THE DOSE an Estimation of Equivalent Doses Between Arbs and Aceis
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Effects of Lacidipine, Ramipril and Valsartan on Serum BNP Levels in Acute and Chronic Periods Following Isoproterenol-Induced Myocardial Infarction in Rats
Original Article Effects of Lacidipine, Ramipril and Valsartan on Serum BNP Levels in Acute and Chronic Periods Following Isoproterenol-Induced Myocardial Infarction in Rats Lasidipin, Ramipril ve Valsartanın Sıçanlarda Isoprotrenol ile Uyarılan Miyokard Infarktüsü Sonrası Akut ve Kronik Periyotta Serum BNP Seviyeleri Üzerine Etkileri Yasin Bayir1, Elif Cadirci2, Halis Suleyman2, Zekai Halici2, Mevlut Sait Keles3 1Ataturk University, Faculty of Pharmacy, Department of Biochemistry, Erzurum, Turkey 2Ataturk University, Faculty of Medicine, Department of Pharmacology, Erzurum, Turkey 3Ataturk University, Faculty of Medicine, Department of Biochemistry, Erzurum, Turkey Correspondence to: Elif Cadirci, Ph.D., Atatürk University, Faculty of Medicine, Department of Pharmacology, 25240, Erzurum, Turkey. Phone: +90.442.2316563, Fax: +90.442.2360968, e-mail: [email protected] Abstract Özet Objective. Myocardial infarction (MI) as a result of cardiovas- Amaç. Miyokard infarktüsü (Mİ) hem gelişmiş hem de cular disease is the principal cause of death in both developed gelişmekte olan ülkelerde kardiyovasküler hastalıklar sonucu and developing countries. Brain natriuretic peptide (BNP) is an oluşan ölümün esas sebebidir. Brain natriuretic peptide (BNP) important marker of cardiac failure. Cardioprotective activities kardiyak hasarın önemli bir göstergesidir. Antihipertansif il- of the antihypertensive drugs lacidipine (LAC), ramipril (RAM) açlar olan lasidipin (LAC), ramipril (RAM) ve valsartanın, izo- and valsartan (VAL), against isoproterenol -
Key Features of Candesartan Cilexetil and a Comparison with Other Angiotensin II Receptor Antagonists
Journal of Human Hypertension (1999) 13, (Suppl 1), S3–S10 1999 Stockton Press. All rights reserved 0950-9240/99 $12.00 Key features of candesartan cilexetil and a comparison with other angiotensin II receptor antagonists PS Sever Imperial College of Science, Technology & Medicine at St Mary’s Hospital, London, UK Current research on angiotensin II AT1-receptor antag- in patients with essential hypertension. Candesartan onists (AIIRAs) and selected studies presented at the cilexetil has a rapid onset of action (approximately 80% recent symposium held in Amsterdam, The Netherlands, of total blood pressure reduction within the first 2 on 6 June 1998, titled ‘Angiotensin II Receptor Antagon- weeks) and dose-dependent effects on blood pressure, ists are NOT all the Same’ are reviewed. AIIRAs offer a is comparable in efficacy to a number of classes of anti- number of potential advantages over alternative antihy- hypertensives, and is effective in combination therapy pertensive agents acting via the renin-angiotensin-aldo- (eg, with hydrochlorothiazide and amlodipine). This sterone system. They combine blood pressure-lowering favourable profile may be due in part to the highly selec- effects at least equivalent to those of angiotensin-con- tive, tight binding to and slow dissociation of candesar- verting enzyme (ACE) inhibitors, coupled with placebo- tan from the AT1 receptor. Preliminary studies suggest like tolerability. Candesartan cilexetil is a novel AIIRA that candesartan cilexetil also protects end organs that has demonstrated clinical -
Apo-Cilazapril/Hydrochlorothiazide Film Coated Tablet
