Pharmacologic class: Bipyridine phosphodiesterase inhibitor
Therapeutic class: Inotropic
Pregnancy risk category C
Increases cellular levels of cyclic adenosine monophosphate, causing inotropic action that relaxes vascular smooth muscle and increases myocardial contractility
Injection: 1 mg/ml in 10-, 20-, and 50-ml vials
Injection (premixed): 200 mcg/ml in dextrose 5% in water (D5W)
Indications and dosages
➣ Heart failure
Adults: Initially, 50 mcg/kg I.V. bolus given slowly over 10 minutes, followed by continuous I.V. infusion of 0.375 to 0.75 mcg/kg/minute. Don't exceed total daily dosage of 1.13 mg/kg.
• Renal impairment
• Hypersensitivity to drug
Use cautiously in:
• atrial flutter or fibrillation, supraventricular and ventricular arrhythmias, renal impairment, electrolyte abnormalities, decreased blood pressure, severe aortic or pulmonic valvular disease, acute phase of myocardial infarction (not recommended), electrolyte abnormalities, abnormal blood digoxin level
• elderly patients
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Dilute 1 mg/ml solution with half-normal saline solution, normal saline solution, or D5W per manufacturer's instructions.
☞ Don't administer through same I.V. line as furosemide or torsemide (precipitate will form).
• Deliver I.V. slowly over 10 minutes.
• Expect to titrate infusion rate depending on response.
CV: hypotension, chest pain, angina, ventricular or supraventricular arrhythmias, ventricular tachycardia or fibrillation
• Monitor vital signs and ECG. Watch closely for ventricular arrhythmias, sustained tachycardia, and fibrillation.
• Assess cardiovascular status closely. Stay alert for complaints of chest pain.
☞ Stop drug and contact prescriber immediately if patient's systolic pressure drops 30 mm Hg or more.
• Instruct patient to change position slowly, to avoid light-headedness or dizziness from hypotension.
• As appropriate, review all other significant and life-threatening adverse reactions.