Heartmedin ® Chew 10 mg, chewable 30 tablets (3 blisters)
Pimobendan 10 mg for dogs
Composition
One tablet (1.6 g) contains the active ingredient:
pimobendan 10 mg
Excipients: lactose monohydrate, microcrystalline cellulose, corn starch, sodium starch glycolate (type A), macrogol 6000, stearoyl macrogol glycerides, dried yeast, liver powder flavor, talc, magnesium stearate.
Pharmacological properties
ATC vet classification code QC01CE90 – Non-glycoside cardiotonic veterinary drugs. Phosphodiesterase inhibitors. Pimobendan.
Pimobendan, a benzimidazole-pyridazine derivative, has a positive inotropic effect and has pronounced vasodilator (vasodilator) properties.
The positive inotropic effect of pimobendan is due to two mechanisms of action: an increase in the sensitivity of cardiac muscle fibers to calcium and inhibition of the activity of phosphodiesterase III. Thus, the positive inotropic effect is neither caused by an action similar to the action of cardiac glycosides, nor by sympathomimetic. The vasodilating effect is associated with inhibition of the activity of phosphodiesterase III.
In cases of symptomatic heart valve insufficiency, when used in combination with furosemide, the drug has been shown to improve the quality and increase the life expectancy of treated dogs.
In a limited number of cases, when used in cases of symptomatic dilated cardiomyopathy in combination with furosemide, enalapril, and digoxin, the drug has been shown to improve quality and increase life expectancy in dogs.
After oral administration of pimobendan, its bioavailability is 60-63%. Because concurrent or prior food intake decreases bioavailability, pimobendan should be administered approximately 1 hour prior to feeding the animal.
The volume of distribution is 2.6 L / kg, indicating that pimobendan is evenly distributed in the tissues. The average plasma protein binding is 93%.
The compound is demethylated by oxidation to the main metabolite (UD-CG212). Subsequent metabolic steps are the phase II UD-CG212 conjugates such as glucuronides and sulfates.
The plasma half-life of pimobendan is 0.4 ± 0.1 hours, which corresponds to a high clearance of 90 ± 19 ml/min/kg and a short average retention time of 0.5 ± 0.1 hours. The most significant active metabolite is excreted from blood plasma with a half-life of 2.0 ± 0.3 hours. Almost the entire dose is excreted in the feces.
Application
For the treatment of congestive heart failure in dogs weighing between 40 kg and 60 kg due to dilated cardiomyopathy or valvular insufficiency (mitral and/or tricuspid valve regurgitation).
For the treatment of dilated cardiomyopathy at the preclinical stage (asymptomatic course with an increase in the end-systolic and end-diastolic diameters of the left ventricle) in Doberman Pinschers after echocardiographic diagnosis of heart disease.
For the treatment of dogs with myxomatous mitral heart disease (MMVD) in the preclinical stage (asymptomatic course with a systolic mitral murmur and signs of enlargement of the heart) to delay the onset of clinical symptoms of heart failure.
Dosage
Before starting treatment, the exact body weight of the animal must be determined to ensure the correct dosage.
The dosage should be from 0.2 mg to 0.6 mg pimobendan per 1 kg of body weight, divided into two doses per day.
The recommended daily dose is 0.5 mg of pimobendan per kg of body weight, divided into two doses.
One 10 mg chewable tablet in the morning and one 10 mg chewable tablet in the evening for a bodyweight of 40 kg to 60 kg.
*Kilograms to a Pounds conversion table
Kilograms (kg) | Pounds (lb) | Pounds+Ounces (lb+oz) |
0.1 kg | 0.220 lb | 0 lb 3.527 oz |
1 kg | 2.205 lb | 2 lb 3.274 oz |
5 kg | 11.023 lb | 11 lb 0.370 oz |
10 kg | 22.046 lb | 22 lb 0.740 oz |
Application features
Do not exceed the recommended dose.
The drug is administered orally.
Apply approximately one hour before feeding.
The drug can be used in combination with a diuretic such as furosemide.
For more accurate dosing, which corresponds to the bodyweight of the animal, the tablet can be divided along the fracture line into two halves.
Contraindications
Do not use pimobendan for hypertrophic cardiomyopathy or for clinical conditions where cardiac output may be increased through functional or anatomical features (eg, aortic stenosis).
Since pimobendan is metabolized primarily through the liver, it should not be used in dogs with severely impaired liver function.
Side effect
In rare cases, a slight positively chronotropic effect (increased heart rate) and vomiting can be observed. However, these effects are dose-dependent and can be avoided by reducing the dose of the drug.
In rare cases, signs of transient diarrhea, lack of appetite, or lethargy are observed.
In rare cases, with long-term treatment with pimobendan in dogs with mitral heart disease, an increase in mitral valve regurgitation is observed.
Although the relationship with the action of pimobendan has not been clearly established, in very rare cases, during treatment, signs of an effect on primary hemostasis (petechiae on the mucous membranes, subcutaneous bleeding) may be observed. These signs disappear after stopping treatment.
Special precautions for use
Blood glucose should be checked regularly when treating dogs with diabetes.
For the use of the drug for the treatment of dilated cardiomyopathy at the preclinical stage (asymptomatic course with an increase in the end-systolic and end-diastolic diameter of the left ventricle), it is necessary to diagnose by a comprehensive cardiac examination (including echocardiographic examination and, possibly, Holter monitoring).
To use the drug for the treatment of myxomatous mitral heart disease in the preclinical stage (stage B2, according to the ACVIM consensus: asymptomatic course with mitral murmur> 3/6 and cardiomegaly, due to myxomatous mitral heart disease), it is necessary to diagnose by a comprehensive physical and cardiological examination, which should include echocardiography or radiography as needed.
Monitoring of cardiac function and morphology in animals receiving pimobendan is recommended.
Flavored tablets. To avoid accidental swallowing, keep the tablets out of the reach of animals.
Use during pregnancy, lactation, egg production
Laboratory studies in rats and rabbits have not revealed any evidence of teratogenic or fetotoxic effects. However, these studies showed the presence of toxic effects on pregnant females and found embryotoxic effects when using the drug in high doses, as well as the fact that pimobendan is excreted in milk. The safety of the drug for pregnant and lactating female dogs has not been evaluated. The drug may only be used by a veterinary physician in accordance with the benefit/risk assessment of the medicinal product.
Interaction with other means and other forms of interaction
In pharmacological studies, no interaction was observed between cardiac glycosides strophanthin and pimobendan. The increase in cardiac contractility caused by pimobendan is attenuated by the calcium antagonists verapamil and diltiazem and the P-antagonist propranolol.
Special warnings
The drug was investigated in cases of asymptomatic dilated cardiomyopathy (DCM) in Dobermans with atrial fibrillation or persistent ventricular tachycardia.
The drug was investigated in cases of asymptomatic myxomatous mitral heart disease in dogs with significant supraventricular and/or ventricular tachyarrhythmias.
Release form
Blister in aluminum foil with sealed seams / PVC / aluminum foil/polyamide containing 10 tablets.
Storage
Dry, dark place inaccessible to children at a temperature not exceeding 25 ° C.
Separated tablets should be returned to the open mesh pocket and put back in the cardboard box.
Shelf life
2 years. The shelf life of the divided (halves) tablets after opening the primary package is 3 days.