New Zealand Data Sheet APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE 1. PRODUCT NAME APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE – cilazapril 5mg and hydrochlorothiazide 12.5mg film coated tablets. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Cilazapril monohydrate 5.22mg (equivalent to Cilazapril 5mg) and Hydrochlorothiazide 12.5mg Excipient(s) with known effect HYDROCHLOROTHIAZIDE contains sulphur. APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE is lactose free and gluten free. APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE contains Red Ferric Oxide (orange shade # 34690). For the full list of excipients, see section 6.1 3. PHARMACEUTICAL FORM APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE are pink, oval biconvex film-coated tablets. Each tablet is engraved “APO” on one side and “5” bisect “12.5” on the other side. Each tablet typically weighs 92mg. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE is indicated for the treatment of patients with hypertension who are not adequately controlled on monotherapy. 4.2 Dose and method of administration Standard Dosage The dosage of APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE is one tablet administered once daily. As food intake has no clinically significant influence on absorption, APO- CILAZAPRIL/HYDROCHLOROTHIAZIDE can be administered before or after meals. The dose should always be taken at about the same time of day. Special Populations Renal insufficiency When concomitant diuretic therapy is required in patients with severe renal impairment, a loop diuretic rather than a thiazide diuretic is preferred for use with cilazapril/hydrochlorothiazide; therefore, for patients with severe renal dysfunction (creatinine Please refer to Medsafe website (www.medsafe.govt.nz) for the most recent datasheet Page 1 of 22 APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE clearance <10ml/min), APO-CILAZAPRIL/HYDROCHLOROTHIAZIDE is not recommended. -
Effective Dose Range of Enalapril in Mild to Moderate Essential Hypertension
Br. J. clin. Pharmac. (1985), 19, 605-611 Effective dose range of enalapril in mild to moderate essential hypertension R. BERGSTRAND', H. HERLITZ2, SAGA JOHANSSON', G. BERGLUND2, A. VEDIN', C. WILHELMSSON', H. J. GOMEZ3, V. J. CIRILLO3 & J. A. BOLOGNESE4 'Department of Medicine, Ostra Hospital and 2Department of Medicine I, Sahlgrenska Hospital, Goteborg, Sweden and Department of 3Cardiovascular Clinical Research and 4Clinical Biostatistics, Merck Sharp & Dohme Research Laboratories, Rahway, New Jersey, USA 1 The dose-response relationship of enalapril was evaluated in a double-blind, balanced, two-period, incomplete-block study in 91 patients with mild to moderate essential hyper- tension. 2 Patients were randomly assigned to two of six treatments: placebo, 2.5, 5, 10, 20 and 40 mg/day of enalapril maleate. There were two 3-week treatment periods, each preceded by a 4-week, single-blind placebo washout. 3 Each dose of enalapril produced significant decreases in standing and supine systolic and diastolic blood pressure after 2 and 3 weeks of treatment. There were no significant changes on placebo. 4 There was a significant linear dose response relationship for both mean blood pressure and mean change from baseline in blood pressure (P < 0.01 for systolic and mean arterial pressure, and P < 0.05 for diastolic pressure). 5 Enalapril was associated with an increasing dose-response relationship across the 2.5- 40 mg/day range. The 2.5 mg/dose is effective in some patients; however, doses ¢ 10 mg/ day may be necessary to achieve satisfactory blood pressure control. Keywords enalapril angiotensin converting enzyme inhibitor dose-response relationship Introduction In recent years much interest has been focused with renal impairment treated with high doses of on angiotensin converting enzyme (ACE) in- captopril. -
A Comparison of the Tolerability of the Direct Renin Inhibitor Aliskiren and Lisinopril in Patients with Severe Hypertension
Journal of Human Hypertension (2007) 21, 780–787 & 2007 Nature Publishing Group All rights reserved 0950-9240/07 $30.00 www.nature.com/jhh ORIGINAL ARTICLE A comparison of the tolerability of the direct renin inhibitor aliskiren and lisinopril in patients with severe hypertension RH Strasser1, JG Puig2, C Farsang3, M Croket4,JLi5 and H van Ingen4 1Technical University Dresden, Heart Center, University Hospital, Dresden, Germany; 2Department of Internal Medicine, La Paz Hospital, Madrid, Spain; 31st Department of Internal Medicine, Semmelweis University, Budapest, Hungary; 4Novartis Pharma AG, Basel, Switzerland and 5Novartis Institutes for Biomedical Research, Cambridge, MA, USA Patients with severe hypertension (4180/110 mm Hg) LIS 3.4%). The most