Kirch W, Halabi A, Linde M, Ohnhaus E E
I. Medizinische Klinik, Christian-Albrechts-Universität, Kiel.
Schweiz Med Wochenschr. 1988 Dec 17;118(50):1912-4.
In a randomized placebo-controlled study, 12 healthy volunteers were treated for one week each with nifedipine 10 mg four times daily or the same dose of nifedipine concurrently with famotidine 40 mg once daily per os. Famotidine did not significantly alter pharmacokinetic parameters of nifedipine. Determination of systolic time intervals showed that pre-ejection period (PEPc) and the ratio of pre-ejection period over left ventricular ejection time (PEP/LVET) were significantly reduced by administration of nifedipine plus placebo. Coadministration of famotidine and nifedipine, however, led to a significant increase in these parameters. Also, administration of famotidine alone to the same subjects led to a significant rise in PEPc and PEP/LVET. In impedance cardiography, stroke volume and cardiac output were significantly reduced by famotidine, whereas the H2-antagonist did not alter heart rate. This observation indicates for the first time that famotidine may exert negative effects on cardiac performance. In our opinion this 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名健康志愿者分别接受为期一周的治疗，其中一组每日4次服用10毫克硝苯地平，另一组每日口服40毫克法莫替丁的同时服用相同剂量的硝苯地平。法莫替丁并未显著改变硝苯地平的药代动力学参数。收缩期时间间期测定显示，服用硝苯地平加安慰剂可使射血前期（PEPc）以及射血前期与左心室射血时间之比（PEP/LVET）显著降低。然而，法莫替丁与硝苯地平联合给药导致这些参数显著升高。同样，对相同受试者单独给予法莫替丁也导致PEPc和PEP/LVET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，但该H2拮抗剂未改变心率。这一观察结果首次表明，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。
