Products
Levosimendan is commercially available as a concentrate for the preparation of an infusion solution (Simdax). It was approved in many countries in 2013.
Structure and properties
Levosimendan (C14H12N6O, Mr = 280.3 g/mol)
Effects
Levosimendan (ATC C01CX08) has positive inotropic and vasodilatory properties. The effects are due to binding to cardiac troponin C. This increases the sensitivity of contractile proteins to calcium. Levosimendan increases the contractile force of the cardiac muscle. At vascular smooth muscle, levosimendan opens ATP-dependent potassium channels, which lowers vascular resistance and preload and afterload, and increases blood flow. Finally, it exerts cardioprotective effects. Levosimendan has a short half-life of approximately one hour.
Indications
As a second-line agent for short-term treatment of acute decompensated severe chronic heart failure.
Dosage
According to the SmPC. The drug is administered as an intravenous infusion.
Contraindications
For complete precautions, see the drug label.
Adverse effects
The most common possible adverse effects include:
- Hypotension (low blood pressure)
- Hypokalemia
- Ventricular tachycardia
- Headache
- Nausea
- Renal insufficiency
