Effects of nabumetone, celecoxib, and ibuprofen on blood pressure control in hypertensive patients on angiotensin converting enzyme inhibitors

Palmer, Robert H.; Weiss, Robert; Zusman, Randall M.; Haig, Ann; Flavin, Susan; MacDonald, Brian

doi:10.1016/s0895-7061(02)03203-x

Cited by 47 publications

(41 citation statements)

References 14 publications

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“…Evaluations of the gastrointestinal mucosal cells after nabumetone and 6-MNA administration have shown very low cytotoxicity activities, similar to that reported for the COX-2 selective NSAIDs (Arai et al 2005;Blower 1992;Somasundaram et al 1995). Although adverse events reported for nabumetone therapy include both cardiovascular disturbance (Palmer et al 2003) and renal impairment (Cangiano et al 1999;Cook et al 1997;Freed et al 1994), the incident rates for these events are lower than those seen for the other NSAIDs. Moreover, nabumetone dosages generally do not need to be reduced in elderly patients (Dollery 1999) or in patients with mild-to-moderate renal function (Brier et al 1995).…”

Section: Discussionmentioning

confidence: 61%

A novel injection strategy of flurbiprofen axetil by inhibiting protein binding with 6-methoxy-2-naphthylacetic acid

Ogata

Takamura

Tokunaga

et al. 2014

Eur J Drug Metab Pharmacokinet

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Flurbiprofen axetil (FPA) is an injection product and a prodrug of a non-steroidal anti-inflammatory drug (NSAID). After injection, it is rapidly hydrolyzed to the active form, flurbiprofen (FP). Since frequent injections of FPA can lead to abnormal physiology, an administration strategy is necessary to ensure there is enhancement of the analgesic efficiency of FP after a single dose and to reduce the total number of doses. FP strongly binds to site II of albumin, and thus the free (unbound) FP concentration is low. This study focused on 6-methoxy-2-naphthylacetic acid (6-MNA), the active metabolite of nabumetone (a prodrug of NSAID). We performed ultrafiltration experiments and pharmacokinetics analysis in rats to investigate whether the inhibitory effect of 6-MNA on FP binding to albumin increased the free FP concentration in vitro and in vivo. Results indicated that 6-MNA inhibited the binding of FP to albumin competitively. When 6-MNA was injected in rats, there was a significant increase in the free FP concentration and the area under concentration-time curve (AUC) calculated from the free FP concentration, while there was a significant decrease in the total (bound + free) FP concentration and the AUC calculated from the total FP concentration. These findings indicate that 6-MNA inhibits the protein binding of FP in vivo. This suggests that the frequency of FPA injections can be reduced when administered with nabumetone, as there is increase in the free FP concentration associated with pharmacological effect.

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Section: Discussionmentioning

confidence: 61%

A novel injection strategy of flurbiprofen axetil by inhibiting protein binding with 6-methoxy-2-naphthylacetic acid

Ogata

Takamura

Tokunaga

et al. 2014

Eur J Drug Metab Pharmacokinet

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“…Another US study of hypertensive patients, treated with ACEIs, and also receiving ibuprofen (2400 mg/day), nabumetone (2000 mg/day), or celecoxib (400 mg/day), found that ibuprofen, but not nabumetone or celecoxib, increased the mean arterial pressure with 6.5±1.4 mm Hg [40].…”

Section: Antihypertensivesmentioning

confidence: 99%

Adverse Effects and Drug Interactions of the Non‐Steroidal Anti‐Inflammatory Drugs

Voștinaru¹

2017

Nonsteroidal Anti-Inflammatory Drugs

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The aim of this chapter is to increase the awareness of health-care professionals concerning potential adverse efects and drug interactions of non-steroidal anti-inlammatory drugs (NSAIDs), which are among the most widely prescribed medicines, globally. They have a variety of clinical applications due to their anti-inlammatory, analgesic, antipyretic, or antithrombotic efect, but these drugs are not entirely innocuous, since they could increase the risk of gastrointestinal and cardiovascular complications. Furthermore, the drugs from this class have the potential of altering the pharmacokinetics of associated drugs, and also pharmacodynamic interactions have been reported. The clinical signiicance, mechanisms, and epidemiology of the adverse efects and drug interactions of NSAIDs are presented in this chapter. Prevention strategies for particularly high-risk groups of patients are also exposed. Detailed and up-to-date information regarding the adverse efects and drug interactions of NSAIDs are needed for all healthcare professionals in order to maximize eicacy in treating various illnesses while minimizing the risks for the patients.

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“…In relation to drug-drug interactions, NSAIDs may antagonise angiotensin-converting enzyme inhibitors (ACE-I), angiotensin-II receptor antagonists, diuretics and beta-blockers. 8,9,12,14 There is some evidence 19 that NSAIDs do not antagonise calcium channel blockers. In sum, the weight of biological evidence appears to suggest an adverse effect of NSAIDs on BP control.…”

Section: Biological Plausibility For and Against Interaction Of Nsaidmentioning

confidence: 99%

“…Prostaglandins are naturally occurring vasodilators and interact with the reninangiotensin system. 4,[8][9][10][11] Previous studies 4,9,10,12 on NSAIDs and hypertension have produced conflicting results and examined relationships between NSAID usage in nontreated and treated patients. Some NSAIDs (particularly indometacin and naproxen 4 may elevate BP and attenuate the effects of antihypertensives, on average being associated with 5 mmHg rise in mean BP.…”

Section: Introductionmentioning

confidence: 99%

NSAID use and BP in treated hypertensives: a retrospective controlled observational study

2005

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The objective of this study was to investigate the association between NSAID use and blood pressure (BP) among a sample of treated hypertensive patients. A controlled observational study was designed in UK primary care setting. Patients with diagnosed hypertension and currently being prescribed antihypertensive medication registered with four general practices, comparing patients also prescribed NSAIDs (exposed) to those not prescribed NSAIDs (unexposed). Majority of the patients were elderly. Systolic and diastolic pressure were the outcome measures. Data were collected for 184 NSAID users and 762 nonusers with a mean age of 68 years. There was no difference in either systolic (adjusted difference 1.9 mmHg, 95% CI À0.7 to 4.5, P ¼ 0.15) or diastolic (adjusted difference 1.0 mmHg, 95% CI À0.3 to 2.3, P ¼ 0.15) blood pressure. There was no evidence of any interactions according to categories of age, sex, or number of antihypertensive drugs prescribed. Among NSAID users, there was no evidence of any differences in blood pressure according to NSAID type or dose. In conclusion we found no evidence for an association between NSAID usage and BP control in known hypertensive patients receiving antihypertensive medication in primary care. The reported association between NSAID use and BP control appears much less substantial than has been previously suggested.

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Effects of nabumetone, celecoxib, and ibuprofen on blood pressure control in hypertensive patients on angiotensin converting enzyme inhibitors

Cited by 47 publications

References 14 publications

A novel injection strategy of flurbiprofen axetil by inhibiting protein binding with 6-methoxy-2-naphthylacetic acid

A novel injection strategy of flurbiprofen axetil by inhibiting protein binding with 6-methoxy-2-naphthylacetic acid

Adverse Effects and Drug Interactions of the Non‐Steroidal Anti‐Inflammatory Drugs

NSAID use and BP in treated hypertensives: a retrospective controlled observational study

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