Santiago T M, Lopez L M
Department of Pharmacy Services, Veterans Administration Medical Center, Gainesville, FL.
DICP. 1990 Feb;24(2):167-75. doi: 10.1177/106002809002400211.
Nitrendipine, an investigational dihydropyridine calcium-channel antagonist for the treatment of hypertension, is reviewed. Clinical trials report efficacy equal to that of hydralazine, diuretics, beta-blockers, and other calcium-channel blockers such as nifedipine, verapamil, and isradipine. Nitrendipine has a favorable pharmacokinetic profile in that it is well absorbed and has a half-life long enough to allow once-daily administration in some patients. However, considerable variation observed with some pharmacokinetic parameters has consequently delayed marketing approval by the Food and Drug Administration. Adverse effects are generally mild and transient, and result from nitrendipine's vasodilatory properties. Nitrendipine may increase digoxin plasma concentrations in some patients, but this may not be clinically significant. Other studies are required to ascertain which drugs interact with nitrendipine. In summary, nitrendipine is safe and effective for treatment of hypertension, and because of its longer duration of action as well as lack of metabolic side effects, may provide an alternative to the present antihypertensive armamentarium.
对用于治疗高血压的研究性二氢吡啶类钙通道拮抗剂尼群地平进行了综述。临床试验报告显示,其疗效与肼屈嗪、利尿剂、β受体阻滞剂以及其他钙通道阻滞剂(如硝苯地平、维拉帕米和伊拉地平)相当。尼群地平具有良好的药代动力学特征,即吸收良好,半衰期足够长,使得部分患者能够每日给药一次。然而,一些药代动力学参数存在显著差异,因此美国食品药品监督管理局推迟了其上市批准。不良反应通常较为轻微且短暂,是由尼群地平的血管舒张特性引起的。尼群地平可能会使部分患者的地高辛血浆浓度升高,但这在临床上可能并不显著。还需要进行其他研究以确定哪些药物与尼群地平相互作用。总之,尼群地平治疗高血压安全有效,由于其作用持续时间较长且缺乏代谢副作用,可能为目前的抗高血压药物提供一种替代选择。