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Pimobendan

PrescriptionCDSCO approved
Positive inotrope / vasodilator (inodilator) — phosphodiesterase III inhibitor + calcium sensitiser
Last reviewed 19 Apr 2026 · PetCare.AI Editorial Team
Species
Dog
Brands
3 available
Interactions
6 documented
Formulations
4

Mechanism of action

Increases myocardial contractility by sensitising troponin C to calcium and inhibiting PDE III; also causes vasodilation, reducing preload and afterload

At a glance

Class
Positive inotrope / vasodilator (inodilator) — phosphodiesterase III inhibitor + calcium sensitiser
Schedule
Prescription
Storage
Store below 25°C. Give 1 hour before food for optimal absorption.
CDSCO (India)
Vet-approved — 2007-01

Dosing

🐕

Dog

Congestive heart failure (DMVD, DCM)
Dose
0.2–0.3 mg/kg
Route
PO
Frequency
BID
Max dose
10 mg/dose; 20 mg/day
Duration: Lifelong — give 1 hour before food
Pre-clinical DMVD (EPIC trial — stage B2)
Dose
0.2–0.3 mg/kg
Route
PO
Frequency
BID
Max dose
10 mg/dose; 20 mg/day
Duration: Lifelong — delays onset of CHF

Formulations

💊

Chewable tablet — 4

Strength
1.25mg
Available in India
Strength
2.5mg
Available in India
Strength
5mg
Available in India
Strength
10mg
Available in India

Storage

Store below 25°C. Give 1 hour before food for optimal absorption.

Safety

Absolute contraindications — do not use

  • Hypertrophic cardiomyopathy (HCM)
    Positive inotrope worsens dynamic outflow tract obstruction — CONTRAINDICATED in cats with HCM
  • Aortic stenosis / subaortic stenosis
    Increased pressure gradient across stenosis
    BoxerGolden RetrieverGerman Shepherd

Use with caution

  • Cats (general)
    Very limited feline data; most feline heart disease is HCM where pimobendan is contraindicated
  • Arrhythmias
    May potentiate tachyarrhythmias

Adverse effects

Common
Increased appetite
Diarrhoea
Lethargy (transient)
Serious
Arrhythmias
Sudden death (in non-cardiac disease)
Increased mitral regurgitation

Monitoring parameters

EchocardiographyHeart rate and rhythmRespiratory rate (resting, <30/min target)Renal functionAppetite and activity level

Interactions

Major — 1

Propranolol
major
Pimobendan's positive inotropic effect is partially mediated by calcium sensitization. Beta-blockers (negative inotropes) directly oppose this, potentially precipitating heart failure decompensation.
Management: Generally avoid combining positive inotrope with beta-blocker in decompensated CHF. If used for arrhythmia control, start beta-blocker at very low dose with careful titration.

Moderate — 2

Atenolol
moderate
Pimobendan is a positive inotrope; beta-blockers have negative inotropic effects. Opposing cardiac actions.
Management: Generally avoid concurrent use in systolic dysfunction. May be acceptable in specific arrhythmia cases with cardiology guidance.
Diltiazem
moderate
Diltiazem is a negative inotrope (calcium channel blocker) that may partially oppose pimobendan's positive inotropy. However, commonly combined in practice for DCM + atrial fibrillation.
Management: Used together clinically under cardiologist supervision. Monitor echocardiographic response.

Minor — 3

Benazepril
minor
Standard CHF combination. Complementary mechanisms — pimobendan (inodilator) + ACE inhibitor (afterload reduction). No pharmacokinetic interaction.
Management: First-line combination for DMVD stage B2/C per ACVIM consensus. Monitor renal function and blood pressure.
Furosemide
minor
Standard CHF triple therapy. Complementary mechanisms. No significant pharmacokinetic interaction.
Management: Cornerstone CHF therapy. Monitor renal function and electrolytes.
Atropine Sulfate
minor
Atropine-induced tachycardia increases myocardial oxygen demand in patients with heart disease. Pimobendan already increases inotropy/chronotropy.
Management: Use atropine cautiously in cardiac patients on pimobendan. Glycopyrrolate (no CNS effects) may be preferred preanesthetic anticholinergic.

Brands

International

Vetmedin
Boehringer Ingelheim
Cardisure
Dechra

India

Pimocard
Intas

FAQs

Frequently asked questions

›What is Pimobendan?
Pimobendan is a positive inotrope / vasodilator (inodilator) — phosphodiesterase iii inhibitor + calcium sensitiser used in pets. Increases myocardial contractility by sensitising troponin C to calcium and inhibiting PDE III; also causes vasodilation, reducing preload and afterload
›What is Pimobendan used for in pets?
Pimobendan is used in veterinary medicine for: Congestive heart failure (DMVD, DCM); Pre-clinical DMVD (EPIC trial — stage B2).
›What is the Pimobendan dose for dogs?
For dogs, Pimobendan is typically dosed as follows — Congestive heart failure (DMVD, DCM): 0.2–0.3 mg/kg PO BID; Pre-clinical DMVD (EPIC trial — stage B2): 0.2–0.3 mg/kg PO BID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What are the side effects of Pimobendan?
Common: Increased appetite, Diarrhoea, Lethargy (transient). Serious (call your vet immediately): Arrhythmias, Sudden death (in non-cardiac disease), Increased mitral regurgitation.
›Does Pimobendan need a prescription?
Yes. Pimobendan is a prescription medication and should only be administered under veterinary supervision.
›When should Pimobendan not be used?
Do not use Pimobendan if: Hypertrophic cardiomyopathy (HCM); Aortic stenosis / subaortic stenosis.

References

CDSCO approvals (India) — 2

Pimobendan 5mg tablet
M/s Boehringer Ingelheim India Ltd · Approved 17.06.2019
for the treatment of canine congestive heart failure originating from dilated cardiomyopathy or valvular insufficiency m
Pimobendan chewable tablets 1.25 mg 2.5mg, 5mg and 10mg brand name cardisure Fla
M/s Panav Bio-Tech, · Approved 20.04.2022
For treatment of canine congestive heart failure orginating from valvular insufficiency mitral and /or tricuspid regurgi
Source: CDSCO Veterinary Drug Approval Registry (1969–2026)

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →