A double‐blind comparison of the effects of hydrochlorothiazide and tienylic acid (a diuretic with uricosuric properties) in hypertension.

Gillies, Alastair J.; Morgan, Trefor

doi:10.1111/j.1365-2125.1978.tb00864.x

Cited by 13 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An advantage of tienilic acid over thiazides is its hypouricaemic effect (Reese & Steele, 1976;Lau, Stote, Goldberg & Agus, 1977). The drugs have similar hypotensive effects (Gillies & Morgan 1978; Veterans Administration Co-operative Study on Antihypertensive Effects, 1979;Nemati, Kyle & Freis, 1977) and act by inhibiting Na+ reabsorption in the cortical segment of the distal tubule (Lau et al, 1977;Stote, Dubb, Erb, Weiherer & Alexander, 1979). As a result hypokalaemia may occur (Gillies & Morgan 1978;Nemati et al, 1977).…”

Section: Introductionmentioning

confidence: 99%

“…The drugs have similar hypotensive effects (Gillies & Morgan 1978; Veterans Administration Co-operative Study on Antihypertensive Effects, 1979;Nemati, Kyle & Freis, 1977) and act by inhibiting Na+ reabsorption in the cortical segment of the distal tubule (Lau et al, 1977;Stote, Dubb, Erb, Weiherer & Alexander, 1979). As a result hypokalaemia may occur (Gillies & Morgan 1978;Nemati et al, 1977). Potassium supplements or a potassium sparing drug are usually prescribed if hypokalaemia occurs during thiazide therapy but to be effective at least 40 mEq potassium as KCI must be given as supplement (Carney, Morgan, Wilson, Mathews & Roberts, 1975) which is at least six additional tablets per day.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of tienilic acid and amiloride in healthy volunteers and in hypertensives with normal renal function.

Jb¹,

Gillies²,

Waga³

et al. 1980

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

1 A double-blind comparison of the effect of tienilic acid (250 mg) and amiloride (5 mg) on renal function in healthy volunteers and of tienilic acid plus amiloride compared to hydrochlorothiazide (50 mg) plus amiloride in patients with mild to moderate essential hypertension for safety and hypotensive efficacy was made.2 Renal plasma flow ([I125] iodohippurate clearance) and glomerular filtration rate ([1"31] iothalamate clearance and 24 h creatinine clearance) were not affected by tienilic acid or amiloride alone or in combination despite a rise in plasma urea and plasma creatinine (within the normal range) in healthy volunteers. 3 In hypertensive patients tienilic acid and tienilic acid plus amiloride treatments caused a rise in plasma urea and plasma creatinine similar to hydrochlorothiazide and hydrochlorothiazide plus amiloride but no significant change in creatinine clearance occurred with any of the treatments. 4 Tienilic acid and hydrochlorothiazide caused hypokalaemia in the patients which was normalized by addition of amiloride. Fewer subjects became hypokalaemic when amiloride was added to tienilic acid than when tienilic acid was given alone. 5 The antihypertensive effect of tienilic acid and tienilic acid plus amiloride was similar to hydrochlorothiazide and hydrochlorothiazide plus amiloride in patients with hypertension. No effect on blood pressure was observed in the healthy volunteers. 6 Plasma uric acid was significantly reduced by tienilic acid alone and in combination in patients and subjects whereas a significant elevation occurred with hydrochlorothiazide. 7 Side effects were increased when amiloride was added to either tienilic acid or hydrochlorothiazide, but side effects were less common after treatment with tienilic acid than following hydrochlorothiazide. 8 The combination of tienilic acid plus amiloride significantly reduces blood pressure and appears to be well tolerated with no adverse effects on renal function or plasma potassium in patients with mild to moderate hypertension and normal renal function. Addition of amiloride may be useful if hypokalaemia occurs following tienilic acid therapy in such patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of tienilic acid and amiloride in healthy volunteers and in hypertensives with normal renal function.

