Last reviewed 2026-04-22 · How we verify

Levosimendan Injection

Levosimendan is a calcium sensitizer that increases the force of cardiac muscle contraction without increasing oxygen consumption, while also causing vasodilation through opening of ATP-sensitive potassium channels.

Levosimendan is a calcium sensitizer that increases the force of cardiac muscle contraction without increasing oxygen consumption, while also causing vasodilation through opening of ATP-sensitive potassium channels. Used for Acute decompensated heart failure, Cardiogenic shock.

At a glance

Mechanism of action

Levosimendan binds to cardiac troponin C and enhances the interaction between actin and myosin filaments, thereby increasing myocardial contractility. Simultaneously, it opens ATP-sensitive potassium channels in vascular smooth muscle, leading to vasodilation and reduced cardiac afterload. This dual mechanism improves cardiac output while reducing myocardial oxygen demand.

Approved indications

• Acute decompensated heart failure
• Cardiogenic shock

Common side effects

• Hypotension
• Headache
• Nausea
• Arrhythmias
• Tachycardia

Key clinical trials

• Levosimendan as Treatment of Aneurysmal SubArachnoid Haemorrhage (PHASE2)
• Open-Label Rollover Study of Levosimendan in PH-HFpEF Patients (PHASE2)
• Effect of Early Use of Levosimendan Versus Placebo on Top of a Conventional Strategy of Inotrope Use on a Combined Morbidity-mortality Endpoint in Patients With Cardiogenic Shock (PHASE3)
• Effect Levosimendan Administration on Postoperative NT-proBNP in Cardiac Risk Patients (PHASE3)
• Hemodynamic Evaluation of Levosimendan in Patients With PH-HFpEF (PHASE2)
• Pharmacokinetics of Inhaled Levosimendan (PHASE2)
• Effects of Levosimendan on Cardiac Function After TAVR in Patients With Heart Failure (PHASE4)
• RCT Study of Levosimendan Improving Prognosis of Cardiac Arrest (PHASE4)

Primary sources

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