A single dose comparison of piretanide and bumetanide in congestive cardiac failure.

Abstract

1 This study has compared the diuresis produced by a single oral administration of 6 mg piretanide, 9 mg piretanide and 1 mg bumetanide in a group of nine patients with cardiac failure using a balanced randomized design. 2 The natriuresis and kaliuresis produced in the first 6 h after administration of piretanide 9 mg and bumetanide 1 mg were similar. Piretanide 6 mg produced a lesser response. 3 There was evidence of sodium and water conservation following the diuresis for up to 48 h with all three treatments. 4 The patterns of urate and calcium excretion were similar for the two diuretics.

The effects of a combination of piretanide and triamterene in healthy subjects.

“…*P <0.05, **P <0.01. duced a potent natriuresis which was complete within 6 h of oral administration of the drug. Sodium output in the 6 h following drug administration and in the first 24 h period was larger than that obtained previously in normal volunteers (Roberts et al, 1978) and considerably greater than that obtained in patients with congestive cardiac failure (Homeida et al, 1979). Triamterene alone produced a natriuresis which was complete within the 12 h following drug administration and was less than that previously reported in normal volunteers (Cattell & Havard, 1962).…”

“…In man, piretanide 6 mg and frusemide 40 mg orally are approximately equipotent (Roberts, Homeida, Roberts & Bogie, 1978). In patients with cardiac failure 9 mg piretanide produces a similar diuresis to 1 mg bumetanide (Homeida, Roberts & Dombey, 1979) and piretanide has been shown to be an effective diuretic in renal insufficiency (Pozet, Hadj-Aissa, Pellet & Traeger, 1980). Piretanide has a duration of action of about 6 h (Lawrence, Ansari, Elliot, Sumner, Brunton, Whiting & Whitesmith, 1978).…”

Assessment of natriuretic drugs.

“…However, because of altered renal sodium handling and pharmacokinetic variations the potency of the diuresis achieved may be less and the dose response relationship may be different. Also the degree of kaliuresis and hypokalaemia may be exaggerated by the presence of hyper-aldosteronism and the effects of the drug on uric acid handling may be less clear-cut (Homeida, Dombey & Roberts, 1979). It is therefore important to elucidate a new drug's basic pharmacological effects in normal man.…”

“…Secondly, the diuretic administration itself causes improvement in the patient's condition, and thus affects the baseline against which further drug administration must be tested. In order to overcome the latter problem we have recommended that at least 48 h should elapse between administration of test drugs (Homeida et al, 1979). Such a period without therapy can only be tolerated by patients with lesser degrees of cardiac failure.…”

Oral piretanide in chronic renal failure.

“…Studies already published indicate that piretanide is an effective salidiuretic agent in normal volunteers (Teredesai & Puschett, 1979) and in patients with congestive cardiac failure (Homeida et al, 1979). It has been shown to be inefficient in normal doses in severe renal insufficiency (Pozet et al, 1980 On the day of the study, the patients were waterloaded with 1 1 at 08.00 h and thereafter, for the duration of the study hydration was maintained by consumption of an equivalent amount of water to urine voided.…”