Levosimendan
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Also known as (-)-OR-1259(r)-simendanNSC-759644OR-1259OR1259SimdaxSimendan, (r)-SID144205744SID170466129SID170466128
Summary
Levosimendan (CHEMBL2051955) is a phase-3 clinical-stage small-molecule vasodilator agent (ATC C01CX08); indicated across 16 conditions including heart failure and congestive heart failure.
At a glance
- Status: Max clinical phase 3 (not approved)
- Modality: Small molecule
- ATC class: C01CX08
- Indications: 16 conditions
- Clinical trials: 89
- Chemistry: 280.28 Da · C14H12N6O
Identifiers
Drug identity and classification
| Field | Value |
|---|---|
| ChEMBL ID | CHEMBL2051955 |
| Name | Levosimendan |
| Type | Small molecule |
| Max phase | 3 |
| FDA approved | no |
| PubChem CID | 3033825 |
| ChEBI | CHEBI:50567 |
| ATC | C01CX08 |
| Molecular formula | C14H12N6O |
| Molecular weight | 280.28 |
| InChIKey | WHXMKTBCFHIYNQ-SECBINFHSA-N |
SMILES: C[C@@H]1CC(=O)NN=C1C2=CC=C(C=C2)NN=C(C#N)C#N
IUPAC name: 2-[[4-[(4R)-4-methyl-6-oxo-4,5-dihydro-1H-pyridazin-3-yl]phenyl]hydrazinylidene]propanedinitrile
Pharmacological roles (ChEBI): vasodilator agent, EC 3.1.4.17 (3’,5’-cyclic-nucleotide phosphodiesterase) inhibitor, cardiotonic drug, anti-arrhythmia drug.
Also known as: (-)-OR-1259, (r)-simendan, Levosimendan, NSC-759644, OR-1259, OR1259, Simdax, Simendan, (r)-, LEVOSIMENDAN, SID144205744, SID170466129, SID170466128
Patent coverage: 810 distinct patent families (3,145 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.
Targets
Targets
Broader ChEMBL bioactivity targets: 2 (assay-derived). Sample: Troponin C, slow skeletal and cardiac muscles, Phosphodiesterase 3.
Bioactivity
ChEMBL activities: 1 potent at pChembl ≥ 5 of 2 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):
| Target | pChembl | Type | Value | Unit | Activity ID |
|---|---|---|---|---|---|
| PDE3B | 8.1 | IC50 | 8 | nM | CHEMBL_ACT_1206298 |
Target pathways
No target-pathway data for this drug (no mapped target genes).
Indications & clinical
Indications
16 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).
| Indication | Trial phase | MONDO | EFO |
|---|---|---|---|
| heart failure | 3 | MONDO:0005252 | EFO:0003144 |
| congestive heart failure | 3 | MONDO:0005009 | EFO:0000373 |
| severe acute respiratory syndrome | 3 | MONDO:0005091 | EFO:0000694 |
| ST-elevation myocardial infarction | 3 | MONDO:0041656 | EFO:0008585 |
| cardiovascular disorder | 3 | MONDO:0004995 | EFO:0000319 |
| amyotrophic lateral sclerosis | 3 | MONDO:0004976 | MONDO:0004976 |
| toxic shock syndrome | 2 | MONDO:0001881 | EFO:0006834 |
| congenital heart disease | 2 | MONDO:0005453 | EFO:0005207 |
| acute kidney injury | 2 | MONDO:0002492 | HP:0001919 |
| muscle tissue disorder | 2 | MONDO:0003939 | EFO:0002970 |
| stroke disorder | 2 | MONDO:0005098 | EFO:0000712 |
| coronary artery disorder | 2 | MONDO:0005010 | EFO:0001645 |
| transient ischemic attack | 2 | MONDO:0005264 | EFO:0003764 |
| heart disorder | 2 | MONDO:0005267 | EFO:0003777 |
2 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.
Clinical trials
Total trials: 89.
