ca concentration and sensitises tropin C to Ca. It also opens ATP-sensitive K channels on vascular smooth muscle which causes coronary and systemic vasodilation.
Pharmacokinetics:
Absorption: Well absorbed. Bioavailability: 85%. Time to peak plasma concentration: 1-2 days.
Distribution: Plasma protein binding: Approx 98% (mainly albumin); approx 40% (active metabolite).
Metabolism: Extensively metabolised to its active metabolite (OR-1855 and OR-1896) which are interconverted by acetylation and de-acetylation.
Excretion: Via urine and faeces as metabolites and unchanged drug (small amount). Elimination half-life: Approx 1 hr.
Disclaimer: This information is independently developed by MIMS based on Levosimendan from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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