治療心衰竭 For the short-term treatment of patients with acute decompensated heart failure (ADHF) when conventional therapies are insufficient and inotropic support is appropriate. 

levosimendane sensitizes calcium-dependent troponin C in cardiac tissue, enhancing contractility. It opens ATP-sensitive potassium channels in vascular smooth muscle, inducing vasodilation. May additionally open ATP-sensitive potassium channels in cardiac mitochondria, suggested to confer anti-ischemic cardioprotection. Increases cardiac output, stroke volume, ejection fraction, and heart rate; decreases blood pressure; decreases pulmonary capillary wedge pressure, right atrial pressure, and peripheral vascular resistance.

Duration of action: Hemodynamic effects continue for up to 7-9 days after discontinuation of a 24-hour infusion. Metabolism: Completely metabolized (primarily by conjugation) into two active metabolites. Excretion: Urine (54%; as metabolites); feces (44%). Elimination Half-life:∼1 hour.

Hypersensitivity to levosimendan or any component of the formulation; significant mechanical obstruction of ventricular filling and/or outflow; severe hypotension and tachycardia; severe renal impairment (CrCl <30 mL/minute); severe hepatic impairment; history of torsade de pointes.

C (Australia Pregnancy (Category B3))

Avoided.

Very common(>1/10): headache, ventricular tachycardia, hypotension, Common(>1/100): dizziness, atrial fibrillation, tachycardia, ventricular extrasystoles, cardiac failure, myocardial ischaemia, extrasystoles, nausea, constipation, diarrhoea, vomiting, haemoglobin decreased.

0.05-0.2 mcg/kg/min IV infusion; Must be diluted prior to administration; may infuse IV in peripheral or central vein.

Store undiluted solution at 2？C to 8？C. Use immediately after dilution; stable for 24 hours at 25？C in D₅W.