Enoximone ๐
โน๏ธ About
Always check the BNF link here ๐ for the most up-to-date guidance.
โ๏ธ Mode of Action
- Enoximone is a phosphodiesterase-3 (PDE-3) inhibitor ๐.
- Increases intracellular cAMP in cardiac myocytes โ enhanced calcium influx โ positive inotropy (increased contractility).
- Also causes vasodilation by relaxing vascular smooth muscle โ reduced preload and afterload.
๐ Indications & Dose
| Indication | Dose / Frequency | Route |
| Acute decompensated congestive cardiac failure (CCF) |
0.5โ1 mg/kg IV (max infusion rate 12.5 mg/min), then 500 mcg/kg every 30 min, titrated to response.
Maximum: 3 mg/kg over 3โ6 h. |
IV |
โ ๏ธ Reserved for short-term management of severe, refractory heart failure when standard therapy is insufficient.
โ ๏ธ Interactions
- See BNF. May interact with other inotropes, vasodilators, and anti-arrhythmics.
๐ Cautions
- Use only under specialist supervision with close monitoring (ECG, BP, renal function).
- Hypotension and arrhythmias are common risks โก.
๐ซ Contraindications
- Avoid in hypertrophic obstructive cardiomyopathy (HOCM) or severe valve stenosis (risk of worsening obstruction).
โ Side Effects
- Hypotension, tachyarrhythmias, chest pain โค๏ธ.
- GI upset (nausea, vomiting, diarrhoea) ๐คข.
- Thrombocytopenia (rare).
๐ References
๐ Revisions
- Added mechanism detail and clarified dosing/monitoring pearls.