피모벤단

Pimobendan

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

다른 이름: Vetmedin · Acardi · Cardisure · Pimocard · Fortekor-Plus · UDCG-115 · Pimobendanum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

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

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
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.

고양이

적응증	용량	경로	빈도	기간	지역
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.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

피모벤단은 강심혈관확장제(Inodilator)로 분류되는 매우 효과적인 심혈관계 약물로, 양성 변력 작용(심장 수축력 증가)과 혈관 확장 특성을 모두 가지고 있습니다.

주요 임상 용도:

개: 주로 확장성 심근병증(DCM) 또는 점액종성/퇴행성 승모판 질환(MMVD)에 속발하는 울혈성 심부전(CHF)을 치료하는 데 사용됩니다. 기존의 ACE 억제제/푸로세마이드 단독 요법과 비교하여 생존 시간과 삶의 질을 크게 향상시킵니다. 도베르만 핀셔의 DCM에 대한 1차 치료제로 간주되며 ACVIM C 및 D 단계 심부전 관리의 초석입니다.
고양이: 제한성 및 확장성 심근병증에 오프라벨로 사용됩니다. 양성 변력 작용으로 인해 비대성 심근병증(HCM)에는 일반적으로 금기입니다.

임상 팁: 모노그래프에는 전임상 사용에 대한 연구가 진행 중이라고 언급되어 있지만, 획기적인 EPIC 연구를 통해 피모벤단은 전임상(ACVIM B2 단계) MMVD가 있는 반려견의 심부전 발병을 지연시키는 표준 치료법으로 확립되었습니다.

작용 기전

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.

안전성·주의사항

금기사항

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

부작용

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)

주의

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.

약물 상호작용

Verapamil

Calcium antagonist; attenuates pimobendan-induced increases in cardiac contractility.

Propranolol

Beta-antagonist; attenuates pimobendan-induced increases in cardiac contractility.

Diltiazem

Calcium channel blocker; assumed to potentially attenuate positive inotropic effects.

Atenolol

Beta-blocker; assumed to potentially attenuate positive inotropic effects.

Beta-blockers (e.g., atenolol, propranolol)Moderate

Attenuates the positive inotropic effects of pimobendan

Calcium-channel blockers (e.g., verapamil, diltiazem)Moderate

Attenuates the positive inotropic effects of pimobendan

모니터링

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

약동학

반감기

고양이Pharmacokinetics may differ from dogs; generally considered to have a longer half-life in cats.개Pimobendan: ~0.5 hours; Active metabolite: ~2 hours

흡수

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).

분포

Steady-state volume of distribution is 2.6 L/kg. Protein binding of pimobendan and active metabolite in dog plasma is >90%.

대사

Oxidatively demethylated to a pharmacologically active metabolite, which is then conjugated with sulfate or glucuronic acid.

배설

Excreted mainly via feces. Clearance is approximately 90 mL/min/kg.

과다투여

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.

제품

제형

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

동물용의약품

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)

인용의약품

None

규제 현황

European Union✓ 승인됨처방전의약품EMA

🐕 Dogs

Licensed for preclinical DCM in Dobermanns and preclinical MMVD.

United Kingdom✓ 승인됨처방전의약품VMD

🐕 Dogs

POM-V classification.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store chewable tablets or capsules at room temperature below 25°C (77°F) in a dry place.

보호자 정보

피모벤단은 반려동물의 심장이 더 효과적으로 혈액을 펌프질하도록 돕고 혈관을 넓혀 심장의 부담을 줄여주는 약물입니다.

투여 방법: 약물이 제대로 흡수될 수 있도록 공복에, 이상적으로는 식사 1시간 전에 이 약을 투여하십시오.
엄격한 일정: 수의사의 지시에 따라 정확히 12시간 간격으로 투여하도록 노력하십시오.
평생 치료: 피모벤단은 심부전을 관리하기 위한 치료제이며 완치제는 아닙니다. 일반적으로 반려동물의 남은 평생 동안 필요합니다. 수의사와 상의 없이 이 약의 투여를 중단하지 마십시오.
가정 내 모니터링: 수면 중 반려동물의 호흡수(안정 시 호흡수)를 관찰하십시오. 지속적으로 분당 30회를 초과하면 수의사에게 연락하십시오.
안전: 어린이와 다른 동물의 손이 닿지 않는 곳에 보관하십시오.

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