Pimobendan
4,5-Dihydro-6-[2-(p-methyoxyphenyl)-5benzimidazolyl]-5-methyl-3(2H)pyridazinone
También conocido como: Vetmedin · Acardi · Cardisure · Pimocard · Fortekor-Plus · UDCG-115 · Pimobendanum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Management of the signs of mild, moderate or severe congestive heart failure due to AV valve insufficiency or dilated cardiomyopathy | 0.5 mg/kg total daily dose. Divide daily dose into two portions that are not necessarily equal (using whole and half tablets) and administer approximately 12 hours apart. | PO | Divided q12h | — | 🌎 NA |
| Treatment of congestive heart failure secondary to myxomatous mitral valve disease (MMVD) | 0.4-0.6 mg/kg PO divided twice daily | PO | Divided twice daily | — | 🌎 NA |
| Treatment of heart failure secondary to dilated cardiomyopathy or chronic mitral valve insufficiency | 0.25 mg/kg PO twice daily | PO | Twice daily | — | 🌎 NA |
| General dosing | 0.2-0.6 mg/kg PO divided q12h | PO | Divided q12h | — | 🌎 NA |
| Adjunctive drug for the emergency treatment of CHF (if not overtly critical and a strong positive oral inotrope is needed) | 0.1-0.3 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Adjunctive treatment of acute or chronic stage D heart failure (refractory to standard treatment) | 0.3 mg/kg PO to three times daily | PO | Up to TID | — | 🌎 NA |
| Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD | 0.15 mg/kg | IV | single dose | Single dose, transition to PO 12 hours later | 🌍 EU |
| Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD | 0.1-0.3 mg/kg | PO | q12h | Lifelong | 🌍 EU |
- Adjunctive treatment of acute or chronic stage D heart failure (refractory to standard treatment): Outside of FDA-approved labeling; requires client consent.
- Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD: Oral pimobendan can be continued 12 hours after administration of the injection.
- Congestive heart failure (MMVD or DCM) / Preclinical DCM / Preclinical MMVD: Administer 1 hour before food.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Management of myocardial failure (DCM), especially if not associated with taurine deficiency | 1.25-1.5 mg/cat PO q12hrs | PO | q12h | — | 🌎 NA |
| Heart failure associated with systolic dysfunction (Off-label) | 0.1-0.3 mg/kg | PO | q12h | Lifelong | 🌍 EU |
- Management of myocardial failure (DCM), especially if not associated with taurine deficiency: Off-label use. Little information about clinical efficacy due to rarity of condition.
- Heart failure associated with systolic dysfunction (Off-label): Not authorized (off-label). Pharmacokinetics may differ from dogs. Administer 1 hour before food.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El pimobendan es un fármaco cardiovascular altamente eficaz clasificado como inodilatador, lo que significa que posee propiedades tanto inotrópicas positivas (aumenta la contractilidad cardíaca) como vasodilatadoras.
Usos clínicos clave:
- Perros: Se utiliza principalmente para tratar la insuficiencia cardíaca congestiva (ICC) secundaria a miocardiopatía dilatada (MCD) o enfermedad valvular mitral mixomatosa/degenerativa (EVMM). Mejora significativamente los tiempos de supervivencia y la calidad de vida en comparación con la terapia tradicional con inhibidores de la ECA/furosemida sola. Se considera un tratamiento de primera línea para la MCD en Doberman Pinschers y es un pilar en el manejo de la insuficiencia cardíaca en estadios C y D de la ACVIM.
- Gatos: Se utiliza fuera de etiqueta (off-label) para la miocardiopatía restrictiva y dilatada. Generalmente está contraindicado en la miocardiopatía hipertrófica (MCH) debido a sus efectos inotrópicos positivos.
Perla clínica: Aunque la monografía señala estudios en curso para su uso preclínico, el estudio fundamental EPIC ha establecido al pimobendan como el estándar de atención para retrasar la aparición de insuficiencia cardíaca en perros con EVMM preclínica (Estadio B2 de la ACVIM).
Mecanismo de acción
Pimobendan exerts its dual inodilator effects through two distinct mechanisms:
- Positive Inotropy (Calcium Sensitization): It increases the sensitivity of the cardiac myofilament Troponin C to intracellular calcium → enhances cardiac contractility. Unlike older inotropes (e.g., digoxin), it achieves this without increasing intracellular calcium levels → no increase in myocardial oxygen consumption.
- Vasodilation (PDE-III Inhibition): It inhibits the enzyme phosphodiesterase III (PDE-III) in vascular smooth muscle → prevents the breakdown of cAMP → ↑ intracellular cAMP → smooth muscle relaxation → mixed arterial and venous dilation. This reduces both cardiac preload and afterload.
