Related Experiment Video

Updated: May 19, 2026

Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes
11:00

Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes

Published on: September 18, 2017

The clinical effects of levosimendan are not attenuated by sulfonylureas

Matti Kivikko1, Markku S Nieminen, Piero Pollesello

  • 1Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. matti.kivikko@hus.fi

Scandinavian Cardiovascular Journal : SCJ
|August 30, 2012
PubMed

Insights

Concurrent use of sulfonylureas does not affect levosimendan's benefits in acute heart failure patients. This study found no clinically significant interactions, ensuring levosimendan efficacy is maintained in diabetic patients also taking sulfonylureas.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Levosimendan is an inodilator for acute heart failure (AHF), acting via ATP-dependent potassium channels (K(ATP) channels).
  • Diabetes mellitus is prevalent in AHF patients, often treated with sulfonylureas, which block K(ATP) channels.
  • Preclinical data suggested a potential interaction between levosimendan and sulfonylureas.

Purpose of the Study:

  • To investigate the influence of concurrent sulfonylurea treatment on levosimendan's effects in AHF patients.
  • To evaluate potential interactions impacting hemodynamics, biomarkers, and clinical outcomes.

Main Methods:

  • Pooled analysis of six randomized levosimendan trials (3004 patients).
  • Comparison of levosimendan effects in patients with and without concurrent sulfonylurea use.
  • Evaluation of hemodynamics, BNP levels, adverse events, and survival.

Main Results:

  • No clinically relevant interactions between sulfonylureas and levosimendan were detected.
  • Similar hemodynamic responses (blood pressure, PCWP) and BNP reductions observed in both groups.
  • Comparable survival rates and adverse event profiles between sulfonylurea users and non-users.

Conclusions:

  • Concomitant use of sulfonylureas does not attenuate the hemodynamic or other effects of levosimendan.
  • Levosimendan can be safely used in AHF patients also treated with sulfonylureas.
Abstract

Related Concept Videos

Oral Hypoglycemic Agents: Sulfonylureas01:17

Oral Hypoglycemic Agents: Sulfonylureas

Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide (Glucotrol),...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Antihypertensive Drugs: Thiazide-Class Diuretics01:15

Antihypertensive Drugs: Thiazide-Class Diuretics

Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...