RESUMO
Most patients inadvertently miss an occasional dose of antihypertensive therapy, and hence drugs that provide sustained blood-pressure (BP) reduction beyond the 24-h dosing interval are desirable. The primary objective of this study was to compare the 24-h mean ambulatory BP reductions from baseline after a simulated missed dose of the direct renin inhibitor aliskiren, irbesartan or ramipril. In this double-blind study, 654 hypertensive patients (24-h mean ambulatory diastolic BP (MADBP) >or=85 mm Hg) were randomized 1:1:1 to once-daily aliskiren 150 mg, irbesartan 150 mg or ramipril 5 mg. Doses were doubled after 2 weeks. At day 42, patients were again randomized equally within each group to receive 1 day of placebo ('missed dose') on either day 42 or day 49. Patients with a successful 24-h ambulatory BP measurement at baseline and on day 42/49 were included in the analyses. The 24-h mean ambulatory systolic BP (MASBP)/MADBP reductions from baseline after a missed dose of aliskiren 300 mg (9.3/7.0 mm Hg) were similar to irbesartan 300 mg (9.5/7.3 mm Hg) and significantly larger than ramipril 10 mg (7.1/5.0 mm Hg, PAssuntos
Amidas/administração & dosagem
, Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem
, Inibidores da Enzima Conversora de Angiotensina/administração & dosagem
, Anti-Hipertensivos/administração & dosagem
, Compostos de Bifenilo/administração & dosagem
, Pressão Sanguínea/efeitos dos fármacos
, Fumaratos/administração & dosagem
, Hipertensão/tratamento farmacológico
, Adesão à Medicação
, Ramipril/administração & dosagem
, Tetrazóis/administração & dosagem
, Adulto
, Idoso
, Amidas/efeitos adversos
, Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos
, Inibidores da Enzima Conversora de Angiotensina/efeitos adversos
, Anti-Hipertensivos/efeitos adversos
, Compostos de Bifenilo/efeitos adversos
, Monitorização Ambulatorial da Pressão Arterial
, Brasil
, Canadá
, Método Duplo-Cego
, Esquema de Medicação
, Europa (Continente)
, Feminino
, Fumaratos/efeitos adversos
, Humanos
, Hipertensão/fisiopatologia
, Irbesartana
, Masculino
, Pessoa de Meia-Idade
, Ramipril/efeitos adversos
, Tetrazóis/efeitos adversos
, Fatores de Tempo
, Resultado do Tratamento
RESUMO
Antiepileptic drugs, especially carbamazepine and phenytoin, are potent liver enzyme inducers. Since praziquantel, the drug used to treat neurocysticercosis, undergoes extensive liver first-pass metabolism, we carried out a prospective study to verify whether there was a decrease in oral bioavailability induced by carbamazepine and phenytoin. Carbamazepine and phenytoin significantly decreased concentrations of praziquantel, due to increased clearance secondary to induction of first pass-liver metabolism. The magnitude of the decrease is surprisingly high and may be responsible for failures of treatment.