Antihypertensive efficacy and safety of urapidil, alone or in combination with beta-blockers, in patients with phaeochromocytoma.

The clinical efficacy and safety of urapidil, used alone or in conjunction with beta-blockers, were evaluated in 14 patients with phaeochromocytoma. Following a 1-week placebo run-in period, the patients were treated with sustained-release capsules of urapidil, initially 30 mg twice a day, followed by dose adjustment within 30-270 mg (mean +/- s.d. 144 +/- 73) per day for 7-29 days (21 +/- 8 days). In six patients, beta-blockers were added to control associated tachycardia. Blood pressure and pulse rate were successfully controlled in 11/14 patients (78.6%) during the therapy. Both the frequency and the severity of hypertensive paroxysms were clearly reduced in 7/8 patients, who showed frequent paroxysms of hypertension during placebo treatment. A variety of subjective symptoms observed in 13 patients during placebo treatment improved during drug therapy in nine patients (69.2%). Side effects occurred in five patients but were minor and well tolerated except in one patient, who was withdrawn from urapidil monotherapy due to facial oedema and finger stiffness which persisted even after reducing the daily dose from 306 to 270 mg. Overall, in terms of antihypertensive effectiveness, improvement in subjective symptoms and the safety profile, urapidil was considered very useful in four patients (28.6%), useful in six (42.9%), slightly useful in three and useless in one. Urapidil therefore appears to be a worthwhile agent in the treatment of patients with phaeochromocytoma.