Kiriyama Akiko, Kimura Shunsuke, Yamashita Shugo
Department of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan.
Pharmacol Res Perspect. 2024 Aug;12(4):e1249. doi: 10.1002/prp2.1249.
This study assessed the pharmacokinetics (PKs) and pharmacodynamics (PDs) of two antihypertensive drugs, nifedipine and captopril, by exploring their main (blood pressure [BP]) and secondary effects (heart rate [HR] and QT interval [QT]) in spontaneously hypertensive rats. This study aimed to assess the relationship between PKs and PDs. Using these PD parameters, BP, HR, and QT during coadministration were estimated. The coadministration of nifedipine and captopril resulted in an increase in nifedipine's total body clearance (CL) and a reduction in its mean residence time (MRT) with an increase in the terminal elimination half-life (t) and volume of distribution at steady state (V) of captopril. However, no significant PK interactions were observed. During monotherapy, BP reduced rapidly following nifedipine infusion. Subsequently, despite the increase in nifedipine plasma concentration, BP recovered, likely because of homeostasis. Similar results were observed with coadministration. Subsequently, BP demonstrated a sustained reduction that was greater than or equal to the additive effect estimated from each PK. Captopril exhibited a minimal effect on HR, except for a transient increase observed immediately after starting infusion, consistent with observations during coadministration. Subsequently, the HR reduction was nearly equal to that calculated from the nifedipine PK. QT prolongation was more rapid with captopril than with nifedipine. Although QT prolongation during the initial 60 min of coadministration was approximately the sum of both effects, the recovery period to baseline QT was faster than that in the simulation.
本研究通过探究硝苯地平和卡托普利这两种抗高血压药物在自发性高血压大鼠中的主要作用(血压[BP])和次要作用(心率[HR]和QT间期[QT]),评估了它们的药代动力学(PKs)和药效动力学(PDs)。本研究旨在评估PKs与PDs之间的关系。利用这些PD参数,估计了联合给药期间的BP、HR和QT。硝苯地平和卡托普利联合给药导致硝苯地平的全身清除率(CL)增加,平均驻留时间(MRT)缩短,而卡托普利的末端消除半衰期(t)和稳态分布容积(V)增加。然而,未观察到显著的PK相互作用。在单药治疗期间,硝苯地平输注后BP迅速降低。随后,尽管硝苯地平血浆浓度升高,但BP恢复了,这可能是由于体内平衡。联合给药时也观察到了类似的结果。随后,BP表现出持续降低,且大于或等于根据每种PK估计的相加效应。卡托普利对HR的影响最小,除了在开始输注后立即观察到的短暂升高外,这与联合给药期间的观察结果一致。随后,HR降低几乎与根据硝苯地平PK计算的结果相等。卡托普利引起的QT延长比硝苯地平更快。虽然联合给药最初60分钟内的QT延长约为两种效应之和,但恢复到基线QT的时间比模拟中的更快。