Levosimendan

C01C - Cardiac stimulants excl. cardiac glycosides ATC C01CX08 Small molecule Natural product

JFDA label: Simdax

Mechanism of Action

Inhibitor of Phosphodiesterase 3 — Phosphodiesterase 3 inhibitor; Positive Modulator of Troponin, cardiac muscle — Troponin, cardiac muscle positive modulator

Target	Action	Gene / class
Phosphodiesterase 3 efficacy	INHIBITOR
Troponin, cardiac muscle efficacy	POSITIVE MODULATOR

Indications

Off-label

Acute Kidney Injury
Amyotrophic Lateral Sclerosis
Cardiovascular Diseases
Coronary Disease
Heart Diseases
Heart Failure
Hemorrhage
Hernias, Diaphragmatic, Congenital
Ischemic Attack, Transient
Muscular Diseases
ST Elevation Myocardial Infarction
Severe Acute Respiratory Syndrome
Shock
Shock, Septic
Stroke

Pregnancy & Lactation

Pregnancy

Chemistry & Properties

Formula	C14H12N6O
Molecular weight	280.29 g/mol
IUPAC name	2-[[4-[(4R)-4-methyl-6-oxo-4,5-dihydro-1H-pyridazin-3-yl]phenyl]hydrazinylidene]propanedinitrile
CAS	141505-33-1
PubChem CID	3033825
InChIKey	`WHXMKTBCFHIYNQ-SECBINFHSA-N`
logP	1.36 (XLogP 2.3)
Polar surface area	113.43 Å²
H-bond acceptors / donors	6 / 2
Drug-likeness (QED)	0.64
Lipinski violations	0

SMILES

C[C@@H]1CC(=O)NN=C1c1ccc(NN=C(C#N)C#N)cc1

Biology & Pharmacokinetics

Pharmacokinetics predicted

Bioavailability	10.0%
Half-life	1.093 h
Volume of distribution	0.203 L/kg
Protein binding	97.7%
BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP1A2	Inhibitor	—
CYP2C19	Inhibitor	—
CYP2C8	Inhibitor	—
CYP2C9	Inhibitor	—
CYP3A4	Substrate	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Registered Products (1)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Simdax	Vial 2.5 mg/ml	1 vial	Awtar Pharmaceutical Co	—