Pimobendan

What it is used for

• Management of myocardial failure (DCM), especially if not associated with taurine deficiency
• Heart failure associated with systolic dysfunction (Off-label)
• Management of the signs of mild, moderate or severe congestive heart failure due to AV valve insufficiency or dilated cardiomyopathy
• Treatment of congestive heart failure secondary to myxomatous mitral valve disease (MMVD)
• Treatment of heart failure secondary to dilated cardiomyopathy or chronic mitral valve insufficiency
• General dosing
• Adjunctive drug for the emergency treatment of CHF (if not overtly critical and a strong positive oral inotrope is needed)
• Adjunctive treatment of acute or chronic stage D heart failure (refractory to standard treatment)
• Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD
• Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD

How it is given

Possible side effects

• Poor appetite
• Lethargy
• Diarrhea
• Dyspnea
• Azotemia
• Weakness and ataxia
• Pleural effusion
• Syncope
• Cough
• Ascites
• Heart murmur
• Arrhythmias (atrial fibrillation, increased ventricular ectopic beats)
• Worsening mitral valve lesions (acute hemorrhages, endocardial papilloform hyperplasia) with chronic use
• Moderate positive chronotropic effect (tachycardia)

Cautions & contraindications

• Hypersensitivity to pimobendan
• Hypertrophic cardiomyopathy (HCM)
• Aortic stenosis
• Any condition where augmentation of cardiac output is inappropriate for functional or anatomic reasons
• Any condition where augmentation of cardiac output via increased contractility is not possible anatomically or functionally
• Use with caution in patients with **uncontrolled cardiac arrhythmias**. Safety has not been evaluated in: * Dogs younger than 6 months of age * Dogs with congenital heart defects * Dogs with diabetes mellitus or other serious metabolic diseases * Breeding, pregnant, or lactating animals (high doses in lab animals caused increased resorptions) > **Note:** Patients treated chronically should be regularly examined for worsening mitral valvular lesions and regurgitation.

Drug interactions

• Verapamil: Calcium antagonist; attenuates pimobendan-induced increases in cardiac contractility.
• Propranolol: Beta-antagonist; attenuates pimobendan-induced increases in cardiac contractility.
• Diltiazem: Calcium channel blocker; assumed to potentially attenuate positive inotropic effects.
• Atenolol: Beta-blocker; assumed to potentially attenuate positive inotropic effects.
• Beta-blockers (e.g., atenolol, propranolol): Attenuates the positive inotropic effects of pimobendan
• Calcium-channel blockers (e.g., verapamil, diltiazem): Attenuates the positive inotropic effects of pimobendan

Frequently asked questions