Canis ISSN: 2398-2942

Pimobendan

Contributor(s): Yolande Bishop, Sonja Fonfara

Introduction

Name

  • USAN.
  • rINN.

Class of drug

  • Positive inotrope.
  • Vasodilator.

Description

Chemical name

  • 4,5-Dihydro-6-[2-(p-methyoxyphenyl)-5-benzimidazolyl]-5-methyl-3(2H-pyridazinone).

Molecular formula

  • C19H18N4O2.

Molecular weight

  • 334.4.

Storage requirements

  • Do not store above 25°C.
  • Store in a dry place.

Uses

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Indications

  • Congestive heart failure Heart: congestive heart failure due to:
    • Dilated cardiomyopathy Heart: dilated cardiomyopathy (DCM) (DCM). Few studies to date:
      • PITCH study reported improvement in clinical signs in dogs with DCM and CHF.
      • Significant improvement in survival of Dobermanns with DCM and CHF compared to dogs treated with placebo.
      • No significant difference between the survival of pimobendan-treated vs placebo-treated Cocker spaniels (small number of dogs).
      • Studies showed no increase in heart rate or arrhythmias.
    • Degenerative valvular disease (MVD Heart: mitral valve degenerative disease ):
      • QUEST study revealed a longer time to reach endpoint in dogs with MVD and CHF treated with pimobendan plus conventional therapy in comparison to benazepril Benazepril plus conventional therapy.
      • PITCH study suggested that therapy with ACEI ACE inhibitor: overview , furosemide Furosemide and pimobendan led to a greater improvement in clinical signs than therapy with an ACEI alone. 80% of cases had dilated cardiomyopathy, the remainder, acquired valvular disease.
  • Pimobendan compared with ramipril Ramipril in dogs with acquired valvular disease over a 6m period showed a significant reduction in adverse outcomes (eg worsening of heart failure, death) in dogs treated with pimobendan.
  • The ACVIM consensus statement recommends treatment of MVD and CHF with furosemide, ACEi and pimobendan. Addition of spironolactone Spironolactone is also recommended as time to reach endpoint is prolonged.

Administration

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Pharmocokinetics

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Precautions

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Interactions

with other drugs

  • Anti-arrhythmics - can be used with anti-arrhythmic drugs.
  • Calcium channel blockers and beta blockers - the pimobendan induced increase in contractility will be weakened theoretically by calcium channel blockers and beta blockers but not reported as a problem in clinical trials.
  • Highly protein bound drugs - pimobendan is highly protein bound.
    Do not use if dog is receiving concomitant therapy with another highly protein bound drug (eg warfarin Warfarin , phenytoin Phenytoin ) in case displacement occurs.

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references from VetMedResource and PubMed.
  • Boswood A, Haggstrom J, Gordon S et al (2016) Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study-A Randomized Clinical Trial.​ JVIM 30, 1765-1779 PubMed.
  • Bernay F, Bland J M et al (2010) Efficacy of spironolactone on survival in dogs with naturally occurring mitral regurgitation caused by myxomatous mitral valve disease. JVIM 24, 331-341 PubMed.
  • Atkins C, Bonagura S et al(2009) Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. ACVIM consensus statement. JVIM 23, 1142-1150 PubMed.
  • Haggstrom J, Boswood A et al(2008) Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous valvular disease: The QUEST study. JVIM 22, 1124-1135 PubMed.
  • O'Grady M R, Minors S L et al(2009) Effect of pimobendan on case fatality rate in Doberman Pinschers with congestive heart failure caused by dilated cardiomyopathy. JVIM 22, 897-904 PubMed.
  • Smith P J, French A et al (2005) Efficacy and safety of pimobendan in canine heart failure caused by myxomatous mitral valve disease. JSAP 46, 121-130.

Other sources of information

  • The Veterinary Formulary. 5th edn (2001) Ed: Y Bishop. British Veterinary Association and Pharmaceutical Press.
  • Lombard C W et al (2000) Clinical experience with pimobendan. VCS Proceedings.Spring Meeting, Birmingham.
  • Luis Fuentes V, Kleeman R et al (1998) The effect of a novel inodilator pimobendan on heart failure status in Cocker Spaniels and Dobermanns with idiopathic dilated cardiomyopathy. Proccedings of the BSAVA Congress. p284.
  • Vetmedin Technical Dossier published by Boehringer Ingelheim Vetmedica.

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