Drug Profile

Apuntes

Drug Profile © Future Drugs Ltd. All rights reserved. ISSN 1477-9072 9 C ONTENTS Levosimendan: mechanisms of action Pharmacokinetics & metabolism Potential interactions with drugs & disease Hemodynamic studies Seven-day study Bolus study Effects on symptoms Safety Health economics Clinical utility Conclusion & expert opinion Five-year view Key issues References Affiliations www.future-drugs.com Levosimendan: first in a new class of inodilator for acute and chronic severe heart failure John GF Cleland † , Nikolay Nikitin and James McGowan Heart failure is the most common malignant disease in the developed world. Levosimendan (Simdax ®) is a novel intravenous agent that exerts inotropic effects through sensitization of myofilaments to calcium and vasodilator effects by opening ATP–dependent potassium channels on vascular smooth muscle. Infusion of levosimendan increases cardiac output due to an increase in stroke volume and heart rate, with a fall in pulmonary capillary wedge pressure. It has an active metabolite with a half-life of about 80 h, therefore infusions of 6 to 24 h result in hemodynamic effects that persist for 7 to 10 days. Preliminary observations suggest that a single ...