Six-Month Treatment of Congestive Heart Failure with Ibopamine:
A Double-Blind Randomized, Placebo-Controlled Multicenter Trial

Kayanakis, J G

doi:10.1159/000470497

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Since in these doses epinine acts only at DA-receptors (see above) these results provide direct evidence that ibopamine -in the above mentioned doses-exerts its effects only through activation of DA-2 (and possibly DA-1) receptors but does not affect ~-and fi-adrenergic receptors. Thus, the beneficial effects of ibopamine observed in treatment of patients with chronic heart failure (Henwood and Todd 1989;Taylor 1989;Spencer et al 1993;Kayanakis 1991) are not due to/3-or c~-adrenoceptor stimulation but are very likely due to activation of only DA-2 (and DA-1) receptors.…”

Section: Discussionmentioning

confidence: 99%

Dose-dependent separation of dopaminergic and adrenergic effects of epinine in healthy volunteers

Daul

Elter-Schulz

Poller

et al. 1995

Naunyn-Schmiedeberg's Arch Pharmacol

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Epinine (N-methyl-dopamine, the active metabolite of ibopamine), is a full agonist at dopamine (DA)-receptors and alpha- and beta-adrenoceptors. To study whether in vivo DA-receptors mediated effects can be separated from alpha- and beta-adrenoceptor effects we compared in 10 male volunteers the effects of i.v. epinine (0.5; 1; 2; 4 micrograms/kg/min for 15 min each) on DA-receptor (changes in serum prolactin)- and alpha- and beta-adrenoceptor (changes in systolic [Psyst] and diastolic blood pressure [Pdiast] and heart rate)-mediated effects with those of dopamine before and after propranolol (5 mg i.v. 45 min pre-infusion), bisoprolol (15 mg p.o. 2 h pre-infusion) and domperidone (10 mg p.o. 1 h pre-infusion). At the 0.5 and 1 microgram doses of dopamine and epinine did not effect Psyst, Pdiast and heart rate but significantly decreased prolactin levels. At the higher dose both dopamine and epinine significantly increased Psyst and heart rate, while only epinine significantly increased Pdiast. In addition, both dopamine and epinine significantly increased diuresis and natriuresis; in contrast, only dopamine, but not epinine dose-dependently increased plasma noradrenaline levels. Domperidone did not affect dopamine- and epinine-evoked blood pressure- and heart rate-changes, but antagonized their prolactin-effects (at least at the lower doses). Bisoprolol and propranolol significantly reduced dopamine-induced Psyst- and heart rate-increases to about the same extent. Propranolol enhanced epinine-induced Psyst- and Pdiast-increases while bisoprolol reduced epinine-evoked Psyst-increase but not Pdiast-increase. Epinine-induced heart rate-increase was abolished by bisoprolol and was converted into heart rate-decrease by propranolol. We concluded that in 0.5 and 1 microgram doses (plasma levels of 20-80 nmol/l)epinine acts only at DA-receptors. Thus, ibopamine in therapeutically recommended doses (3 x 100 mg/day with peak plasma epinine-levels of 50-80 nmol/l) very likely activates only DA-receptors. In higher doses, however, epinine-like dopamine-activates alpha- and beta-adrenoceptors whereby epinine has a stronger alpha-adrenoceptor agonistic activity than dopamine. Moreover, part of the dopamine-effects are indirect via release of endogenous noradrenaline whereas epinine-effects do not appear to include an indirect component.

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Section: Discussionmentioning

confidence: 99%

Dose-dependent separation of dopaminergic and adrenergic effects of epinine in healthy volunteers

Daul

Elter-Schulz

Poller

et al. 1995

Naunyn-Schmiedeberg's Arch Pharmacol

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“…but also on its vasodilating properties [24][25][26][27], Other studies have re ported that ibopamine improves abnormali ties induced by cardiac disease in the sympa thetic nerve system, renin-angiotensin system and antidiuretic hormones [28],…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Effects and Pharmacokinetics of Long-Term Therapy with Ibopamine in Patients with Chronic Heart Failure

Itoh¹,

Taniguchi²,

Tsujibayashi³

et al. 1992

Cardiology

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To evaluate the attenuation of the effectiveness of long-term ibopamine therapy, ibopamine was administered in single doses of 100 and 200 mg to 10 patients with chronic heart disease. The hemodynamic studies using Swan-Ganz catheter and pharmacokinetic studies were carried out. Ibopamine was found to increase cardiac output and stroke index and to decrease systemic vascular resistance in this acute study. Six patients underwent long-term therapy with the drug and were evaluated for the development of tolerance. Three out of 5 patients experienced an improvement in NYHA functional class after 12-23 weeks of treatment. There was no attenuation in the effects of ibopamine on hemodynamics, pharmacokinetic parameters remained almost unchanged, and tolerance was not observed. These results suggest that ibopamine is useful as an orally administered anti-heart failure drug.

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Clinical efficacy of ibopamine in patients with chronic heart failure

Metra

Del

1995

Clin Cardiol

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Summary: Ibopamine, the most widely studied dopaminergic drug for the treatment of chronic heart failure, appears to have beneficial hemodynamic, renal, and neurohormonal effects in this setting. Angiotension-converting enzyme (ACE) inhibitors have become the recommended standard treatment for chronic heart failure; however, some patients may benefit from additional drugs to improve their symptoms and functional capacity. Ihopamine may be effective as an additive drug for patients with chronic heart failure. It is also possible that ibopamine will improve survival in these patients. Large-scale trials are needed to assess the effects on morbidity and mortality when ibopamine is added to ACE inhibitors, diuretics, and possibly digitalis.

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Six-Month Treatment of Congestive Heart Failure with Ibopamine: A Double-Blind Randomized, Placebo-Controlled Multicenter Trial

Cited by 4 publications

References 7 publications

Dose-dependent separation of dopaminergic and adrenergic effects of epinine in healthy volunteers

Dose-dependent separation of dopaminergic and adrenergic effects of epinine in healthy volunteers

Hemodynamic Effects and Pharmacokinetics of Long-Term Therapy with Ibopamine in Patients with Chronic Heart Failure

Clinical efficacy of ibopamine in patients with chronic heart failure

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