frequently reported AEs in both require large blood pressure (BP) reductions to reach groups were headache, nasopharyngitis and dizziness. recommended treatment goals (o140/90 mm Hg) and At end point, ALI showed similar mean reductions from usually require combination therapy to do so. This baseline to LIS in msDBP (ALI À18.5 mm Hg vs LIS 8-week, multicenter, randomized, double-blind, parallel- À20.1 mm Hg; mean treatment difference 1.7 mm Hg group study compared the tolerability and antihyperten- (95% confidence interval (CI) À1.0, 4.4)) and mean sitting sive efficacy of the novel direct renin inhibitor aliskiren systolic blood pressure (ALI À20.0 mm Hg vs LIS with the angiotensin converting enzyme inhibitor À22.3 mm Hg; mean treatment difference 2.8 mm Hg lisinopril in patients with severe hypertension (mean (95% CI À1.7, 7.4)). Responder rates (msDBPo90 mm Hg sitting diastolic blood pressure (msDBP)X105 mm Hg and/or reduction from baselineX10 mm Hg) were 81.5% and o120 mm Hg). -
Perindopril | Memorial Sloan Kettering Cancer Center
PATIENT & CAREGIVER EDUCATION Perindopril This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider. Brand Names: US Aceon [DSC] Brand Names: Canada AG-Perindopril; APO-Perindopril; Auro-Perindopril; BIO-Perindopril; Coversyl; JAMP-Perindopril; M-Perindopril Erbumine; MAR-Perindopril; MINT- Perindopril; NRA-Perindopril; PMS-Perindopril; Priva-Perindopril Erbumine; RIVA-Perindopril; SANDOZ Perindopril Erbumine; TEVA-Perindopril Warning Do not take if you are pregnant. Use during pregnancy may cause birth defects or loss of the unborn baby. If you get pregnant or plan on getting pregnant while taking this drug, call your doctor right away. What is this drug used for? It is used to treat high blood pressure. It is used to lower the risk of heart attack and death from heart disease in certain people. It may be given to you for other reasons. Talk with the doctor. Perindopril 1/7 What do I need to tell my doctor BEFORE I take this drug? If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have ever had a very bad or life-threatening reaction called angioedema. Signs may be swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; unusual hoarseness. If you have kidney disease. If you are taking a drug that has aliskiren in it and you also have diabetes or kidney problems. -
AVAPRO Rx Only (Irbesartan) Tablets
NDA 20-757/S-038 Page 3 ® AVAPRO Rx only (irbesartan) Tablets USE IN PREGNANCY When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. When pregnancy is detected, AVAPRO should be discontinued as soon as possible. See WARNINGS: Fetal/Neonatal Morbidity and Mortality. DESCRIPTION ®* AVAPRO (irbesartan) is an angiotensin II receptor (AT1 subtype) antagonist. Irbesartan is a non-peptide compound, chemically described as a 2-butyl-3-[p-(o-1H-tetrazol-5- ylphenyl)benzyl]-1,3-diazaspiro[4.4]non-1-en-4-one. Its empirical formula is C25H28N6O, and the structural formula: Irbesartan is a white to off-white crystalline powder with a molecular weight of 428.5. It is a nonpolar compound with a partition coefficient (octanol/water) of 10.1 at pH of 7.4. Irbesartan is slightly soluble in alcohol and methylene chloride and practically insoluble in water. AVAPRO is available for oral administration in unscored tablets containing 75 mg, 150 mg, or 300 mg of irbesartan. Inactive ingredients include: lactose, microcrystalline cellulose, pregelatinized starch, croscarmellose sodium, poloxamer 188, silicon dioxide and magnesium stearate. CLINICAL PHARMACOLOGY Mechanism of Action Angiotensin II is a potent vasoconstrictor formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system (RAS) and also stimulates aldosterone synthesis and secretion by adrenal NDA 20-757/S-038 Page 4 cortex, cardiac contraction, renal resorption of sodium, activity of the sympathetic nervous system, and smooth muscle cell growth. -
Download Leaflet View the Patient Leaflet in PDF Format
