Nephrotoxicity Associated With Concomitant ACE Inhibitor and NSAID Therapy

Seelig, Charles B.; Maloley, Pierre A.; Campbell, James

doi:10.1097/00007611-199010000-00007

Cited by 57 publications

(21 citation statements)

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“…Renal dysfunction is known to affect the pharmacokinetics and pharmacodynamics of all ACE inhibitors, often necessitating lower dosages in patients with renal impairment [10]. ACE inhibitors and NSAIDs are commonly co-prescribed and the co-administration of these drugs is associated with significant nephrotoxicity [11,12] as well as a reduction in the hypotensive efficacy of the ACE inhibitor [13,14].…”

Section: Discussionmentioning

confidence: 99%

The effect of tenidap on the anti‐hypertensive efficacy of ACE inhibitors in patients treated for mild to moderate hypertension.

Rapeport

Grimwood

Hosie

et al. 1995

Brit J Clinical Pharma

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1 A randomised, placebo controlled, double-blind, parallel group study was conducted to assess the effect of tenidap sodium, a novel cytokine modulating drug, on the stable hypotensive response to the angiotension converting enzyme (ACE) inhibitor enalapril in subjects with mild to moderate, uncomplicated, essential hypertension. 2 Twenty-four male and female hypertensives, aged 33-77 years, received either 120 mg tenidap sodium or matched placebo daily for 22 days concomitantly with enalapril. 3 Mean endpoint supine and standing, systolic and diastolic pressures remained within 10% of baseline in each treatment group. However, the endpoint values were marginally above baseline during double-blind treatment with tenidap and marginally below baseline in the group receiving placebo. The increases in supine and standing systolic pressures in the tenidap group differed significantly from the changes in the placebo group. There were no significant differences between groups in changes in pulse rate. 4 Gastrointestinal side effects of mild to moderate severity attributed to treatment with tenidap were experienced by five subjects, one of whom was withdrawn during the third week of treatment. One subject receiving placebo was withdrawn because of a moderate headache attributed to study treatment. 5 The results of this study suggest that treatment with tenidap may interfere with the anti-hypertensive efficacy of ACE inhibitors. It is recommended that blood pressure should be monitored when tenidap is administered concomitantly with an ACE inhibitor.

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Section: Discussionmentioning

confidence: 99%

The effect of tenidap on the anti‐hypertensive efficacy of ACE inhibitors in patients treated for mild to moderate hypertension.

Rapeport

Grimwood

Hosie

et al. 1995

Brit J Clinical Pharma

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“…As also mentioned before, the combination of an angiotensin I converting enzyme inhibitor with a non-steroidal anti-inftammatory drug should be avoided, especially in patients with a pretreatment impaired glomerular filtration rate [50][51][52]. During these combined treatment regimens the patient is also at greater risk for the development of h yperkalemia.…”

Section: Risk For Combined Treatmentmentioning

confidence: 98%

Renal injury from angiotensin I converting enzyme inhibitors

Jong¹,

Woods²

1998

Clinical Nephrotoxins

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“…diabetes mellitus) and those who are receiving ACE inhibitors. [24,36) In patients receiving NSAIDs, it is possible to experimentally demonstrate an accentuation of the action of antidiuretic hormone, which manifests as an increase in the ability to concentrate the urine and a reduction in the capacity to clear free water. However, in practice, hyponatraemia is a rare clinical © Adis International Limited.…”

Section: Renal Effects Of Nonsteroidal Anti-inflammatory Drugs (Nsaids)mentioning

confidence: 99%

Nonsteroidal Anti-Inflammatory Drugs and Acute Renal Failure in the Elderly

Ailabouni

Eknoyan

1996

Drugs & Aging

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most valuable groups of available medications because of their effectiveness in relieving pain, particularly that associated with rheumatoid arthritis. They are also among the most commonly prescribed drugs and, because of their availability over-the-counter, they are among the most widely consumed agents, especially by elderly people. Older individuals are more predisposed to the renal adverse effects of NSAIDs, because of: (i) age-associated changes in renal function; (ii) the prevalence of comorbid conditions (congestive heart failure, hypertension, hepatic cirrhosis, renal insufficiency); and (iii) the pervasive use of concomitant drugs that affect kidney function (diuretics, antihypertensives). However, because the incidence of NSAID-induced acute renal failure (ARF) is relatively low, and because it occurs in an identifiable and therefore preventable setting, the benefits of limited NSAID use outweigh the risks of this adverse effect. Using NSAIDs for a restricted period of time at the lowest effective dosage, and informing patients of the conditions in which ARF can occur, should minimise the risk of this effect. If the use of an NSAID in a patient at potential risk of ARF is necessary, close monitoring of renal function should further reduce the already low risk:benefit ratio for this adverse effect.

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Nephrotoxicity Associated With Concomitant ACE Inhibitor and NSAID Therapy

Cited by 57 publications

References 0 publications

The effect of tenidap on the anti‐hypertensive efficacy of ACE inhibitors in patients treated for mild to moderate hypertension.

The effect of tenidap on the anti‐hypertensive efficacy of ACE inhibitors in patients treated for mild to moderate hypertension.

Renal injury from angiotensin I converting enzyme inhibitors

Nonsteroidal Anti-Inflammatory Drugs and Acute Renal Failure in the Elderly

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