Sudoh T, Fujimura A, Shiga T, Tateishi T, Sunaga K, Ohashi K, Ebihara A
Department of Clinical Pharmacology, Jichi Medical School, Tochigi, Japan.
J Clin Pharmacol. 1993 Jul;33(7):640-3. doi: 10.1002/j.1552-4604.1993.tb04717.x.
It has been reported that the urinary excretions of chloride (Cl), potassium (K), and magnesium (Mg), but not sodium (Na), after furosemide, a loop diuretic, were decreased by pretreatment with lisinopril, an ACE inhibitor in hypertensive subjects. The electrolytes disturbance induced by furosemide might be ameliorated by lisinopril. The present study re-examines this potential drug interaction in healthy subjects. Lisinopril (20 mg) or its matching placebo was given orally using a double-blind, crossover design. Four hours after lisinopril administration, furosemide (20 mg) was injected intravenously and urine was collected during the following intervals: 0-0.5, 0.5-1, 1-1.5, 1.5-2, 2-3, 3-4, and 4-6 hours. Blood samples for plasma furosemide concentration were obtained at 0.5, 1, 1.5, 2, 3, 4, and 6 hours after the agent. There were no significant differences between the two trials in plasma concentrations of furosemide or urinary excretions of the agent. Urine volume and urinary excretions of electrolytes (Na, Cl, K, and Mg) after the furosemide with lisinopril administration were not significantly different from those of placebo at any observation period. These results suggest that the urinary excretions of electrolytes after furosemide administration are not influenced by pretreatment with lisinopril.
据报道，在高血压患者中，一种袢利尿剂呋塞米使用后，氯（Cl）、钾（K）和镁（Mg）的尿排泄量会降低，但钠（Na）不会，而血管紧张素转换酶抑制剂赖诺普利预处理后可减少这种降低。呋塞米引起的电解质紊乱可能会被赖诺普利改善。本研究重新审视了健康受试者中这种潜在的药物相互作用。采用双盲交叉设计口服给予赖诺普利（20mg）或其匹配的安慰剂。在给予赖诺普利4小时后，静脉注射呋塞米（20mg），并在以下时间段收集尿液：0 - 0.5、0.5 - 1、1 - 1.5、1.5 - 2、2 - 3、3 - 4和4 - 6小时。在给药后0.5、1、1.5、2、3、4和6小时采集血样以测定血浆呋塞米浓度。两项试验在呋塞米血浆浓度或药物尿排泄量方面无显著差异。在任何观察期，给予呋塞米并联合赖诺普利后的尿量和电解质（Na、Cl、K和Mg）尿排泄量与安慰剂组无显著差异。这些结果表明，给予呋塞米后电解质的尿排泄不受赖诺普利预处理的影响。
