Levosimendan
About Levosimendan
Levosimendan belongs to the group of medications called 'calcium sensitizer' primarily used to treat hospitalized patients with acute heart failure. Heart failure can occur when your heart cannot pump blood sufficiently required to the remainder of the body. A heart attack is the blockage of blood flow to the heart muscle. The blockage is most often a build-up of fat, cholesterol, and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). Heart attack and brain stroke can occur simultaneously as the brain's stroke blood supply gets interrupted, causing a part of the brain to die.
Levosimendan contains 'levosimendan', which works by increasing the heart's sensitivity to calcium ion (Ca) without increasing the amount of calcium present in the heart's muscles cells. Levosimendan widens up the heart's blood vessels (coronary artery) and, in turn, relaxes the smooth muscles of the heart so that blood and oxygen can flow easily to the whole body.
The most common side effects of Levosimendan are headache, low blood pressure, and nausea (stomach discomfort). Most of these side effects of Levosimendan do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.
Levosimendan should not be given to the patients with low blood pressure (hypotension), dehydration, low blood count, chest pain (angina), or have abnormal heart rhythm. Pregnant or lactating women should consult a doctor before administration of Levosimendan. This medicine should not be given to children and adolescents under 18 years of age.
Uses of Levosimendan
Medicinal Benefits
Levosimendan is a calcium sensitizer that enhances the heart's pumping forces and allows blood vessels to relax. Improvement of the cardiac function by Levosimendan helps reduce the congestion in your lungs and enhances blood and oxygen delivery to the organs. Thus, treatment with Levosimendan relieves the shortness of breath from severe heart failure.
Directions for Use
Storage
Side Effects of Levosimendan
- Headache
- Low blood pressure (hypotension)
- Nausea (feeling sick)
- Tachycardia (fast heartbeat)
Drug Warnings
Do not use Levosimendan if you are allergic to any of its contents. Do not take Levosimendan if you are pregnant, think you may be pregnant, or trying for pregnancy. Consult your doctor before taking Levosimendan if you are breastfeeding. Try not to stop taking this medicine of your own as stopping Levosimendan abruptly may worsen your condition and increase your risk of a future heart attack. Levosimendan should not be given to the patients with low blood pressure (hypotension), dehydration, low blood count, chest pain (angina), or have abnormal heart rhythm. This medicine should not be given to children and adolescents under 18 years of age. Levosimendan should not be given into the same vein as other medicines except for heart-related medicines like frusemide, digoxin or glyceryl trinitrate. This is because if you have been given other heart-related medicines through your veins, your blood pressure might drop if you are given Levosimendan.
Drug Interactions
Drug-Drug Interactions: Levosimendan may have interaction with medications used to treat high blood pressure like Atenolol, drugs used to treat attention deficit hyperactivity disorder like Atomoxetine. This is not a complete list of all the possible drug interactions.
Drug-Food Interactions: Avoid consuming grapefruit and grapefruit juice with Levosimendan. Do not take St. John’s wort (herbal supplement to treat depression) with Levosimendan.
Drug-Disease Interaction: Levosimendan may have interactions with disease conditions such as rhabdomyolysis (muscle breakdown), Reye’s syndrome, asthma, gout, glaucoma, liver disease, diabetes, and cognitive impairment.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid consumption of alcohol while taking Levosimendan as it may cause increased dizziness.
Pregnancy
unsafeDo not take Levosimendan if you are pregnant, think you may be pregnant or if you are trying for pregnancy. Consult a doctor immediately if you become pregnant while taking Levosimendan.
Breast Feeding
cautionIt is not recommended to take Levosimendan if you are breastfeeding. Consult your doctor before taking Levosimendan; your doctor will decide whether Levosimendan can be taken by breastfeeding mothers or not.
Driving
cautionLevosimendan may cause dizziness. Do not drive or operate machinery unless you are alert.
Liver
cautionDose adjustment may be needed in patients with liver impairment. Please consult your doctor if you have a liver impairment or any concerns regarding this.
Kidney
cautionDose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
cautionLevosimendan is not recommended for children as the safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
- Follow a cholesterol-lowering diet.
- Consume a low-salt and a low-fat diet.
- Exercise regularly. It helps in maintaining proper weight and lowers cholesterol.
- Limit salt and sugar intake.
- Avoid smoking and alcohol consumption.
- Choose healthy fats and cut down on trans-fat.
- Include omega-3 fatty acids, fibre-rich food, fruits, and vegetables.