Jb¹,

Gillies²,

Waga³

et al. 1980

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mean rise in serum urea and creatinine, although greater than that seen in the control group, was small. Reports from other studies vary; some have found that tienilic acid and hydrochlorothiazide caused very similar rises in serum urea and creatinine (Gillies & Morgan, 1978;Miller & Vertes, 1979;Huang et al, 1979;Beg et al, 1979), or that tienilic acid caused a greater rise in serum urea Bauer & Brooks, 1979) but not in serum creatinine. The large Veterans Administration study (1979) and a smaller study (Okun & Beg, 1978) reported a slightly greater rise in serum creatinine and urea with tienilic acid therapy than with hydrochlorothiazide, as we also found.…”

Section: Withdrawalsmentioning

confidence: 95%

“…In this study, it was significantly more effective than allopurinol and it has already been shown to compare favourably with probenecid (Waal-Manning & Simpson, 1979;Jain et al, 1979). Its antihypertensive properties were similar to those of conventional diuretics, and its effect on serum sodium and potassium were also similar, as has been widely reported (Okun & Beg, 1978;Bolli etal., 1978;Waal-Manning & Simpson, 1979;Gillies & Morgan, 1978;Miller & Vertes, 1979;Veterans Administration Cooperative Study Group, 1979;Bauer & Brooks, 1979: Haung et al, 1979Smith & Clements, 1979). The mean rise in serum urea and creatinine, although greater than that seen in the control group, was small.…”

Section: Withdrawalsmentioning

confidence: 99%

“…Tienilic acid was an exciting new drug, possessing the same diuretic and antihypertensive properties as the thiazides (Okun & Beg, 1978;Bolli etal., 1978;WaalManning & Simpson, 1979;Gillies & Morgan, 1978;Miller & Vertes, 1979;Veterans Administration Cooperative Study Group, 1979;Bauer & Brooks, 1979;Huang et al, 1979;Smith & Clements, 1979), but being also an extremely potent uricosuric (Reese & Steele, 1976;Lau et al, 1977;Stote et al, 1978;Wood et al, 1978;Lejnieux et al, 1978). During phase II clinical trials with tienilic acid at the Dunedin Hypertension Clinic, two patients showed a substantial rise in transaminase activity which appeared to be associated with tienilic acid Waal-Manning & Simpson, 1979).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multicentre controlled trial of tienilic acid in hyperuricaemic, hypertensive subjects, with intensive monitoring of liver function.

Orchard¹,

Ritter²,

Shepherd³

et al. 1983

Brit J Clinical Pharma

View full text Add to dashboard Cite

1 Tienilic acid, a diuretic with potent uricosuric properties, has been compared with conventional diuretic therapy, mainly thiazide, in a parallel group (random allocation) multicentre study in hyperuricaemic hypertensives (n = 96). 2 The study was designed to last 1 year but tienilic acid was withdrawn for suspected hepatotoxicity before the study was complete. Mean follow‐up was 8.5 (range 1‐12) months and the mean daily dose of tienilic acid was 278 (range 125‐500 mg). 3 Blood pressure levels on tienilic acid and on conventional diuretics were similar. 4 Serum potassium and sodium levels were also similar in the two groups, but serum urea and creatinine rose somewhat more in the tienilic acid group. 5 Serum uric acid fell dramatically in the patients on tienilic acid from 0.56 to 0.32 mmol/l, but did not alter significantly in the control group. 6 There were no problems with renal failure or urate deposition probably because patients were instructed to drink plenty of fluid when tienilic acid was started, because initial dose was low and because all previous diuretics were stopped for 3 days before tienilic acid was started. 7 Mean liver function indices did not rise in either group. Mild elevation in liver enzymes occurred in one control patient and one patient on tienilic acid; the latter drug was stopped and the values returned to normal. 8 The general incidence of side‐effects was low. 9 Our impression was that tienilic acid was a useful drug. Whether it could have been used safely with monitoring of liver function will not now be known.

show abstract

Adverse Reactions Associated With Ticrynafen Use

McLain¹

1980

JAMA

View full text Add to dashboard Cite

Three hypertensive patients receiving ticrynafen, a new uricosuric diuretic, experienced adverse reactions. One patient experienced acute renal failure, the second experienced a renal stone, and the third had a fatal hemorrhage while receiving anticoagulation therapy with warfarin sodium. All complications can be explained by known actions of the drug and are preventable. However, these reactions illustrate the potential hazards from widespread substitution of ticrynafen for thiazide diuretics in the treatment of hypertension.

show abstract

A double‐blind comparison of the effects of hydrochlorothiazide and tienylic acid (a diuretic with uricosuric properties) in hypertension.

Cited by 13 publications

References 6 publications

Effect of tienilic acid and amiloride in healthy volunteers and in hypertensives with normal renal function.

Effect of tienilic acid and amiloride in healthy volunteers and in hypertensives with normal renal function.

Multicentre controlled trial of tienilic acid in hyperuricaemic, hypertensive subjects, with intensive monitoring of liver function.

Adverse Reactions Associated With Ticrynafen Use

Contact Info

Product

Resources

About