Haemodialysis does not affect the pharmacokinetics of nifedipine.

Martre, H.; Sari, Ratih Pratiwi; Taburet, A. M.; Jacobs, C; Singlas, E

doi:10.1111/j.1365-2125.1985.tb05049.x

Cited by 26 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, the pharmacokinetics of these new calcium antagonists in renal failure did not differ from those obtained in subjects with normal renal function, as already reported for nifedipine (Kleinbloesem et al 1985;Martre et al 1985), nicardipine (Clair et al 1985;Lee et al 1986), felodipine (Edgar et al 1989), isradipine (Chandler et al 1988;Schran et al 1988), nisoldipine (Boelaert et al 1988Van Harten et al 1989), amlodipine (Doyle et al 1989) and nitrendipine (Ankermann et al 1989;Aronoff & Sloan 1985;Bortel et al 1989).…”

Section: Calcium Antagonistssupporting

confidence: 71%

See 1 more Smart Citation

Pharmacokinetics of Newer Drugs in Patients with Renal Impairment (Part II)

Singlas

Fillastre

1991

Clinical Pharmacokinetics

View full text Add to dashboard Cite

Cardiovascular diseases occur frequently in patients with renal failure. Any pharmacokinetic impairment in these diseases should be considered when individualizing drug therapy. The pharmacokinetics of new cardiovascular drugs in uraemic patients are reviewed: alpha- and beta-blocking agents, ACE inhibitors, centrally acting antihypertensive agents, calcium antagonists, antiarrhythmic agents and inotropic agents. Guidelines are proposed for adjustment of dosage regimens as a function of renal impairment. Renal or extrarenal elimination of drugs and their metabolites, and the activity of the latter, are taken into account. The disposition of new drugs such as flestolol, alacepril, delapril, propafenone, milrinone or enoximone, is not well documented in patients with renal failure. Further characterizations of the elimination of these compounds are needed and the potential therapeutic or toxic effects of the metabolites require evaluation to determine whether the dosage needs to be adjusted. Until such investigations are performed, those drugs should not be used in uraemic patients; if no therapeutic alternative is available, clinical controls are necessary at regular intervals. Relationships between pharmacological or therapeutic effects and drug plasma concentrations should be evaluated for such long term use drugs. The knowledge of a plasma concentration therapeutic window is important to provide information which will be useful in determining appropriate drug dosage in renal failure.

show abstract

Section: Calcium Antagonistssupporting

confidence: 71%

“…The protein binding of nisoldipine (Boelaert et al 1988), felodipine (Edgar et al 1989) and nitrendipine (Bortel et al 1989) did not change in uraemic patients, whereas that of nifedipine was decreased (Kleinbloesem et al 1985;Martre et al 1985); as a result, V ss and t'l2 were increased.…”

Section: Calcium Antagonistsmentioning

confidence: 99%

Pharmacokinetics of Newer Drugs in Patients with Renal Impairment (Part II)

Singlas

Fillastre

1991

Clinical Pharmacokinetics

View full text Add to dashboard Cite

show abstract

“…In these studies the effect of haemodialysis on drug disposition was not studied. There are only a few studies of calcium antagonist pharmacokinetics in patients with end stage renal failure on regular haemodialysis and for nifedipine there were no significant differences (Kleinbloesem et al, 1986;Martre et al, 1985).…”

Section: Discussionmentioning

confidence: 98%

Inhibitory effect of uraemia on the hepatic clearance and metabolism of nicardipine.

Ahmed

Grant

Rodger

et al. 1991

Brit J Clinical Pharma

View full text Add to dashboard Cite

“…Drug dialysability can be evaluated by different parameters, such as dialysis clearance, extraction ratio of the dialyzer, fractional drug removal or half-life. However, each parameter has advantages and disadvantages (19,20). In our study, we used three parameters to evaluated NlT dialysability: dialysisclearance (Cl HO ) ' dialyzer extraction ratio (E HO ) and the amount removed (Ar).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and dialysability of naltrexone in patients undergoing hemodialysis

Kambia

Dine

Odou³

et al. 2004

European Journal of Drug Metabolism and Pharmacokinetics

View full text Add to dashboard Cite

The disposition of naltrexone (NLT) (REVIA), an opioid antagonist intended for patients with impaired renal function and with severe intractable itching refractory to regular antipruritic therapy, was characterized. Hemodialysis effects on both efficacy and elimination of NLT also were assessed. We developed a simple, sensitive and selective reverse-phase high-performance liquid chromatographic (HPLC) method for measuring NLT plasma concentration in hemodialysis patients treated to relieve pruritus. NLT and the internal standard, naloxone (NLX) were extracted from plasma using a solid-phase extraction method with sep-pack C18 cartridge. The method was employed to determine both naltrexone pharmacokinetics and dialysability parameters during 4-h in dialyzed patients with chronic renal impairment. Thus, seven patients (2 men, 5 women) with end-stage renal disease and pruritus on regular hemodialysis were included. They received one tablet of NLT (Revia, 50 mg) orally prior dialysis session. The Cmax at the inlet and at the outlet the dialyzer were higher (255+/-117 ng/mL and 206+/-137 ng/ml respectively) in comparison with healthy subjects (9 - 44 ng/mL). The decrease hepatic first-pass metabolism of NLT consecutive to end-stage renal disease and the renal impairment could explain the increased levels of the drug in plasma. Tmax before and after dialysis plates remain unchanged as healthy subjects (approximately 1h). With regard to dialysability, a high dialyzer extraction ratio averating 30 % was found with a low dialysis clearance of 58.70+/-17 mL/min. The amount removed by dialysis is only 1.27 mg. We concluded that hemodialysis has little effect on NLT blood levels, and consequently on drug pharmacokinetics, when the drug is delivered to dialyzed patients following oral route. Thus, dosage adjustement is not required in the presence of advanced dialysis-dependant renal failure. In patients with end-stage renal disease, hemodialysis does not result in clinically significant alterations in the disposition of NLT. Post-dialysis supplementation is not required. These data suggest that there is no pharmacokinetic basis for modification of the initial dosage, but in view of NLT plasma concentration levels in the patients, a clinician could determine whether dosage adjustment are necessary and, if so, make the required calculations accurately.

show abstract

Haemodialysis does not affect the pharmacokinetics of nifedipine.

Cited by 26 publications

References 13 publications

Pharmacokinetics of Newer Drugs in Patients with Renal Impairment (Part II)

Pharmacokinetics of Newer Drugs in Patients with Renal Impairment (Part II)

Inhibitory effect of uraemia on the hepatic clearance and metabolism of nicardipine.

Pharmacokinetics and dialysability of naltrexone in patients undergoing hemodialysis

Contact Info

Product

Resources

About