 Moreover, a few studies inferred that tolerance may develop with long-term administration of NAPA, necessitating increased doses.There are no specific dosage recommendations for patients with left ventricular dysfunction, although care should be taken to reduce the dose in patients with moderate to severe renal dysfunction.The loading dose of this medicine is 15–18 mg/kg administered over 30 to 60 minutes for people without insufficient renal function or decreased cardiac output and 12 mg/kg for people with this disorders.