The most frequent adverse events (53% of patients) reported in clinical studies were headache, marked reduction in blood pressure, ventricular tachycardia.
In SURVIVE clinical study, 18% of patients experienced ventricular tachycardia, atrial fibrillation, expressed lowering blood pressure, ventricular arrythmia, tachycardia, headache.
The following are the adverse effects, which are registered in clinical studies of patients. Adverse events were distributed in frequency as follows: very common (> 1/10), common masteron steroids. Often Metabolism: hypokalemia. From the mental state: insomnia. On the part of the gastrointestinal tract: nausea, constipation, diarrhea, vomiting.From the laboratory parameters: reduction of hemoglobin concentration. It is often the part of the central nervous system: dizziness, headache. On the part of the cardiovascular system: atrial fibrillation, atrial flutter, tachycardia, ventricular premature beats, ventricular tachycardia, hypotension up to severe, heart failure, myocardial ischemia, arrythmia. In marketing using the drug reported ventricular fibrillation.
Overdose Symptoms: marked reduction of blood pressure and tachycardia, an increase in the blood of the active metabolite, possibly lengthening the interval the . Treatment: In marked decrease in blood pressure can be applied vasopressor agents: dopamine in patients with congestive heart failure, and epinephrine (adrenaline) after cardiac surgery. Sharp reduction in ventricular filling pressure of the heart may limit the effect of levosimendan; in order to restore the pressure shown parenteral administration of fluid. It is necessary to carry out continuous monitoring, repeated determination of serum electrolytes and invasive monitoring of hemodynamic parameters.
Interaction with other drugs
Levosimendan should be used with caution in combination with intravenous vasodilators due to possible increased risk of hypotension. In vitro studies in human liver microsomes showed that levosimendan should not interact with drugs metabolized by the action of cytochrome masteron steroids, low affinity due to various isozymes . In population pharmacokinetic analysis showed no evidence of interaction between digoxin and levosimendan. Levosimendan can be used in patients receiving beta-blockers, which does not affect the effectiveness of the treatment. Concomitant use of isosorbide mononitrate and levosimendan in healthy volunteers resulted in a significant increase in orthostatic hypotension. Incompatibility The product should not be mixed with other drugs or solutions except those listed in section Dosage and administration / Compatibility.
The drug can be used only in a hospital, the necessary equipment for the control of vital functions and having the medical staff with experience with inotropic agents.
The drug can be used if no expiration date, and storage was carried out in accordance with the instructions for use.
An initial haemodynamic effect of levosimendan is to reduce systolic and diastolic blood pressure, so it should be used with caution in patients with low baseline systolic and diastolic blood pressure, or with a tendency to hypotension. For these patients, it is recommended the use of low doses of the drug.
It is necessary to select a dose, injection rate and duration of treatment depending on the patient’s condition and response to therapy.
Expressed hypovolemia must be removed before the masteron steroids drug infusion Simdaks. If there are significant changes or fluctuations in blood pressure and heart rate, it is necessary to reduce the rate of infusion or stop the infusion.
Hemodynamic effects usually occur within 7-10 days. This is partly due to the circulation of the active metabolite, whose concentration in blood plasma reaches its maximum about 48 hours after completion of the infusion. test cancer where is your waist line dr simeons diet food list