Kirch W, Halabi A, Linde M, Santos S R, Ohnhaus E E
I. Medizinische Klinik, Christian-Albrechts-Universität, Kiel, Federal Republic of Germany.
Gastroenterology. 1989 Jun;96(6):1388-92. doi: 10.1016/0016-5085(89)90503-9.
In a randomized placebo-controlled study 12 healthy volunteers were treated for 1 wk each with 10 mg of nifedipine four times daily plus placebo or the same dose of nifedipine concurrently with 40 mg of famotidine once a day. Famotidine did not significantly alter pharmacokinetic parameters of nifedipine. Determination of systolic time intervals showed that the preejection period and the ratio of the preejection period and the left ventricular ejection time were significantly reduced by administration of nifedipine plus placebo. Coadministration of famotidine and nifedipine, however, led to a significant increase of these parameters. In an additional double-blind study, a significant rise of the preejection period and of the ratio was detected after administration of famotidine alone. In impedance cardiography stroke volume and cardiac output were significantly reduced by famotidine. Heart rate and blood pressure values were not altered by the H2-antagonist. For the first time, to our knowledge, the observed changes of hemodynamic parameters appear to indicate that famotidine may exert negative effects on cardiac performance which, in our opinion, could be of clinical relevance in elderly subjects or in patients with heart failure.
在一项随机安慰剂对照研究中，12名健康志愿者接受治疗，为期1周，每日4次，每次服用10毫克硝苯地平加安慰剂，或每日同时服用相同剂量的硝苯地平与40毫克法莫替丁。法莫替丁未显著改变硝苯地平的药代动力学参数。收缩期时间间期的测定显示，服用硝苯地平加安慰剂后，射血前期以及射血前期与左心室射血时间的比值显著降低。然而，法莫替丁与硝苯地平合用导致这些参数显著升高。在另一项双盲研究中，单独服用法莫替丁后，检测到射血前期及该比值显著升高。在阻抗心动图检查中，法莫替丁使每搏输出量和心输出量显著降低。H2拮抗剂未改变心率和血压值。据我们所知，首次观察到的血流动力学参数变化似乎表明，法莫替丁可能对心脏功能产生负面影响，我们认为，这在老年受试者或心力衰竭患者中可能具有临床意义。
