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January 1, 2000British Journal of Clinical PharmacologyOpen Access

Comparison of the pharmacokinetics of fosinoprilat with enalaprilat and lisinopril in patients with congestive heart failure and chronic renal insufficiency

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Why the study?

Does fosinopril exhibit less pharmacokinetic accumulation than enalapril or lisinopril in patients with congestive heart failure and chronic renal insufficiency?

Population

55 patients with congestive heart failure and chronic renal insufficiency

Comparison

Fosinopril 10 mg every morning for 10… vs Enalapril 2.5 mg or lisinopril 5 mg every…

Design

RCT, Randomized to receive fosinopril, enalapril or lisinopril in two…

Follow-up

10 days

Authors

RGR. GreenbaumDeakin UniversityPZP ZucchelliUniversity of Modena and Reggio EmiliaACAbraham CaspiKaplan Medical Center

Discussion

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Overview

Supports preferring fosinopril in HF with renal insufficiency to minimize accumulation; extends RCT evidence of its pharmacokinetic advantage versus enalapril or lisinopril.

Structured PICO

Does fosinopril exhibit less pharmacokinetic accumulation than enalapril or lisinopril in patients with congestive heart failure and chronic renal insufficiency?

P
Population
55 patients with congestive heart failure (NYHA Class II-IV) and chronic renal insufficiency (creatinine clearance <=30 ml min-1)
I
Intervention
Fosinopril 10 mg every morning for 10 consecutive days
C
Comparator
Enalapril 2.5 mg (Study 1) or lisinopril 5 mg (Study 2) every morning for 10 consecutive days
O
Outcome
Area under the curve (AUC) between the first and last days of treatment and the accumulation index (AI)surrogate

Fosinopril exhibits significantly less accumulation than enalapril or lisinopril in patients with heart failure and severe renal insufficiency, likely due to its dual hepatic and renal elimination pathways.

Cite This Study

Greenbaum et al. (2000) studied this question.

synapsesocial.com/papers/6a6fc27c3ce530166bc2ae92https://doi.org/10.1046/j.1365-2125.2000.00103.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pharmacokinetics of fosinopril in patients with various degrees of renal function1991 · 93 citations
  2. 2The pharmacokinetics of lisinopril in hospitalized patients with congestive heart failure.1989 · 22 citations
  3. 3Enalapril maleate and a lysine analogue (MK‐521): disposition in man.1982 · 213 citations
  4. 4Converting enzyme inhibitors in heart failure1988 · 9 citations
  5. 5Pharmacokinetics of enalapril in normal subjects and patients with renal impairment.1986 · 57 citations