- Get active by doing any physical activity such as swimming, brisk walking, or jogging. Take the stairs instead of elevators/lifts.
Special Advise
- Levosimendan is for in-hospital use only. Hence it should be administered in a hospital setting where adequate monitoring facilities and expertise with inotropic agents are available.
- The effect on your heart of Levosimendan will last for at least 24 hours after the Levosimendan infusion is stopped. This effect may continue for 7-9 days after the infusion is stopped.
- It is advisable to have complete cholesterol tests (lipid profile test) at least once a year. It will help you to closely monitor your heart health and risk of heart attack and stroke.
- Regularly monitor blood pressure levels, heart rate and electrolyte levels.
- Your doctor will measure how you respond to Levosimendan by measuring your heart rate, blood pressure, ECG, and how you are feeling.
Patients Concern
Disease/Condition Glossary
Heart failure: It happens, the heart becomes unable to pump blood in the whole body as it should. Certain conditions like high blood pressure can put the heart at risk of heart failure.
Heart attack: Heart attack or stroke occurs due to the blockage of blood flow to the heart muscle. The blockade usually occurs due to the build-up of fat/cholesterol in the coronary artery. High cholesterol levels might lead to a build-up of fat on the arteries' walls, leading to blockage of blood flow to the heart and other body parts, which could cause heart diseases, heart attack, or stroke. Cholesterol is mainly of two types, namely bad cholesterol and good cholesterol. Bad cholesterol comprises low-density lipoprotein (LDL) and triglycerides (TG) which deposits fat in the arteries leading to their blockage. Good cholesterol consists of high-density lipoprotein (HDL), which prevents the deposition of fats. Angina symptoms include pain or tightness in the chest, discomfort, pain in the neck, arms, or back, weakness, lightheadedness, and abnormal heartbeat. Risk factors include obesity, stress, smoking, a high-fat diet, lack of exercise and genetics.
FAQs
Levosimendan is used to treat heart failure.
Levosimendan is composed of levosimendan that belongs to the therapeutic class of drugs called calcium sensitizers used to increase the heart sensitivity to calcium without increasing the amount of calcium present in the heart cells. This medication widens up the blood vessels and relaxes the smooth muscles of the heart so that blood can flow easily to the whole body. Thus, treatment with Levosimendan relieves the shortness of breath from severe heart failure.
Do not discontinue Levosimendan without consulting your doctor as it could increase the risk of a heart attack. To treat your condition effectually continue taking Levosimendan for as long as prescribed. Do not be reluctant to speak with your doctor if you feel any difficulty while taking Levosimendan.
Constipation could be a side-effect of Levosimendan. Drink plenty of fluids and eat fibre rich food if you experience constipation. Consult your doctor if you have severe constipation.
Orthostatic hypotension could be a side-effect of Levosimendan. Orthostatic hypotension is a sudden lowering in blood pressure leading to dizziness on standing. If you experience this, do not try to stand up suddenly or start walking, instead lie down and get up slowly only when you feel better. People taking Levosimendan are advised to regularly monitor their blood pressure levels to avoid such unpleasant events.
Heart failure happen heart become unable to pump blood in the whole body as it should. Certain conditions like high blood pressure can put the heart at risk of heart failure.
Levosimendan may not be recommended for patients with severe liver disease. It should be used with caution in people with mild or moderate liver impairment. While no dose adjustment is typically needed, it's essential to monitor your liver function closely to ensure safe treatment. Inform the doctor if you have liver impairment or liver disease.
Levosimendan may cause a decrease in blood pressure. To ensure your safety, your blood pressure will be closely monitored after receiving the medicine. This will help the doctor detect any changes and take necessary actions.
Inform the doctor if you have kidney disease before receiving Levosimendan. Dose adjustment may be needed in people with mild to moderate kidney problems and it may not be recommended for patients with severe kidney problems.
Before and during treatment with Levosimendan, your doctor may advise monitoring of heart, kidneys, and liver function, ECG, blood pressure, and blood tests. The doctor may also check your urine output to ensure safety.
Levosimendan may increase heart rate. The doctor will take appropriate action if they notice a fast heart rate during treatment with Levosimendan.
Headaches are a common side effect of Levosimendan. To manage headaches, make sure to get plenty of rest, eat a balanced diet, and avoid alcohol. If your headache becomes severe, be sure to consult your doctor for further guidance and support.
The common side effects of Levosimendan include headache, low blood pressure, and nausea (stomach discomfort). Most of these side effects of Levosimendan do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.
