Special precautions for use in animals:
- The blood glucose should be tested regularly during treatment in dogs with existing diabetes mellitus.
- Monitoring of cardiac function and morphology is recommended in animals treated with pimobendan.
- The chewable tablets are flavoured. To avoid any accidental ingestion, store tablets out of reach of the animals.
Special precautions to be taken by the person administering the veterinary medicinal product to animals:
- Accidental ingestion, especially by a child, may lead to tachycardia, orthostatic hypotension, flushing of the face and headaches.
- Unused part-tablets should be returned to the open blister space, or to the bottle and inserted back into the outer packaging. Keep in a safe place out of the sight and reach of children.
- Close bottle tightly with cap directly after removal of the required number of tablets or part-tablets.
- In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.
- Wash hands after use.
Adverse reactions (frequency and seriousness):
In rare cases, a slight positively chronotropic effect (rise in heart rate) and vomiting can occur. These effects are dose-dependent and can be avoided by reducing the dose.
In rare cases, transient diarrhoea, anorexia, or lethargy have been observed.
Although a relationship with pimobendan has not been clearly established, in very rare cases, signs of effects on primary haemostasis (petechiae on mucous membranes, subcutaneous haemorrhages) may be observed during treatment. These signs disappear when the treatment is withdrawn.
In rare cases, an increase in mitral valve regurgitation has been observed during chronic pimobendan treatment in dogs with mitral valve disease.
Use during pregnancy, lactation or lay:
Laboratory studies have shown evidence of maternotoxic and embryotoxic effects at high doses, and that pimobendan is excreted into milk. The safety of the product has not been assessed in pregnant or nursing bitches. Use only according to the benefit/risk assessment by the responsible veterinarian.
Interaction with other medicinal products and other forms of interaction:
No interaction between cardiac glycosides strophanthin and pimobendan was observed. The pimobendan-induced increase in cardiac contractility is attenuated by calcium antagonists (verapamil and diltiazem) and by the β-antagonist (propranolol).
Overdose (symptoms, emergency procedures, antidotes):
In case of overdose, a positive chronotropic effect, vomiting, apathy, ataxia, heart murmurs or hypotension may occur. In this situation, the dosage should be reduced and appropriate symptomatic treatment initiated. Prolonged exposure (6 months) of healthy beagle dogs at 3 and 5 times the recommended dose showed mitral valve thickening and left ventricular hypertrophy in some dogs.