Enoximone

How it works

By inhibiting phosphodiesterase type 3 it raises intracellular cyclic AMP, increasing myocardial contractility and causing peripheral vasodilatation (inodilator effect).

Prescribing in practice

• It is for short-term use under specialist supervision and can cause hypotension and arrhythmias, requiring continuous haemodynamic and cardiac monitoring.
• Reserve for severe heart failure where other treatments are inadequate, given the lack of benefit and potential harm with prolonged inotrope use.
• Use with caution in hypovolaemia and in outflow-tract obstruction such as significant aortic or pulmonary stenosis.

Monitoring

Monitor blood pressure, cardiac rhythm and haemodynamic status continuously during administration in a monitored setting.

Counselling the patient

• This is a hospital infusion given under close monitoring.
• The care team should watch blood pressure and cardiac rhythm closely.
• It is intended only for short-term circulatory support.

Evidence & guidelines

Phosphodiesterase inhibitors improve haemodynamics in acute heart failure but long-term inotrope use is associated with increased mortality, so their role is limited to short-term support.