Xipamide A Review of its Pharmacodynamic and Pharmacokinetic Properties and Therapeutic Efficacy

Prichard, B. N. C.; Brogden, Rex N.

doi:10.2165/00003495-198530040-00002

Cited by 33 publications

(11 citation statements)

References 21 publications

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“…Xipamide 52 is chemically related to salicylic acid, and although it has a powerful diuretic action similar to that of furosemide, its onset of action (about 1 h) and duration of action (often in excess of 12 h) are more akin to hydrochlorthiazide, which is a medium-acting thiazide. Its long duration of action can prove troublesome for elderly recipients, and serum potassium concentrations as low as 2.2 mmol/L have been encountered with its long-term use.…”

Section: Clinical Uses Of Diureticsmentioning

confidence: 99%

Diuretics: a review

Wile

2012

Ann Clin Biochem

117

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Diuretics, in one form or another, have been around for centuries and this review sets out to chart their development and clinical use. Starting with the physiology of the kidney, it progresses to explain how diuretics actually work, via symports on the inside of the renal tubules. The different classes of diuretics are characterized, along with their mode of action. The clinical use of diuretics in conditions like congestive cardiac failure and hypertension, as well as some rarer, but clinically important, conditions is then examined. An account is given of the adverse effects of diuretics and how they come about. Common adverse effects like hypokalaemia and hyponatraemia are examined in some detail, and other electrolyte disturbances like hypomagnesaemia also gain a mention. Diuretic use in chronic kidney disease is examined and new guidelines that have been introduced are presented. A section on diuretic abuse is included as this is becoming an all too common clinical scenario, and the sometimes tragic consequences of this abuse are emphasized. Diuretics also find a role in the diagnosis of forms of renal tubular acidosis and this role is explored. Finally, a selection of some of the newer approaches to diuretic therapy are presented, often the consequence of the increasing development of molecular biology, and some of the novel compounds -which may be in drug formularies of the future -are revealed.

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Section: Clinical Uses Of Diureticsmentioning

confidence: 99%

Diuretics: a review

Wile

2012

Ann Clin Biochem

117

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“…We used the diuretic xipamide, which is a salicylic acid derivative chemically related to chlorthalidone; it is neither a thiazide nor a loop diuretic in its mechanism of action [11].…”

Section: Cardiovasc Drugs Ther 1991; 5:741-746mentioning

confidence: 99%

Hormonal effects of the diuretic xipamide in healthy men

Lijnen

Fagard

Staessen

et al. 1991

Cardiovasc Drug Ther

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The effect of xipamide on plasma alpha-atrial natriuretic peptide and the renin-aldosterone-kallikrein system have been studied in 12 healthy men, using a double-blind cross-over design. After a run-in period on placebo of 1 week, the subjects were treated with either placebo (n = 6) or xipamide 20 mg once daily (n = 6) for 16 weeks and were then switched to the alternative medication for another 16 weeks. The plasma concentration of alpha-atrial natriuretic peptide fell after 1 week of xipamide administration and increased during prolonged xipamide administration but remained reduced. The changes in plasma alpha-ANP observed after 1 week of xipamide were negatively correlated with the changes in hematocrit and hemoglobin. Plasma renin activity (PRA), aldosterone concentration (PAC), and urinary excretion of aldosterone and kallikrein increased after 1 week of xipamide administration, levelled off during the second and fourth weeks, but remained elevated during further prolonged xipamide administration for 16 weeks. The xipamide-induced changes in PRA and PAC were positively correlated with the changes in the hematocrit and hemoglobin. The changes in plasma renin, aldosterone, and alpha-atrial natriuretic peptide during xipamide administration may be related to diuretic-induced volume contraction.

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“…It is used mainly as an antihypertensive in doses of 10 to 40mg daily. Most data indicate that xipamide exerts its renal effect on the distal convoluted tubules (Prichard & Brogden 1985), eventually via a mechanism different from that of the thiazides. However, the pattern of side effects with regard to disturbances in electrolyte balance is similar to that of the thiazides.…”

Section: Xipamidementioning

confidence: 99%

Clinical Pharmacokinetics of Some Newer Diuretics

Beermann

Grind

1987

Clinical Pharmacokinetics

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Several new diuretics have recently been developed. This review summarises the published knowledge about some of them. Azosemide is a loop diuretic. The bioavailability is about 15% and it has a half-life of 2 to 3 hours. Renal and non-renal clearance are 1.32 and 5.4 L/h, respectively. Etozolin is also a loop diuretic. It is rapidly metabolised to the active metabolite, ozolinone. The gastrointestinal uptake of etozolin is almost complete. The plasma half-life of etozolin and ozolinone are 2 and 10 hours, respectively. The compounds are mainly eliminated as metabolites. Renal and liver impairment do not seem to change the pharmacokinetics. Fenquizone has properties similar to the thiazides. The plasma half-life is approximately 17 hours. Apparent volume of distribution averaged 686 L and renal clearance is 7.2 L/h. Indapamide acts predominantly on the proximal segment of the distal tubule and also has direct vasodilatory effects. Gastrointestinal uptake is at least 80%. The drug binds highly to carbonic anhydrases of red blood cells. Protein binding is about 80%, while terminal plasma half-life is 15 hours and the apparent volume of distribution 25 L. Renal clearance is 0.3 L/h and non-renal clearance 0.9 L/h. Several metabolites have been described, of which one major metabolite is pharmacologically active. Muzolimine is a loop diuretic. Its uptake is almost complete, but decreased substantially by food. The protein binding is about 65%, the apparent volume of distribution is about 1 L/kg and average terminal half-life 10 to 20 hours. Elimination is mainly non-renal, and non-renal clearance ranges between 0.5 and 1.32 L/h. The pharmacokinetics of the drug do not seem to be changed in cardiac failure. Terminal plasma half-life is essentially unchanged in patients with renal failure, except in those with very severe reduction of glomerular filtration rate. Piretanide is a loop diuretic which is about 6 times as potent as frusemide (furosemide). Its bioavailability is most likely complete in healthy subjects and in renal patients. Protein binding in healthy subjects is about 95%. The plasma half-life of the drug is about 1 hour and apparent volume of distribution averages about 17 L. Renal and non-renal clearance are about 6 L/h, although renal clearance is decreased in renal failure: this decrease is correlated with glomerular filtration rate. Non-renal clearance is unchanged in renal failure, as is the apparent volume of distribution.(ABSTRACT TRUNCATED AT 400 WORDS)

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Xipamide A Review of its Pharmacodynamic and Pharmacokinetic Properties and Therapeutic Efficacy

Cited by 33 publications

References 21 publications

Diuretics: a review

Diuretics: a review

Hormonal effects of the diuretic xipamide in healthy men

Clinical Pharmacokinetics of Some Newer Diuretics

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