Clinical pharmacology of tolmesoxide in refractory heart failure

The haemodynamic effects and pharmacokinetics of single intravenous doses of tolmesoxide, a new vasodilator agent, were studied in 6 patients with severe cardiac failure secondary to ischaemic cardiomyopathy and refractory to concentional therapy. The mean (±SEM) baseline cardiac index (CI) and pulmonary artery diastolic pressure (PADP) were 1.7±0.11/ min/m2 and 30.5±4.1 mm Hg respectively. The mean % rise in CI was 78.8±23.3 and the mean % fall in PADP was 35.2±5.2. The mean half life of tolmesoxide in these patients was markedly prolonged at 15.6±6.6h. Side effects were minimal — vomiting was seen in 1 patient. This agent warrants further study in the long term management of refractory cardiac failure.