Elimination of nadolol by patients with renal impairment.

Herrera, J; Vukovich, R. A.; Griffith, D. L.

doi:10.1111/j.1365-2125.1979.tb04694.x

Cited by 31 publications

(17 citation statements)

References 10 publications

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“…With improved blood and effluent flows and better catheters and filters, these data are expected to be more favorable. For example, atenolol clearance by ECTR has tripled in 30 years [ 78 , 101 ], bisoprolol clearance has doubled in 20 years [ 98 , 101 ], and nadolol clearance has increased by 50% in 5 years [ 75 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

et al. 2021

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Background β-adrenergic antagonists (BAAs) are used to treat cardiovascular disease such as ischemic heart disease, congestive heart failure, dysrhythmias, and hypertension. Poisoning from BAAs can lead to severe morbidity and mortality. We aimed to determine the utility of extracorporeal treatments (ECTRs) in BAAs poisoning. Methods We conducted systematic reviews of the literature, screened studies, extracted data, and summarized findings following published EXTRIP methods. Results A total of 76 studies (4 in vitro and 2 animal experiments, 1 pharmacokinetic simulation study, 37 pharmacokinetic studies on patients with end-stage kidney disease, and 32 case reports or case series) met inclusion criteria. Toxicokinetic or pharmacokinetic data were available on 334 patients (including 73 for atenolol, 54 for propranolol, and 17 for sotalol). For intermittent hemodialysis, atenolol, nadolol, practolol, and sotalol were assessed as dialyzable; acebutolol, bisoprolol, and metipranolol were assessed as moderately dialyzable; metoprolol and talinolol were considered slightly dialyzable; and betaxolol, carvedilol, labetalol, mepindolol, propranolol, and timolol were considered not dialyzable. Data were available for clinical analysis on 37 BAA poisoned patients (including 9 patients for atenolol, 9 for propranolol, and 9 for sotalol), and no reliable comparison between the ECTR cohort and historical controls treated with standard care alone could be performed. The EXTRIP workgroup recommends against using ECTR for patients severely poisoned with propranolol (strong recommendation, very low quality evidence). The workgroup offered no recommendation for ECTR in patients severely poisoned with atenolol or sotalol because of apparent balance of risks and benefits, except for impaired kidney function in which ECTR is suggested (weak recommendation, very low quality of evidence). Indications for ECTR in patients with impaired kidney function include refractory bradycardia and hypotension for atenolol or sotalol poisoning, and recurrent torsade de pointes for sotalol. Although other BAAs were considered dialyzable, clinical data were too limited to develop recommendations. Conclusions BAAs have different properties affecting their removal by ECTR. The EXTRIP workgroup assessed propranolol as non-dialyzable. Atenolol and sotalol were assessed as dialyzable in patients with kidney impairment, and the workgroup suggests ECTR in patients severely poisoned with these drugs when aforementioned indications are present.

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Section: Resultsmentioning

confidence: 99%

Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

et al. 2021

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“…Higher variability could be seen in PK of nadolol during the first year of life, that's why it is recommended that close monitoring should be done during treatment with nadolol in infants 7 . The serum t ½ of nadolol was prolonged up to 45 h in a patient with severe renal failure thus to minimize the accumulation of nadolol in the body, there is a need to adjust the dosage interval according to the creatinine clearance of the individual patient 19 . Haemodialysis was an effective way to remove the drug from the body and significantly reduced the serum t ½ of nadolol 19 …”

Section: Discussionmentioning

confidence: 99%

“…Nadolol is contraindicated in asthma, chronic obstructive pulmonary disease (COPD), cardiogenic shock, decompensated heart failure, sinus bradycardia, and allergy to nadolol 3 . The primary route of nadolol elimination is renal therefore the serum t ½ of the drug is increased in the presence of renal impairment which leads to the accumulation of nadolol in the kidneys and may cause serious adverse effects 19 . Nadolol can be removed by haemodialysis from the body in end‐stage renal disease patients 19 …”

Section: What Is Known and Objectivementioning

confidence: 99%

“…The primary route of nadolol elimination is renal therefore the serum t ½ of the drug is increased in the presence of renal impairment which leads to the accumulation of nadolol in the kidneys and may cause serious adverse effects 19 . Nadolol can be removed by haemodialysis from the body in end‐stage renal disease patients 19 …”

Section: What Is Known and Objectivementioning

confidence: 99%

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Clinical pharmacokinetics of nadolol: A systematic review

Kalsoom

Zamir

Rehman

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objective: Nadolol is a non-selective beta-adrenergic antagonist that is used for the treatment of hypertension and angina. The primary route for its administration is oral. It is given once daily as it has a longer half-life (t½). The purpose of conducting this systematic review is to provide a comprehensive view of all the available pharmacokinetic (PK) data on nadolol in humans. This review aimed to systematically collate and analyze publish data on the clinical PK of nadolol in humans and this can be beneficial for the clinicians in dosage adjustments.Methods: Two electronic databases PubMed and Google Scholar were used for conducting a systematic literature search. All the relevant articles containing PK data of nadolol in humans were retrieved. A total of 1275 articles were searched from both databases and after applying eligibility criteria finally, 22 articles were included for conducting the systematic review.Results and discussion: The area under the plasma concentration curve (AUC) and maximum plasma concentration (C max ) of nadolol increased in a dose-dependent manner. The t½ of nadolol was increased to double (18.2-68.6 h) in the patients with chronic kidney disease while the serum t½ became shorter (3.2-4.3 h) when administered to the children. The bioavailability of nadolol was greatly reduced by the coadministration of green tea. Nadolol can be effectively removed by hemodialysis. It undergoes enterohepatic circulation thus activated charcoal decreased its bioavailability.What is new and conclusion: Since, there is no previous report of a systematic review on the PK of nadolol, the current review encompasses all the relevant published articles on nadolol in humans. The analysis and understanding of PK parameters (AUC, C max , and t½) of nadolol may be helpful in the development and evaluation of PK models.

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“…The mean serum half-life of nadolol was decreased from 39.2 hours before dialysis to 4.4 hours during dialysis. 21 Since the drug undergoes biliary excretion, hepatic dysfunction could potentially alter its elimination; however, insufficient data exist to analyze this relationship. The lipid solubility of nadolol is perhaps lower than that of propranolol or metoprolol since, in dogs, only minimal amounts of nadolol were detected in the brain relative to amounts found in other body fluids and tissues.…”

Section: Pharmacokineticsmentioning

confidence: 99%