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Denosumab‐induced hypophosphataemia in a case of normocalcaemic primary hyperparathyroidism

effects. We hypothesise that this novel extended release formulation of oral milrinone trialled here will abrogate many of the previously noted adverse effects and in the current patient no evidence of hypotension or proarrhythmia was observed. Intravenous inotropic therapy is commonly used in decompensated HFREF, to improve cardiac output and organ perfusion and decrease congestion. A key objective of ongoing HF therapy is the commencement or reintroduction of anti-failure therapies, including ACE-I/ ARB (angiotensin receptor blockade), beta blockers and MRA (mineralocorticoid receptor antagonists). In some cases, it may not be possible to wean inotropic therapy or to recommence anti-failure due to hypotension or precipitating symptoms of low output. In this patient, introduction of anti-failure therapy was only possible with the provision of oral inotropic support. Further studies are required to determine safety and efficacy in larger groups of patients with advanced heart failure.