Püchler K, Sierakowski B, Roots I
Sankyo Europe GmbH, Duesseldorf, Germany.
Br J Clin Pharmacol. 1998 Oct;46(4):363-7. doi: 10.1046/j.1365-2125.1998.t01-1-00785.x.
The aim of this study was to determine the potential impact of age on the pharmacokinetics of temocapril and its pharmacologically active diacid metabolite, temocaprilat, in hypertensive patients.
Male and female patients with mild to moderate essential hypertension (DBP 95-114 mmHg inclusive) were allocated to two age groups: young, < or = 40 years; elderly, > or = 69 years, (n = 18 per group). In Part I of the study, subjects took a single oral tablet dose of 20 mg temocapril hydrochloride following an overnight fast. In Part II they took seven once daily oral tablet doses of 20 mg temocapril hydrochloride. Pharmacokinetic profiles were determined after the single and the last dose. Trough plasma samples were taken before each dose in Part II. Urine was collected for 24 h following the single and the last dose.
Steady state was reached within 1 week in both groups. Statistically significant differences were detected in AUC and AUCss for temocaprilat as well as in CL(R) for temocapril and temocaprilat, respectively, after a single dose and at steady state. All other pharmacokinetic parameters for temocapril and temocaprilat did not show any significant difference.
The pharmacokinetic differences detected in the elderly do not require a dose adjustment per se. Nonetheless, a lower starting dose may be appropriate as elderly hypertensive patients are usually considered to be at an increased risk of first dose hypotension at the onset of treatment with an ACE inhibitor.
本研究旨在确定年龄对高血压患者中替莫卡普利及其药理活性二酸代谢物替莫卡普利拉药代动力学的潜在影响。
将轻至中度原发性高血压(舒张压95 - 114 mmHg,含此范围)的男性和女性患者分为两个年龄组:年轻组,年龄≤40岁;老年组,年龄≥69岁,(每组n = 18)。在研究的第一部分,受试者在禁食过夜后口服单剂量20 mg盐酸替莫卡普利片。在第二部分,他们每日口服七次20 mg盐酸替莫卡普利片。在单剂量和最后一剂后测定药代动力学曲线。在第二部分中,在每次给药前采集谷值血浆样本。在单剂量和最后一剂后收集24小时尿液。
两组均在1周内达到稳态。单剂量给药后和稳态时,替莫卡普利拉的AUC和AUCss以及替莫卡普利和替莫卡普利拉的CL(R)分别检测到统计学上的显著差异。替莫卡普利和替莫卡普利拉的所有其他药代动力学参数均未显示任何显著差异。
在老年人中检测到的药代动力学差异本身并不需要调整剂量。尽管如此,较低的起始剂量可能是合适的,因为老年高血压患者在用ACE抑制剂治疗开始时通常被认为首剂低血压风险增加。