Phase distribution
| Phase | Trials |
|---|---|
| PHASE4 | 30 |
| PHASE3 | 19 |
| Not specified | 18 |
| PHASE2 | 15 |
| PHASE2/PHASE3 | 6 |
| PHASE1/PHASE2 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT07105202 | PHASE4 | RECRUITING | Shorter Weaning From Invasive Ventilation With Levosimendan |
| NCT00154115 | PHASE4 | COMPLETED | Levosimendan in High Risk Heart Valve Surgery |
| NCT00219388 | PHASE4 | COMPLETED | Efficacy and Safety of Treatment With Simdax® Versus Dobutrex® in Decompensated Heart Failure Patients. |
| NCT00324766 | PHASE4 | COMPLETED | Levosimendan in Acute Heart Failure Following Acute Myocardial Infarction. |
| NCT00610350 | PHASE4 | COMPLETED | Levosimendan and Myocardial Protection |
| NCT00988806 | PHASE4 | UNKNOWN | Long-Term Intermittent Administration of Levosimendan in Patients With Advanced Heart Failure |
| NCT00994825 | PHASE4 | COMPLETED | Levosimendan in High Risk Patients Undergoing Cardiac Surgery |
| NCT01022983 | PHASE4 | WITHDRAWN | Preoperative Levosimendan and Heart Failure |
| NCT01188369 | PHASE4 | TERMINATED | Effects of Levosimendan in Patients Eligible for Aortic Valve Replacement With Left Ventricular Hypertrophy |
| NCT01210976 | PHASE4 | COMPLETED | The Effects of Levosimendan on Haemodynamics in Patients Undergoing Elective Aortic Valve Replacement (AVR)Together With Coronary Artery Bypass Grafting (CABG) Surgery |
| NCT01318460 | PHASE4 | COMPLETED | Prophylactic Administration of Levosimendan in Patients Undergoing Coronary Surgery |
| NCT01500785 | PHASE4 | TERMINATED | Intracoronary Administration of Levosimendan in Cardiac Surgery Patients |
| NCT01536132 | PHASE4 | COMPLETED | Intermittent Intravenous Levosimendan in Ambulatory Advanced Chronic Heart Failure Patients |
| NCT01595737 | PHASE4 | COMPLETED | Comparison of the Administration of Levosimendan and Placebo in the Preparation of Critical Patients for Heart Surgery |
| NCT01616069 | PHASE4 | COMPLETED | Assessment of Hemodynamic Response in Cardiopulmonary Bypass Graft After Cardiopulmonary Bypass Using Transesophegeal Echocardiography |
| NCT01969071 | PHASE4 | COMPLETED | The Effects of Levosimendan During Mitral Valve Surgery |
| NCT02012946 | PHASE4 | UNKNOWN | Levosimendan Versus Dobutamine in Cardiopatic Patients Undergoing Major Non Cardiac Surgery |
| NCT02261948 | PHASE4 | COMPLETED | Levosimendan Efficacy Assessment by Cardiopulmonary Exercise Test (CPET) |
| NCT02531724 | PHASE4 | COMPLETED | Effects of Levosimendan in Acute Kidney Injury After Cardiac Surgery |
| NCT02640846 | PHASE4 | UNKNOWN | Effects of Levosimendan, Milrinone and Norepinephrine on Left and Right Ventricular Function in Septic Shock |
| NCT03189901 | PHASE4 | UNKNOWN | Early Management Strategies of Acute Heart Failure for Patients With NSTEMI |
| NCT03576677 | PHASE4 | UNKNOWN | Effect of Levosimendan or Placebo on Exercise in Advanced Chronic Heart Failure |
| NCT03764722 | PHASE4 | UNKNOWN | Effectiveness of a Repetitive Use of 24-hour Levosimendan Infusions in Patients With Severe Systolic Heart Failure in Order to Prevent Rehospitalizations |
| NCT03855579 | PHASE4 | UNKNOWN | Levosimendan Versus Milrinone in Off Pump CABG Surgery |
| NCT04330755 | PHASE4 | COMPLETED | Levosimendan Versus Combination With Magnesium Sulphate on Spine Protection by NIRS in Infants Undergoing Coarctectomy |
| NCT04573049 | PHASE4 | UNKNOWN | The Effectiveness and Safety of Levosimendan in Patients With Severe Aortic Stenosis and Heart Failure Undergoing Transcatheter Aortic Valve Replacement |
| NCT04705337 | PHASE4 | TERMINATED | Levosimendan In Ambulatory Heart Failure Patients |
| NCT04950569 | PHASE4 | UNKNOWN | Effect of Levosimendan on miRNAs Regulation in the Failing Hearts |
| NCT04970238 | PHASE4 | UNKNOWN | Effect of Levosimendan on Left Ventricular Systolic Function and Heart Failure After PCI in Patients With Acute Anterior Myocardial Infarction |
| NCT05956431 | PHASE4 | UNKNOWN | RCT Study of Levosimendan Improving Prognosis of Cardiac Arrest |
| NCT04020263 | PHASE3 | RECRUITING | 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 |
| NCT07262723 | PHASE2/PHASE3 | NOT_YET_RECRUITING | Levosimendan in Acute Decompensated Heart Failure |
| NCT00048425 | PHASE3 | COMPLETED | Evaluation of Intravenous Levosimendan Efficacy in the Short Term Treatment of Decompensated Chronic Heart Failure. |
| NCT00093301 | PHASE2/PHASE3 | UNKNOWN | Levosimendan Versus Dobutamine in Shock Patients |
| NCT00166127 | PHASE3 | TERMINATED | Study of Blood Concentrations and Physiologic Effects of Levosimendan Given During Heart Surgery |
| NCT00348504 | PHASE3 | COMPLETED | Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support: a Multicentre, Parallel-Group, Randomised, Double-Blind, Double-Dummy Study of Levosimendan Versus Dobutamine in Patients With Acute Heart Failure. |
| NCT01065194 | PHASE3 | UNKNOWN | Efficacy and Safety of Pulsed Infusions of Levosimendan in Outpatients With Advanced Heart Failure |
| NCT01290146 | PHASE3 | TERMINATED | ELEVATE Early LEvosimendan Vs Usual Care in Advanced Chronic hearT failurE |
| NCT01720030 | PHASE2/PHASE3 | UNKNOWN | Levosimendan in Acute Kidney Injury Study |
| NCT01721434 | PHASE2/PHASE3 | UNKNOWN | Effects of Levosimendan on Diaphragm Function in Mechanically Ventilated Patients |
Clinical evidence (CIViC)
No CIViC predictive evidence (expected for non-precision-medicine drugs).
Pharmacology
Pharmacogenomics
No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.
Related molecules
Related molecules
No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).