Additionally, pimobendan possesses mild antithrombotic activity.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to pimobendan
- Hypertrophic cardiomyopathy (HCM)
- Aortic stenosis
- Any condition where augmentation of cardiac output is inappropriate for functional or anatomic reasons
- Any condition where augmentation of cardiac output via increased contractility is not possible anatomically or functionally
Efectos adversos
- Poor appetite
- Diarrhea
- Dyspnea
- Azotemia
- Weakness and ataxia
- Pleural effusion
- Syncope
- Cough
- Ascites
- Heart murmur
- Arrhythmias (atrial fibrillation, increased ventricular ectopic beats)
- Worsening mitral valve lesions (acute hemorrhages, endocardial papilloform hyperplasia) with chronic use
- Moderate positive chronotropic effect (tachycardia)
- Vomiting (dose-dependent)
- Reduced appetite or lethargy (rare)
Precauciones
Use with caution in patients with uncontrolled cardiac arrhythmias.
Safety has not been evaluated in:
- Dogs younger than 6 months of age
- Dogs with congenital heart defects
- Dogs with diabetes mellitus or other serious metabolic diseases
- Breeding, pregnant, or lactating animals (high doses in lab animals caused increased resorptions)
Note: Patients treated chronically should be regularly examined for worsening mitral valvular lesions and regurgitation.
Interacciones farmacológicas
Calcium antagonist; attenuates pimobendan-induced increases in cardiac contractility.
Beta-antagonist; attenuates pimobendan-induced increases in cardiac contractility.
Calcium channel blocker; assumed to potentially attenuate positive inotropic effects.
Beta-blocker; assumed to potentially attenuate positive inotropic effects.
Attenuates the positive inotropic effects of pimobendan
Attenuates the positive inotropic effects of pimobendan
Monitorización
- ECG (rate and rhythm)
- Blood pressure
- Echocardiography (cardiac function and valve lesions)
- Clinical signs of heart failure (coughing, exercise intolerance)
- Resting respiratory rate (RRR) at home
- Heart rate and rhythm
- Respiratory rate and effort (Resting Respiratory Rate - RRR)
- Echocardiographic parameters (fractional shortening, left atrial/ventricular dimensions)
- Clinical signs of congestive heart failure
Farmacocinética
Vida media
Absorción
Peak levels of parent compound and active metabolite observed 1-4 hours post-dose. Food decreases bioavailability of aqueous solutions (effect on chewable tablets is unknown).
Distribución
Steady-state volume of distribution is 2.6 L/kg. Protein binding of pimobendan and active metabolite in dog plasma is >90%.
Metabolismo
Oxidatively demethylated to a pharmacologically active metabolite, which is then conjugated with sulfate or glucuronic acid.
Eliminación
Excreted mainly via feces. Clearance is approximately 90 mL/min/kg.
Sobredosis
Overdoses primarily manifest as cardiovascular signs.
Clinical Signs:
- Tachycardia (dose-dependent increases in heart rate)
- Mild, non-clinical heart murmurs
- Hypotension
Treatment:
- Decontamination: Induce emesis and administer activated charcoal if exposure was recent.
- Monitoring: Continuously monitor heart rate, blood pressure, and ECG.
- Supportive Care: Control hypotension with IV fluids and dopamine if necessary.
Productos disponibles
Formulaciones
- Injectable: 0.75 mg/ml solution
- Oral: 1.25 mg, 2.5 mg, 5 mg, 10 mg flavoured chewable tablets
- Oral: 5 mg hard capsules
- Compound Oral: 1.25 mg pimobendan / 2.5 mg benazepril tablets
- Compound Oral: 5 mg pimobendan / 10 mg benazepril tablets
Veterinario
- Vetmedin Chewable Tablets: 1.25 mg, 2.5 mg, 5 mg
- Vetmedin 0.75 mg/ml injectable solution
- Vetmedin 1.25 mg, 5 mg, 10 mg chewable tablets
- Vetmedin 5 mg hard capsules
- Cardisure 1.25 mg, 2.5 mg, 5 mg, 10 mg flavoured tablets
- Pimocard 1.25 mg, 2.5 mg, 5 mg, 10 mg flavoured tablets
- Fortekor-Plus (pimobendan/benazepril combination tablets)
Etiquetado para humanos
- None
Estado regulador
Licensed for preclinical DCM in Dobermanns and preclinical MMVD.
POM-V classification.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store chewable tablets or capsules at room temperature below 25°C (77°F) in a dry place.
Información para el cliente
El pimobendan es un medicamento utilizado para ayudar a que el corazón de su mascota bombee con mayor eficacia y para dilatar los vasos sanguíneos, reduciendo así la carga de trabajo del corazón.
- Administración: Administre este medicamento con el estómago vacío, idealmente una hora antes de comer, para asegurar que se absorba correctamente.
- Horario estricto: Intente administrar las dosis exactamente con 12 horas de diferencia, según las indicaciones de su veterinario.
- Terapia de por vida: El pimobendan es un tratamiento para controlar la insuficiencia cardíaca, no una cura. Por lo general, es necesario durante el resto de la vida de su mascota. No deje de administrar este medicamento sin consultar a su veterinario.
- Monitoreo en casa: Observe la frecuencia respiratoria de su mascota mientras duerme (frecuencia respiratoria en reposo). Si aumenta constantemente por encima de 30 respiraciones por minuto, comuníquese con su veterinario.
- Seguridad: Manténgalo fuera del alcance de los niños y otros animales.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.