Clinical pharmacokinetics of the nifedipine/co-dergocrine combination in impaired liver and renal function

Abstract

Following a single oral dose of 20 mg nifedipine combined with 2 mg co-dergocrine to 24 subjects, the pharmacokinetics of this drug were studied. 8 normotensive subjects had normal renal and hepatic function, 8 patients had chronic renal insufficiency (creatinine clearance less than 30 ml.min-1) and 8 patients had liver cirrhosis which was confirmed by liver biopsy. The area under the plasma level time curve (AUC infinity) of co-dergocrine increased from 0.59 +/- 0.41 ng.ml-1. (mean +/- SD) in the normals to 1.24 +/- 0.95 ng.ml-1.h in liver cirrhosis (P less than 0.05) and to 1.81 +/- 0.9 ng.ml-1.h in renal failure (P less than 0.05 compared with the control group). Corresponding values for the nifedipine AUC infinity were 564.5 +/- 268 ng.ml-1.h, 1547.5 +/- 1134 (P less than 0.05) and 929 +/- 533 ng.ml-1.h (P less than 0.05; gas chromatographic method). The incidence of adverse effects was lower in patients with renal failure than in subjects with normal renal and liver function as well as in those with liver cirrhosis.

Single Dose Pharmacokinetics of α-Dihydroergocryptine in Patients with Moderate to Severe Renal Insufficiency

“…Similar results were reported for co-dergocrine (a mixture of hydrogenated ergot alkaloids including αdihydroergocrytine). C max and AUC (0-ϱ) were 2.3 times and 3 times higher in patients with renal failure as compared to a control group [13]. A study in elderly patients found a marked reduction of approximately 50 % in renal clearance of co-dergocrine related to the decrease in creatinine clearance in this population [14].…”