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SummaryA total of 130 patients with mild to moderate hypertension were recruited to an open study and treated with the vascular selective calcium antagonist felodipine (10 to 40mg once daily) for I year. For patients completing the study, median lipid concentrations (mmoIfL) at baseline were: total cholesterol 6.50, triglycerides 1.44, low density lipoprotein (LDL) 4.20, and high density lipoprotein (HDL) 1.40. Plasma concentrations of total cholesterol, triglycerides and LDL were essentially unchanged during the study, while there was a statistically significant increase in HDL concentration which reflected in a significant decrease in the LDL/HDL ratio; these changes were about 5% in magnitude. Blood pressure was well controlled during treatment and adverse effects were principally related to vasodilation, In total 13 patients were withdrawn during the study, 10 of these due to adverse events. In conclusion, long term antihypertensive treatment with felodipine does not adversely affect plasma lipids. In fact, there was a slight increase in HDL, indicating a possible favourable action.

Male Wistar rats received a single stomach load (10 ml/kg) of a 150 mmol LiCl solution, either alone or together with tetracycline (33.5 mg/10 ml), ampicillin (33.5 mg/10 ml), or metronidazole (15 mg/10 ml). Urine was collected 1–5 hours after administration and blood samples were drawn after 1, 6, and 24 hours. All antibiotics caused a reduction in urinary lithium excretion but did not affect renal lithium clearance. Serum lithium levels were reduced by tetracycline and metronidazole 6 hours after administration but increased after 24 hours. Additional experiments including frequent mapping of serum lithium levels confirmed these findings. Tetracycline, also reduced renal sodium clearance and increased distal sodium reabsorption. Short‐term daily treatment during one week with tetracycline or metronidazole showed that these initial changes were only transient, since after treatment for one week no differences could be observed between antibiotic‐treated rats and control rats. The results indicate that antibiotics may cause a delay but no decrease of the gastrointestinal absorption of lithiim and that they do not affect renal lithium clearance. Signs of lithium intoxication during combined use of lithum and antibiotics are therefore probably not caused by a renal interaction mechanism affecting the renal lithium clearance.

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