Population pharmacokinetics of ramipril in patients with chronic heart failure: A real-world longitudinal study.
body composition
chronic heart failure
pharmacokinetics
ramipril
ramiprilat
Journal
Acta pharmaceutica (Zagreb, Croatia)
ISSN: 1846-9558
Titre abrégé: Acta Pharm
Pays: Poland
ID NLM: 9303678
Informations de publication
Date de publication:
01 Jun 2024
01 Jun 2024
Historique:
accepted:
15
04
2024
medline:
30
5
2024
pubmed:
30
5
2024
entrez:
30
5
2024
Statut:
epublish
Résumé
In patients with chronic heart failure (CHF), the use of angiotensin-converting enzyme inhibitors, including ramipril, is recommended to reduce the risk of heart failure worsening, hospitalisation, and death. Our aim was to investigate the influence of body composition on the pharmacokinetics of ramipril and its active metabolite ramiprilat and to evaluate the changes in pharmacokinetics after prolonged therapy. Twenty-three patients with CHF who were on regular therapy with ramipril participated at the first study visit ( median age 77 years, 65 % male, and 70 % New York Heart Association Class II); 19 patients attended the second study visit and the median time between the two visits was 8 months. Pharmacokinetics were assessed using a nonlinear mixed-effects parent-metabolite model comprising two compartments for ramipril and one compartment for ramiprilat. The influence of body size and composition was best described by an allometric relationship with fat-free mass. In addition, ramipril clearance was related to patient age and daily ramipril dose, while clearance of ramiprilat was influenced by glome rular filtration rate and daily ramipril dose. There were no clinically relevant changes in the pharmacokinetics of ramipril and ramiprilat between the study visits. Due to the relatively stable pharmacokinetics of ramipril, regular outpatient visits at 6-month intervals seem appropriate to evaluate ramipril therapy.
Identifiants
pubmed: 38815200
pii: acph-2024-0018
doi: 10.2478/acph-2024-0018
doi:
Substances chimiques
Ramipril
L35JN3I7SJ
Angiotensin-Converting Enzyme Inhibitors
0
ramiprilat
6N5U4QFC3G
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
315-328Informations de copyright
© 2024 Katja Čvan Trobec et al., published by Sciendo.
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