What question did this study set out to answer?

To assess the pharmacokinetics and drug accumulation profiles of fosinoprilat relative to enalaprilat and lisinopril in patients with impaired renal function.

January 1, 1992Journal of Cardiovascular Pharmacology

Kinetics of Angiotensin-Converting Enzyme Inhibitors in Renal Failure

View Full Paper

Ask AI

Bookmark

Why the study?

Does fosinopril accumulate less than enalapril and lisinopril in patients with moderate to severe renal insufficiency?

Population

29 patients with moderate to severe renal insufficiency, mean age 62.8 years.

Comparison

Fosinopril (single and multiple doses) vs Enalapril and lisinopril

Design

RCT, randomized, parallel, open-label

Follow-up

10 days

Authors

DSDomenic A. SicaPreventive Cardiology

Discussion

Member takes

Implication

Supports omitting dose adjustment for fosinopril in moderate-severe renal insufficiency; extends RCT evidence on ACEI accumulation.

Key Points

To assess the pharmacokinetics and drug accumulation profiles of fosinoprilat relative to enalaprilat and lisinopril in patients with impaired renal function.
Conducted an open-label, randomized, parallel study involving 29 evaluable patients (mean age 62.8 years) with moderate to severe renal insufficiency defined by a creatinine clearance below 30 ml/min.
Measured serum drug levels following single and multiple doses across 10 days to assess accumulation of fosinoprilat, enalaprilat, and lisinopril.
Mean accumulation indices between Day 10 and Day 1 were 1.26 ± 0.10 for fosinoprilat (n = 9), 1.77 ± 0.17 for enalaprilat (n = 10), and 2.62 ± 0.32 for lisinopril (n = 10).
Fosinoprilat accumulated significantly less than both enalaprilat (p < 0.05) and lisinopril (p < 0.001) in patients with severe renal impairment.

Structured PICO

Does fosinopril accumulate less than enalapril and lisinopril in patients with moderate to severe renal insufficiency?

Population

29 patients with moderate to severe renal insufficiency (creatinine clearance < 30 ml/min), mean age 62.8 years.

Intervention

Fosinopril (single and multiple doses)

Comparator

Enalapril and lisinopril (single and multiple doses)

Outcome

Mean accumulation indices [(AUC Day 10)/(AUC Day 1)] of the active metabolitessurrogate

Fosinopril accumulates significantly less than enalapril and lisinopril in patients with moderate to severe renal insufficiency, suggesting dosage adjustment may be unnecessary.

Cite This Study

Domenic A. Sica (1992) studied this question.

synapsesocial.com/papers/6a85c67b734852141cd4e015 https://doi.org/10.1097/00005344-199200101-00004

View Full Paper

Ask AI

Bookmark

Kinetics of Angiotensin-Converting Enzyme Inhibitors in Renal Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Kinetics of Angiotensin-Converting Enzyme Inhibitors in Renal Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider