Once daily felodipine monotherapy in mild to moderate hypertension.

In a single-blind study conducted at our centres, 78 hypertensive patients were enrolled with 58 completing the study according to the protocol. Mean supine and standing blood pressures were significantly reduced after treatment with felodipine, reductions being 27/21 mmHg (p < 0.0001) and 25/19 mmHg (p < 0.0001) respectively. Of 46 patients given felodipine 5 mg, 44 (95.7%) achieved target blood pressure defined as a diastolic blood pressure of < 90 mmHg, while all 12 patients on felodipine 10 mg did so. The 2 patients who did not achieve target pressure at the final visit did so on previous visits. There were no differences in pre and post-treatment laboratory variables. Treatment was discontinued in 6 patients because of headaches. No adverse events of clinical significance were reported in the 58 patients who completed the study. In conclusion, we found felodipine given once daily to be effective in the treatment of mild to moderate hypertension.

Dose requirement and effect of nicardipine on lipid profile in mild to moderate essential hypertensives.

Twenty eight patients who satisfied the entry criteria and had completed an initial 2 weeks treatment with placebo were titrated fortnightly with doses of Nicardipine ranging from 30 mg to 90 mg daily in two or three divided doses. Nicardipine treatment significantly reduced blood pressures both in the supine and standing positions (p < 0.0004) when compared with placebo treatment. Heart rates however did not change significantly. Forty six percent (13/28) of patients on 20 mg twice daily, 25% (7/28) on 10 mg three times daily, 18% (5/28) of patients on 20 mg three times daily and 11% (3/28) on 30 mg three times daily achieved supine diastolic blood pressures < 90 mm Hg. Nicardipine treatment at 16 weeks and at 24 weeks did not significantly alter the lipid profile when compared to the end of placebo treatment period. No other biochemical abnormalities were reported during the study period. Except for 2 cases of mild pedal oedema and 2 cases of transient headaches, no serious side-effects were encountered.

Individual variation in daily dosage requirements for phenytoin sodium in patients with epilepsy.

1 Ninety adult patients receiving phenytoin sodium were studied prospectively in an epileptic centre. Serum concentrations of phenytoin under steady state conditions were measured by gas liquid chromatography. When clinically indicated the daily dosage rate was adjusted by 50 mg steps until a serum concentration of 10--20 mg/l was produced. 2 Concentrations within the above range were obtained in 50 patients; the required dosage rate varied from 200--500 mg/day. Twenty-five clinical, biochemical and haematological attributes were recorded for each patient and tested for correlation with dosage requirement. 3 The dosage requirement correlated most strongly (r = 0.57, P less than 0.001) with body surface area. This relationship (approximately 200 mg/day per m2) accounted however for only one third of the total dosage variance. 4 Amongst 18 patients receiving simultaneous treatment with phenobarbitone, the effective plasma clearance of this drug taken in conjunction with body surface area accounted for a significantly greater proportion of the total dosage variance. Multiple regression analysis failed to reveal other, more widely applicable predictors of individual phenytoin dosage requirements.