Levosimendan

Levosimendan
Clinical data
Trade names	Simdax
AHFS/Drugs.com	International Drug Names
Routes of; administration	IV
ATC code	C01CX08 (WHO) ;
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	85% (oral)
Protein binding	97–98%
Metabolism	Extensive hepatic
Elimination half-life	~1 hour (levosimendan), 75–80 hours (metabolites)
Excretion	urine (54%), feces (44%)
Identifiers
	IUPAC name 2-[[4-[(4R)-4-methyl-6-oxo-4,5-dihydro-1H-pyridazin-3-yl]phenyl]hydrazinylidene]propanedinitrile;
CAS Number	141505-33-1 ;
PubChem CID	3033825;
DrugBank	DB00922 ;
ChemSpider	2298414 ;
UNII	C6T4514L4E;
KEGG	D04720 ;
ChEBI	CHEBI:50567 ;
ChEMBL	ChEMBL313136 ;
CompTox Dashboard (EPA)	DTXSID9046445 ;
ECHA InfoCard	100.189.828
Chemical and physical data
Formula	C14H12N6O
Molar mass	280.291 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C2N/N=C(/c1ccc(N/N=C(\C#N)C#N)cc1)[C@H](C)C2;
	InChI InChI=1S/C14H12N6O/c1-9-6-13(21)19-20-14(9)10-2-4-11(5-3-10)17-18-12(7-15)8-16/h2-5,9,17H,6H2,1H3,(H,19,21)/t9-/m1/s1 ; Key:WHXMKTBCFHIYNQ-SECBINFHSA-N ;
	(what is this?) (verify)

Levosimendan (INN) /ˌliːvoʊsaɪˈmɛndən/ is a calcium sensitizer used in the management of acutely decompensated congestive heart failure. It is marketed under the trade name Simdax (Orion Corporation). Overall the drug has a two fold mechanism of action. It leads to greater inotropy by increasing the calcium sensitivity as it binds to troponin and this results in a greater positive inotrophic force. Secondly, the drug is able to open ATP sensitive potassium channels in vascular smooth muscle cells, and the vascular dilatory effects of the drug lead to a decreased preload and afterload, putting less work on the heart. This drug is in the process of review by the FDA but has not been approved for use in the United States yet.