What is the role of levosimendan (Simdax) in the treatment of calcium channel blocker (CCB) toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Levosimendan (Simdax) is an investigational drug in the United States that acts intracellularly to sensitize myocytes to calcium by binding to cardiac troponin C but that does not increase intracellular calcium. [71] Therefore, it theoretically should help increase cardiac output while not altering the metabolic demands of the cell. It is thought to accomplish this by stabilizing the kinetics of actin-myosin cross-bridges. It also opens K+ channels, which leads to vasodilation, decreasing afterload to aid cardiac output in depressed myocardial states. It cannot be recommended at this time for CCB toxicity.

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