Flurbiprofen interaction with single doses of atenolol and propranolol.

Webster, J; Petrie, J. C.; McLean, I; Hawksworth, GM

doi:10.1111/j.1365-2125.1984.tb02556.x

Cited by 19 publications

(4 citation statements)

References 18 publications

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“…This effect may be small and may not represent the maximal response but is quite clearly present on analysis of standing and post-exercise systolic pressures. These observations are consistent with other studies showing rapid hypotensive effects of single doses of propranolol (Galloway et al, 1976) and atenolol (Webster et al, 1984).…”

Section: Discussionsupporting

confidence: 93%

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Webster¹,

Petrie²,

Robb³

et al. 1985

Brit J Clinical Pharma

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Single doses of bucindolol 50, 100 and 200 mg were compared to placebo and single doses of oxprenolol 40, 80 and 160 mg in seven patients with mild hypertension, in a double‐blind randomized study. Both bucindolol and oxprenolol inhibited exercise induced tachycardia. The mean maximum inhibition of exercise heart rate was similar after each dose of both drugs (20%, P less than 0.001). Bucindolol produced a significantly greater reduction in blood pressure than either oxprenolol or placebo. This was most apparent in standing systolic and diastolic and post‐ exercise systolic blood pressures between 1 and 2 h after dosing and was dose‐related. All seven patients experienced adverse effects related to hypotension within the first 2 h after ingestion of bucindolol 200 mg. Plasma concentrations of oxprenolol, bucindolol or 5‐ hydroxy‐bucindolol, sampled 2 h after dosing, could not be related to either the changes in blood pressure or to the occurrence of symptoms. The results emphasise the need for careful dose‐finding of new drugs prior to their more widespread evaluation in phase 3 studies.

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Section: Discussionsupporting

confidence: 93%

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Webster¹,

Petrie²,

Robb³

et al. 1985

Brit J Clinical Pharma

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“…Chalmers et al 1984;Mills et al 1982;Salvetti et al 1982a,b;Steiness & Waldorff 1982;Watkins et al 1980 -fig. 7;Wing et al 1981), but has also been reported with piroxicam (Pugliese et al 1984;Wong et al 1986), naproxen (Abate et al 1990;Chalmers et al 1984), ibuprofen (Radack et al 1987), flurbiprofen (Webster et al 1984) and tiaprofenic acid (Smith et al 1985), although not with sulindac or diclofenac (Stokes et al 1991). A wide variety of antihypertensive agents have been involved including diuretics, ~-blockers, angiotensin converting enzyme (ACE) inhibitors and vasodilators.…”

Section: Nsaids Affecting Other Drugsmentioning

confidence: 89%

Adverse Drug Interactions with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

1993

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The prevalence and incidence of adverse drug interactions involving nonsteroidal anti-inflammatory drugs (NSAIDs) remains unknown. To identify those proposed drug interactions of greatest clinical significance, it is appropriate to focus on interactions between commonly used and/or commonly coprescribed drugs, interactions for which there are numerous well documented case reports in reputable journals, interactions validated by well designed in vivo human studies and those affecting high-risk drugs and/or high-risk patients. While most interactions between NSAIDs and other drugs are pharmacokinetic, NSAID-related pharmacodynamic interactions may be considerably more important in the clinical context, and prescriber ignorance is likely to be a major determinant of many adverse drug interactions. Prescribing NSAIDs is relatively contraindicated for patients on oral anticoagulants due to the risk of haemorrhage, and for patients taking high-dose methotrexate due to the dangers of bone marrow toxicity, renal failure and hepatic dysfunction. Combination NSAID therapy cannot be justified as toxicity may be increased without any improvement in efficacy. Where lithium or anti-hypertensives are coprescribed with NSAIDs, close monitoring is mandatory for lithium toxicity and hypertension, respectively, and aspirin (acetylsalicylic acid) or sulindac are preferred. Phenytoin or oral hypoglycaemic agents may be administered with NSAIDs other than pyrazoles and salicylates provided that patients are monitored carefully at the initiation and cessation of NSAID treatment. Digoxin, aminoglycosides and probenecid may be coprescribed with NSAIDs, but close monitoring is required, particularly for high-risk patients such as the elderly. Indomethacin and triamterene should be avoided due to the risk of renal failure. High dose aspirin should be replaced by naproxen in patients on valproic acid (sodium valproate) and care is required when corticosteroids are administered to patients taking salicylates long term in high dosage. Interactions between NSAIDs and antacids or cholestyramine are generally avoidable. Adverse drug interactions involving NSAIDs may be limited by rational prescribing and by careful monitoring, particularly for high-risk patients, drugs and therapy periods.

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“…As both classes of drugs reduce PRA, pre-ß-blocker administration of NSAIDs may limit the antihy pertensive component related to PRA lowering. The blunting of the antihypertensive effect has not been ob served uniformly in all studies [24,29,30,32], The differ ences in some of the results between nonselective and selective beta blockers may be due to the fact that inhibi tion of prostaglandin synthesis might result in increased adrenoceptor sensitivity. Enhancement of alpha-medi ated vascular tone by NSAIDs might, therefore, be more apparent in the presence of a nonselective beta blocker than in the presence of a highly cardioselective one.…”

Section: Beta Blockersmentioning

confidence: 99%

“…Several studies have documented a blunting of antihy pertensive effects of beta blockers by NSAIDs [11,23,25,[27][28][29][30][31][32], the most common NSAID being indomethacin [11,23,25,27,30,31]. The variety of interactions between members of the different classes can be observed in table 3.…”

Section: Beta Blockersmentioning

confidence: 99%