Package leaflet: Information for the patient Fosinopril Sodium 10 mg Tablets Fosinopril Sodium 20 mg Tablets Fosinopril sodium Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet 1. What Fosinopril is and what it is used for 2. What you need to know before you take Fosinopril 3. How to take Fosinopril 4. Possible side effects 5. How to store Fosinopril 6. Contents of the pack and other information. 1. What Fosinopril is and what is it used for Fosinopril belongs to the class of medicines called Angiotensin Converting Enzyme (ACE) inhibitors that act on the heart and blood vessels. You may have been given Fosinopril to: • lower your blood pressure if it is too high (a condition called hypertension) • help your heart pump blood around your body if you have a condition known as heart failure and are also being treated with diuretics (medicines which help to remove excess fluid from the body). 2. What you need to know before you take Fosinopril Do not take Fosinopril: • if you are allergic to fosinopril or any other ACE inhibitor, or any of the other ingredients of this medicine (listed in section 6). -
Summary of Product Characteristics
Proposed var 24 psusa cilazapril SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT [Fosinopril sodium 10 mg, tablets] [Fosinopril sodium 20 mg, tablets] 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 10 or 20 mg fosinopril sodium. Excipient with known effect: Each tablet fosinopril sodium 10 mg contains 87 mg of lactose, anhydrous. Each tablet fosinopril sodium 20 mg contains 174 mg of lactose, anhydrous. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Tablet. The 10 mg tablets are white and shaped like a capsule with indents. On one side they are engraved with the letters “APO” and on the other side with “FOS-10”. The 20 mg tablets are white and their shape is oval. On one side they are engraved with the letters “APO” and on the other side with “FOS-20”. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications - Treatment of hypertension. - Treatment of symptomatic heart failure. 4.2 Posology and method of administration Posology Fosinopril sodium should be administered orally in a single daily dose. As with all other medicinal products taken once daily, it should be taken at approximately the same time each day. The absorption of fosinopril sodium is not affected by food. The dose should be individualised according to patient profile and blood pressure response (see section 4.4). Hypertension: Fosinopril sodium may be used as a monotherapy or in combination with other classes of antihypertensive medicinal products (see section 4.3, 4.4, 4.5 and 5.1). Hypertensive patients not being treated with diuretics: Starting dose The initial recommended dose is 10 mg once a day. -
Accupril® (Quinapril Hydrochloride Tablets)
Accupril® (Quinapril Hydrochloride Tablets) WARNING: FETAL TOXICITY When pregnancy is detected, discontinue ACCUPRIL as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See Warnings: Fetal Toxicity DESCRIPTION ACCUPRIL® (quinapril hydrochloride) is the hydrochloride salt of quinapril, the ethyl ester of a non-sulfhydryl, angiotensin-converting enzyme (ACE) inhibitor, quinaprilat. Quinapril hydrochloride is chemically described as [3S-[2[R*(R*)], 3R*]]-2-[2-[[1- (ethoxycarbonyl)-3-phenylpropyl]amino]-1-oxopropyl]-1,2,3,4-tetrahydro-3- isoquinolinecarboxylic acid, monohydrochloride. Its empirical formula is C25H30N2O5 •HCl and its structural formula is: Quinapril hydrochloride is a white to off-white amorphous powder that is freely soluble in aqueous solvents. ACCUPRIL tablets contain 5 mg, 10 mg, 20 mg, or 40 mg of quinapril for oral administration. Each tablet also contains candelilla wax, crospovidone, gelatin, lactose, magnesium carbonate, magnesium stearate, synthetic red iron oxide, and titanium dioxide. CLINICAL PHARMACOLOGY Mechanism of Action: Quinapril is deesterified to the principal metabolite, quinaprilat, which is an inhibitor of ACE activity in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor, angiotensin II. The effect of quinapril in hypertension and in congestive heart failure (CHF) appears to result primarily from the inhibition of circulating and tissue ACE activity, thereby reducing angiotensin II formation. Quinapril inhibits the elevation in blood pressure caused by intravenously administered angiotensin I, but has no effect on the pressor response to angiotensin II, norepinephrine or epinephrine. Angiotensin II also stimulates the secretion of aldosterone from the adrenal cortex, thereby facilitating renal sodium and fluid reabsorption. -
