Tanaka Hirotaka, Nagasawa Yasuyuki, Matsui Isao, Hamano Takayuki, Iwatani Hirotsugu, Kawada Noritaka, Horio Masaru, Ito Takahito, Isaka Yoshitaka, Imai Enyu
Department of Nephrology, Osaka University Graduate School of Medicine, B6 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Clin Exp Nephrol. 2009 Feb;13(1):61-5. doi: 10.1007/s10157-008-0067-0. Epub 2008 Jun 24.
Olmesartan medoxomil is a new angiotensin-2 receptor blocker (ARB). Its pharmacokinetics in hemodialysis patients has not been investigated. We evaluated the pharmacokinetics of olmesartan medoxomil in six patients on maintained hemodialysis. We divided these six patients into two groups; one group (n = 3) took the drug when hemodialysis started (HD day group), and the other group (n = 3) took in the morning on non-dialysis day (non HD day group). In each group, plasma concentrations of olmesartan were evaluated seven points after drug administration. In each point, blood pressure and heart rate were also measured. On HD day group, plasma concentrations in upstream of dialyser were compared with those in downstream of dialyser in three points. The area under the plasma concentration-time curve (AUC) in HD day group had no remarkable difference from those in non-HD day group. Another pharmacokinetic parameter, such as maximum plasma drug concentration (C (max)), biological half-life (t (1/2)) and time to reach C (max) (t (max)), were almost similar in both groups. Blood pressure and heart rate showed the same consequence as well. This result suggests that plasma concentration of olmesartan medoxomil does not decrease during hemodialysis, and that it is not necessary to change prescription on hemodialysis day or not.
奥美沙坦酯是一种新型血管紧张素 II 受体阻滞剂（ARB）。其在血液透析患者中的药代动力学尚未得到研究。我们评估了奥美沙坦酯在 6 例维持性血液透析患者中的药代动力学。我们将这 6 例患者分为两组；一组（n = 3）在血液透析开始时服用药物（HD 日组），另一组（n = 3）在非透析日早晨服用（非 HD 日组）。在每组中，给药后 7 个时间点评估奥美沙坦的血浆浓度。在每个时间点，还测量血压和心率。在 HD 日组中，比较了透析器上游三个时间点与下游三个时间点的血浆浓度。HD 日组的血浆浓度-时间曲线下面积（AUC）与非 HD 日组相比无显著差异。其他药代动力学参数，如最大血浆药物浓度（C（max））、生物半衰期（t（1/2））和达到 C（max）的时间（t（max）），在两组中也几乎相似。血压和心率也呈现相同结果。该结果表明，奥美沙坦酯的血浆浓度在血液透析期间不会降低，并且在透析日与否时无需更改处方。
