1
|
Cong Y, Du C, Wang M, Jiang Z, Xing K, Bian Y, Wang M. Investigation on the Hansen solubility parameter, solvent effect and thermodynamic analysis of indapamide dissolution and molecular dynamics simulation. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2021.116489] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
2
|
Lin Z, Wong LYF, Cheung BMY. Diuretic-induced hypokalaemia: an updated review. Postgrad Med J 2021; 98:477-482. [PMID: 33688065 DOI: 10.1136/postgradmedj-2020-139701] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/24/2022]
Abstract
Diuretic-induced hypokalaemia is a common and potentially life-threatening adverse drug reaction in clinical practice. Previous studies revealed a prevalence of 7%-56% of hypokalaemia in patients taking thiazide diuretics. The clinical manifestations of hypokalaemia due to diuretics are non-specific, varying from asymptomatic to fatal arrhythmia. Diagnosis of hypokalaemia is based on the level of serum potassium. ECG is useful in identifying the more severe consequences. A high dosage of diuretics and concomitant use of other drugs that increase the risk of potassium depletion or cardiac arrhythmias can increase the risk of cardiovascular events and mortality. Thiazide-induced potassium depletion may cause dysglycaemia. The risk of thiazide-induced hypokalaemia is higher in women and in black people. Reducing diuretic dose and potassium supplementation are the most direct and effective therapies for hypokalaemia. Combining with a potassium-sparing diuretic or blocker of the renin-angiotensin system also reduces the risk of hypokalaemia. Lowering salt intake and increasing intake of vegetables and fruits help to reduce blood pressure as well as prevent hypokalaemia.
Collapse
Affiliation(s)
- Ziying Lin
- Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Louisa Y F Wong
- Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Bernard M Y Cheung
- Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong .,State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
3
|
Alexander RT, Dimke H. Effect of diuretics on renal tubular transport of calcium and magnesium. Am J Physiol Renal Physiol 2017; 312:F998-F1015. [DOI: 10.1152/ajprenal.00032.2017] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/22/2017] [Accepted: 02/27/2017] [Indexed: 01/07/2023] Open
Abstract
Calcium (Ca2+) and Magnesium (Mg2+) reabsorption along the renal tubule is dependent on distinct trans- and paracellular pathways. Our understanding of the molecular machinery involved is increasing. Ca2+ and Mg2+ reclamation in kidney is dependent on a diverse array of proteins, which are important for both forming divalent cation-permeable pores and channels, but also for generating the necessary driving forces for Ca2+ and Mg2+ transport. Alterations in these molecular constituents can have profound effects on tubular Ca2+ and Mg2+ handling. Diuretics are used to treat a large range of clinical conditions, but most commonly for the management of blood pressure and fluid balance. The pharmacological targets of diuretics generally directly facilitate sodium (Na+) transport, but also indirectly affect renal Ca2+ and Mg2+ handling, i.e., by establishing a prerequisite electrochemical gradient. It is therefore not surprising that substantial alterations in divalent cation handling can be observed following diuretic treatment. The effects of diuretics on renal Ca2+ and Mg2+ handling are reviewed in the context of the present understanding of basal molecular mechanisms of Ca2+ and Mg2+ transport. Acetazolamide, osmotic diuretics, Na+/H+ exchanger (NHE3) inhibitors, and antidiabetic Na+/glucose cotransporter type 2 (SGLT) blocking compounds, target the proximal tubule, where paracellular Ca2+ transport predominates. Loop diuretics and renal outer medullary K+ (ROMK) inhibitors block thick ascending limb transport, a segment with significant paracellular Ca2+ and Mg2+ transport. Thiazides target the distal convoluted tubule; however, their effect on divalent cation transport is not limited to that segment. Finally, potassium-sparing diuretics, which inhibit electrogenic Na+ transport at distal sites, can also affect divalent cation transport.
