Effects of a finnish sauna on the pharmacokinetics and haemodynamic actions of propranolol and captopril in healthy volunteers

Abstract

The effects of a Finnish sauna on propranolol pharmacokinetics and on the pharmacodynamics of propranolol and captopril were studied in healthy, young volunteers (2 males, 6 females) in a double-blind, cross-over trial. The subjects received single oral doses of placebo, propranolol (40 mg) or captopril (12.5 mg) in sauna and control sessions at a one-week interval. The sauna sessions consisted of three repetitive 10-min stays in a sauna (85-100 degrees C, relative humidity 25-35%) separated by two 5-min rest periods in a cool room. Sauna bathing started 35, 50 and 65 min after ingestion of the drugs. Venous blood for plasma propranolol measurement were collected before and 15, 30, 45, 60, 75, 90 min and 2, 3, 4, 5, 7 and 24 h after drug intake. The sauna significantly increased the maximum concentration (Cmax 41 vs. 28 ng.ml-1) of propranolol and the mean plasma propranolol concentration 60 and 90 min, and 2 and 3 h after drug administration. It also significantly increased the AUC0-5h (119 vs 71 micrograms.h.l-1) of propranolol from 0 to 5 hours tmax, t1/2 beta and AUC0-24h of propranolol did not differ between the control and sauna sessions. The higher propranolol levels during and after the cessation of sauna bathing did not lead to significant changes in blood pressure or heart rate compared to the control period. Captopril had no major effects on these parameters during the post-sauna phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Simulation of differential drug pharmacokinetics under heat and exercise stress using a physiologically based pharmacokinetic modeling approach

“…During heat exposure, the slight C max increase of midazolam during sauna sessions (80-100°C) compared with that under normothermic conditions with no change in clearance (IV not different) suggests a faster rate of absorption, although the authors suggest that this has little clinical significance (Vanakoski et al 1996). While propanolol C max is increased during similar heat exposures, there was no change in the 24 h area under the curve (Vanakoski and Seppälä 1995). In the case of heat, little clinical significance is expected because of slightly altered absorption kinetics (Vanakoski and Seppälä 1998).…”

Epidemiologie und Prävention hitzebedingter Gesundheitsschäden älterer Menschen

“…B. trizyklische Antidepressiva oder β-Rezeptoren-Blocker. So steigt bei großer Hitze beispielsweise die Plasma-Konzentration von Propranolol um 67 % an, was mit verstärkter Pulsverlangsamung einhergeht [81]. Die WHO empfiehlt, dass Risikopersonen in Hitzewellen mindestens täglich besucht werden sollen [47].…”

Sauna as a Therapeutic Option for Cardiovascular Disease

“…[22][23][24] Although there is no adverse effect from sauna on healthy people receiving ␤-blockers, 33,34 there have been reports of a hypotensive reaction caused by sauna use in hypertensive patients receiving ␤-blockade 25,26 or short-acting nitroglycerin 27 resulting from the hypotensive effects of these medications. However, hypertensive patients receiving calcium channel blockers, 26 digitalis, 23 or diuretics 23 tolerate sauna well.…”