Short-term treatment of acutely decompensated severe chronic heart failure (ADHF) wherein conventional therapy is not sufficient & in cases where inotropic support is appropriate.
IV infusion Individualized dosage. Initially 6-12 mcg/kg loading dose infused over 10 min followed by a continuous infusion of 0.1 mcg/kg/min. Lower loading dose of 6 mcg/kg is recommended in patients on concomitant IV vasodilators or inotropes or both at start of infusion. Rate of infusion may be decreased to 0.05 mcg/kg/min or discontinued if response is deemed excessive; may be increased to 0.2 mcg/kg/min if initial dose is tolerated. Duration of infusion: 24 hr.
View Simdax overdosage for action to be taken in the event of an overdose.
Contraindications
Hypersensitivity. Severe hypotension & tachycardia. Significant mechanical obstructions affecting ventricular filling or outflow or both. Severe renal impairment (CrCl <30 mL/min) & severe hepatic impairment. History of Torsades de Pointes.
Patient's w/ low baseline systolic or diastolic BP or those at risk for a hypotensive episode. Correct severe hypovolaemia prior to infusion. Reduce or discontinue if excessive changes in BP or heart rate are observed. Non-invasive monitoring for haemodynamic effects for at least 4-5 days after the end of infusion is recommended. Mild to moderate renal & hepatic impairment. Correct low serum K conc prior to treatment & monitor during therapy. Ischaemic CV disease & concurrent anaemia. Concomitant use w/ vasoactive agents, including inotropic agents (except digoxin). Tachycardia atrial fibrillation w/ rapid ventricular response or potentially life-threatening arrhythmias. Closely monitor ECG in patients w/ on-going coronary ischaemia, long QTc interval regardless of aetiology & concomitant use w/ drugs that prolong QTc interval. Childn & adolescent <18 yr. Pregnancy & lactation.
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