Collapse
Affiliation(s)
- R. Todd Alexander
- Membrane Protein Disease Research Group, Department of Physiology, University of Alberta, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada; and
| | - Henrik Dimke
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
4
|
Ölçer A, Ölçer M, İnce I, Karasulu E. The advantages of combination therapy on hypertension: development of immediate release perindopril-indapamide tablet and assessment of bioequivalence studies. Pharm Dev Technol 2016; 21:239-49. [PMID: 26794937 DOI: 10.3109/10837450.2014.991878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Hypertension has a major associated risk for organ damage and mortality, which is further heightened in patients with prior cardiovascular events, comorbid diabetes mellitus, microalbuminuria and renal impairment. Convers Plus tablet including perindopril erbumine (PE), which is an angiotensin converting enzyme (ACE) inhibitor, and indapamide, which is diuretic, was designed as a combined tablet to succes in the treatment of hypertension. Physico-pharmaceutical properties and characterization studies were evaluated in vitro conditions. Later on in vivo study was planned as a cross-designed, randomized, open-labeled, single-dose, single-center study via peroral route in 24 healthy male subjects. In this study, bioequivalence with primary pharmacokinetical target parameters reference (Bipreterax 4/1.25 mg Tablet-S.A.Servier Benelux N.V.) and test (Convers Plus 4/1.25 mg Tablet-ARGESAN Pharmaceutical Company) tablets have been found bioequivalent. The results of pharmacokinetic parameters for perindopril, perindoprilat and indapamide were found as Cmax = 23.179 µg/mL, tmax = 0.729 h, t1/2 = 1.429 h; AUC0-t = 26.998 µgs/mL, AUC0-inf = 27.117 µgs/mL; Cmax = 1.834 µg/mL, tmax = 8.792 h, t1/2 = 40.699 h; AUC0-t = 54.828 µgs/mL, AUC0-inf = 77.113 µgs/mL; Cmax = 18.994 µg/mL, tmax = 3.417 h, t1/2 = 16.626 h and AUC0-t = 385.829 µgs/mL, AUC0-inf = 410.728 µgs/mL respectively. In conclusion, physico-pharmaceutical properties and results of clinical trials show that Convers Plus tablets have been found as bioequivalent for perindopril, perindoprilat and indapamide in terms of AUC and Cmax, in 90% confidence limits.
Collapse
Affiliation(s)
- A Ölçer
- a Argis Pharmaceuticals Inc. Co. , Ankara , Turkey and
| | - M Ölçer
- a Argis Pharmaceuticals Inc. Co. , Ankara , Turkey and
| | - I İnce
- b Center for Drug R&D and Pharmacokinetic Applications, Ege University , Bornova , Izmir , Turkey
| | - E Karasulu
- b Center for Drug R&D and Pharmacokinetic Applications, Ege University , Bornova , Izmir , Turkey
| |
Collapse
|
5
|
Roush GC, Ernst ME, Kostis JB, Tandon S, Sica DA. Head-to-head comparisons of hydrochlorothiazide with indapamide and chlorthalidone: antihypertensive and metabolic effects. Hypertension 2015; 65:1041-6. [PMID: 25733245 DOI: 10.1161/hypertensionaha.114.05021] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/07/2015] [Indexed: 12/27/2022]
Abstract
Hydrochlorothiazide (HCTZ) has often been contrasted with chlorthalidone, but relatively little is known about HCTZ versus indapamide (INDAP). This systematic review retrieved 9765 publications, and from these, it identified 14 randomized trials with 883 patients comparing HCTZ with INDAP and chlorthalidone on antihypertensive potency or metabolic effects. To make fair comparisons, the dose of the diuretic in each arm was assigned 1 of 3 dose levels. In random effects meta-analysis, INDAP and chlorthalidone lowered systolic blood pressure more than HCTZ: -5.1 mm Hg (95% confidence interval, -8.7 to -1.6); P=0.004 and -3.6 mm Hg (95% confidence interval, -7.3 to 0.0); P=0.052, respectively. For both comparisons, there was minimal heterogeneity in effect across trials and no evidence for publication bias. The HCTZ-INDAP contrast was biased in favor of greater HCTZ potency because of a much greater contribution to the overall effect from trials in which the HCTZ arm had a higher dose level than the INDAP arm. For the HCTZ-INDAP comparison, no single trial was responsible for the overall result nor was it possible to detect significant modifications of this comparison by duration of follow-up, high- versus low-bias trials, or the presence or absence of background medications. There were no detectable differences between HCTZ and INDAP in metabolic adverse effects, including effects on serum potassium. In conclusion, these head-to-head comparisons demonstrate that, like chlorthalidone, INDAP is more potent than HCTZ at commonly prescribed doses without evidence for greater adverse metabolic effects.