Quinapril, an ACE Inhibitor, Reduces Markers of Oxidative Stress in the Metabolic Syndrome
Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes ORIGINAL ARTICLE Quinapril, an ACE Inhibitor, Reduces Markers of Oxidative Stress in the Metabolic Syndrome 1 3 BOBBY V. KHAN, MD, PHD W. CRAIG HOOPER, PHD ing the link between inflammation, met- 1 1 SRIKANTH SOLA, MD REKHA G. MENON, MD abolic disorders, and cardiovascular 1 1 WRIGHT B. LAUTEN, BS STAMATIOS LERAKIS, MD 2 1 disease (5,6). Chronic inflammation and RAMA NATARAJAN, PHD TAREK HELMY, MD an abnormal pro-oxidant state are both found in the metabolic syndrome and may play a role in its pathogenesis (7,8). The renin-angiotensin system (RAS) plays a central role in the pathogenesis of OBJECTIVE — Patients with the metabolic syndrome often have abnormal levels of proin- atherosclerosis-related diseases. Angio- flammatory and pro-oxidative mechanisms within their vasculature. We sought to determine tensin II, the central molecule in the RAS, whether the ACE inhibitor quinapril regulates markers of oxidative stress in the metabolic syndrome. has multiple effects on inflammation, ox- idation, atherosclerotic plaque initiation, RESEARCH DESIGN AND METHODS — Forty patients with the metabolic syndrome and progression (9). In the present study, were randomized in a double-blind manner to either the ACE inhibitor quinapril (20 mg/day) or we determine potential mechanisms by matching placebo for 4 weeks. Serum markers of vascular oxidative stress were measured. which the administration of the ACE in- hibitor quinapril regulates mechanisms of RESULTS — After 4 weeks of therapy, serum 8-isoprostane was reduced by 12% in the oxidative stress in subjects with the met- Ϯ Ϯ quinapril group when compared with placebo (quinapril, 46.7 1.0; placebo, 52.7 0.9 abolic syndrome. -
Ace Inhibitors (Angiotensin-Converting Enzyme)
Medication Instructions Ace Inhibitors (Angiotensin-Converting Enzyme) Generic Brand Benazepril Lotensin Captopril Capoten Enalapril Vasotec Fosinopril Monopril Lisinopril Prinivil, Zestril Do not Moexipril Univasc Quinapril Accupril stop taking Ramipril Altace this medicine Trandolapril Mavik About this Medicine unless told ACE inhibitors are used to treat both high blood pressure (hypertension) and heart failure (HF). They block an enzyme that causes blood vessels to constrict. This to do so allows the blood vessels to relax and dilate. Untreated, high blood pressure can damage to your heart, kidneys and may lead to stroke or heart failure. In HF, using by your an ACE inhibitor can: • Protect your heart from further injury doctor. • Improve your health • Reduce your symptoms • Can prevent heart failure. Generic forms of ACE Inhibitors (benazepril, captopril, enalapril, fosinopril, and lisinopril) may be purchased at a lower price. There are no “generics” for Accupril, Altace Mavik, and of Univasc. Thus their prices are higher. Ask your doctor if one of the generic ACE Inhibitors would work for you. How to Take Use this drug as directed by your doctor. It is best to take these drugs, especially captopril, on an empty stomach one hour before or two hours after meals (unless otherwise instructed by your doctor). Side Effects Along with needed effects, a drug may cause some unwanted effects. Many people will not have any side effects. Most of these side effects are mild and short-lived. Check with your doctor if any of the following side effects occur: • Fever and chills • Hoarseness • Swelling of face, mouth, hands or feet or any trouble in swallowing or breathing • Dizziness or lightheadedness (often a problem with the first dose) Report these side effects if they persist: • Cough – dry or continuing • Loss of taste, diarrhea, nausea, headache or unusual fatigue • Fast or irregular heartbeat, dizziness, lightheadedness • Skin rash Special Guidelines • Sodium in the diet may cause you to retain fluid and increase your blood pressure.