Key result
A single 5 mg dose of ramipril in patients with severe heart failure resulted in high and sustained plasma levels of the active metabolite and 95% inhibition of ACE activity.
Why the study?
What are the pharmacokinetic and pharmacodynamic properties of a single 5 mg oral dose of ramipril in patients with severe heart failure?
Population
27 patients, mean age 62 years with severe congestive heart failure
Design
Cohort
Follow-up
10 days
Authors
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May support lower starting doses in severe HF; leaves open confirmation in randomized outcome studies.
What are the pharmacokinetic and pharmacodynamic properties of a single 5 mg oral dose of ramipril in patients with severe heart failure?
In patients with severe heart failure, ramipril and its active metabolite have higher plasma levels and longer half-lives than in healthy volunteers, suggesting a lower starting dose (1.25-2.5 mg) is appropriate.
Gerckens et al. (1989) studied Congestive Heart Failure (NYHA III-IV) (n=27). Ramipril was evaluated on Pharmacokinetics and pharmacodynamics (plasma and urine levels of ramipril and ramiprilat, ACE plasma activity, blood pressure, and pulse rate). A single 5 mg dose of ramipril in patients with severe heart failure resulted in high and sustained plasma levels of the active metabolite and 95% inhibition of ACE activity.
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