Collapse
Affiliation(s)
- George C Roush
- From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick (J.B.K.); and Department of Medicine and Pharmacology, Virginia Commonwealth University, Richmond (D.A.S.).
| | - Michael E Ernst
- From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick (J.B.K.); and Department of Medicine and Pharmacology, Virginia Commonwealth University, Richmond (D.A.S.)
| | - John B Kostis
- From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick (J.B.K.); and Department of Medicine and Pharmacology, Virginia Commonwealth University, Richmond (D.A.S.)
| | - Suraj Tandon
- From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick (J.B.K.); and Department of Medicine and Pharmacology, Virginia Commonwealth University, Richmond (D.A.S.)
| | - Domenic A Sica
- From the Department of Medicine, University of Connecticut School of Medicine and St. Vincent's Medical Center, Bridgeport (G.C.R., S.T.); Department of Family Medicine, University of Iowa Hospital and Clinics, Iowa City (M.E.E.); Department of Medicine, Cardiovascular Institute, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick (J.B.K.); and Department of Medicine and Pharmacology, Virginia Commonwealth University, Richmond (D.A.S.)
| |
Collapse
|
6
|
|
7
|
Gao X, Chen J, Mei N, Tao W, Jiang W, Jiang X. HPLC Determination and Pharmacokinetic Study of Indapamide in Human Whole Blood. Chromatographia 2005. [DOI: 10.1365/s10337-005-0548-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
8
|
Cremonesi G, Cavalieri L, Cikes I, Dobovisek J, Bacchelli S, Degli Esposti D, Costa FV, Borghi C, Ambrosioni E. Fixed combinations of delapril plus indapamide vs fosinopril plus hydrochlorothiazide in mild to moderate essential hypertension. Adv Ther 2002; 19:129-37. [PMID: 12201354 DOI: 10.1007/bf02850269] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This 12-week randomized, parallel-group, multicenter study compared fixed combinations of delapril (D) 30 mg plus indapamide (I) 2.5 mg and fosinopril (F) 20 mg plus hydrochlorothiazide (H) 12.5 mg in 171 adult patients with mild to moderate essential hypertension. After a 2-week placebo run-in, sitting and standing systolic (SBP) and diastolic blood pressure (DBP) was measured by conventional sphygmomanometry. The primary efficacy endpoint was the percentage of normalized (sitting DBP < or =90 mm Hg) and responder (sitting DBP reduction of 10 mm Hg or DBP < or =90 mm Hg) patients. Treatment effects were analyzed in the intention-to-treat (ITT; n = 171) and the per-protocol (PP; n = 167) populations. The percentage of normalized and responder patients did not differ significantly between the D + I (87.4% and 92%) and the F + H (81% and 86.9%) ITT groups. Similar results were seen in the PP population. In ITT and PP patients, sitting and standing SBP and DBP values were comparable at baseline in the two groups and were significantly (P<.01) and similarly reduced at weeks 4, 8, and 12. Neither treatment induced reflex tachycardia, and both regimens were well tolerated. Four patients in the F + H group dropped out because of adverse events. In this study, the efficacy and safety of D + I were comparable to those of F + H in patients with mild to moderate essential hypertension.
Collapse
|
9
|
Pickkers P, Schachter M, Hughes AD, Feher MD, Sever PS. Thiazide-induced hyperglycaemia: a role for calcium-activated potassium channels? Diabetologia 1996; 39:861-4. [PMID: 8817113 DOI: 10.1007/s001250050522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- P Pickkers
- Department of Clinical Pharmacology, St. Mary's Hospital Medical School, London, UK
| | | | | | | | | |
Collapse
|
10
|
Indapamide. ACTA ACUST UNITED AC 1994. [DOI: 10.1016/s0099-5428(08)60604-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
11
|
Mascioli S, Gonzalez NM. Use of Antihypertensive Agents with Particular Comorbid Problems. Clin Geriatr Med 1989. [DOI: 10.1016/s0749-0690(18)30659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|