Pimobendan (Vetmedin/Cardisure) Medication Guide

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How does Pimobendan work and what is it used for?

Pimobendan produces both positive inotropic and vasodilatory effects. It increases the contractility of heart muscles through calcium sensitivity and phosphodiesterase inhibition. Phosphodiesterase inhibition also promotes arterial and venous dilation, thereby reducing the force against which the heart has to contract to eject blood into the arteries, and the amount the heart muscles need to stretch (to fill the ventricle of the heart) before it contracts. Thus Pimobendan increases the strength of the contraction of the heart and reduces its workload.

Pimobendan has been shown to increase both the quality of life and survival time of dogs with DCM (dilated cardiomyopathy) or heart failure due to valvular insufficiency such as MVD (mitral valve disease). It is indicated for use in dogs with CHF (chronic heart failure) from DCM and valvular insufficiencies (mitral valve and tricuspid valve). It is also indicated for use in preclinical DCM in large breed dogs like Doberman Pinschers.

Pimobendan is not registered for use in cats, but it has been used off label by veterinary cardiologists to treat certain cardiac conditions in cats. It's use in dogs for conditions other than those listed above and it's use in cats is off-label (meaning that it has not been registered in these cases), but it may be prescribed for other conditions as well. In these cases, please follow the directions of your treating Veterinarian closely.

How is it administered?

Pimobendan comes in a few different forms as follows: tablets (CorMedin), capsules (Vetmedin), chewable tablets (Vetmedin, Cardisure) or as an oral liquid (Vetmedin).

All forms need to be given to your dog by mouth twice a day on an empty stomach, approximately 1 hour before food. Ideally give the medication your dog morning and evening, roughly 12 hours apart. The chewable tablets are usually readily consumed by dogs when offered as a treat. If not voluntarily eaten, the chewable tablets can be given as a tablet directly into the dog's mouth.

The tablets and chewable tablets are scored, allowing them to be halved. They come in bottles (Vetmedin, CorMedin) or Blister Packs (Cardisure). The capsules (Vetmedin) come in a bottle as does the Vetmedin oral liquid.

How quickly does it work?

This depends on they severity of heart disease and every dog is different. Usually you will see improvements within a week of your dog starting pimobendan.

If your dog has an asymptomatic heart disease or is in the early stages of heart disease, you are less likely to notice any changes.

If you are concerned that there are no noticeable changes please contact your veterinarian.

What are the potential side effects of Pimobendan?

Pimobendan is well tolerated in most dogs but side effects can occur. The most common side effects are:

vomiting
diarrhoea
lethargy
loss of appetite

Other potential side effects include:

increase in mitral valve regurgitation
increase in heart rate
dyspnea (shortness of breath)
weakness
ataxia (wobbliness)
azotemia (abnormally high levels of nitrogen waste products in the bloodstream)

If you are concerned about your dog for any reason, please refer to the adverse reactions section on the package leaflet or contact your veterinarian for advice.

Precautions and Contraindications

Precautions:

The safe use of pimobendan has not been evaluated in pregnant and lactating bitches, dogs younger than 6 months of age, dogs with congenital heart defects and dogs with diabetes mellitus or other serious metabolic diseases.
The safety of Pimobendan has not been established in dogs with asymptomatic heart disease or in heart failure caused by etiologies other that mitral valve disease or dilated cardiomyopathy.

Contraindications:

Pimobendan should not be taken by dogs who are allergic to it.
Pimobendan should not be given in cases of hypertrophic cardiomyopathy, aortic stenosis, or any other conditions where augmentation of cardiac output is not recommended.

Does Pimobendan interact with other drugs?

The following medications may interact with Pimobendan :

Calcium antagonists (such as verapamil and diltiazem)
Beta-agonists (such as propranolol and atenolol)
Phosphodiesterase Inhibitors (such as theophylline)

It is extremely important to let your veterinarian know of any medications (including vitamins, supplements or herbal therapies) your dog is taking.

Storage and Handling

You should wash your hands immediately after handling Pimobendan.

This medication should be stored in the original packaging in a cool dry area protected from moisture and light. It should be stored out of reach of animals and children.

If from a bottle, half-tablets should be stored in the bottle with cap sealed and used within 60 days. If from a blister pack, half tablets should be stored in the opened blister and the blister returned to the carton, and these half-tablets should be used within 3 days.

Accidental ingestion of pimobendan can be harmful for children. To avoid accidental ingestion, administer the medication to your dog immediately after removal from the package, and observe your dog closely to ensure that the entire dose has been consumed. Keep out of reach and sight of children.

Dosage

The recommended dose of Pimobendan is a total daily dose of 0.2mg - 0.6 mg/kg body weight, divided into two daily doses administered 12 hours apart. It is crucial that you follow your Veterinarian's specific instructions regarding dosage for your individual pet.

What should I do if my pet misses a dose?

If you miss giving your dog a dose of Pimobendan, give it as soon as you remember. However, if it is close to the time for the next dose, skip the missed dose and resume the dosing schedule as normal - do not give two doses at once.

Stopping Pimobendan

Do not stop giving your dog Pimobendan without first discussing it with your veterinarian. Any cessation or change to your dog's medication should only be done under the close supervision and recommendation of your treating Veterinarian.

What should I do if my pet has taken too much Pimobendan?

If you know or suspect your dog has had an overdose of Pimobendan, we recommend that you contact your treating veterinarian or emergency veterinary hospital immediately.

Importance of Veterinary Monitoring

It is important for your dog to have regular check ups with their vet while taking Pimobendan. This allows the veterinarian to monitor your dog's heart condition, and make changes to the medication as needed. Your veterinarian will let you know how frequently they would like to see your pet and his may change depending on how stable your dog's heart condition is.

Alternative and Related Medications

Pimobendan is available in several brands for dogs in Australia:

Vetmedin
Cardisure
Cormedin

Related medicines:

Frusemide
Spironolactone
Benazepril

References: