Comparative efficacy of ibuprofen, indomethacin, and placebo in the treatment of primary dysmenorrhea.

Forty-two women with primary dysmenorrhea were successfully enrolled in a double-blind, three-way crossover study in which each patient received either ibuprofen (Motrin), indomethacin (Indocin), or a placebo during each of three successive painful menstrual cycles. Thirty-one patients successfully completed the study. The results showed that ibuprofen and indomethacin were superior to the placebo in their ability to relieve pain and that patients preferred ibuprofen to indomethacin. Ibuprofen was significantly superior to the placebo regarding the number of patients who could pursue normal daily function, whereas indomethacin was not. Four patients reported side effects, all during the indomethacin cycle.

A randomized study of beef lung and pork mucosal heparin in cardiac surgery.

Beef lung heparin had substantially greater anticoagulant activity than pork mucosal heparin during a preoperative heparin tolerance test and also during cardiopulmonary bypass (CPB) in 100 randomized patients. Supplemental heparin was needed during CPB in many more of the patients receiving pork mucosal heparin. Heparin rebound was detected in 16 patients; this low incidence may result from a relatively high protamine:heparin ratio. There was notably less postoperative bleeding in those who received beef lung heparin. Platelet counts were not altered by either type of heparin. It is surprising that the preoperative tolerance curve only predicted heparin sensitivity during CPB in one-half of the patients. Blood activated coagulation time levels were increased markedly by hemodilution and further raised by hypothermia. These data demonstrate that beef lung heparin is better than pork mucosal heparin for CPB.

Comparative efficacy of colestipol and clofibrate in type IIa hyperlipoproteinemia.

A multiclinic study was performed comparing colestipol hydrochloride, clofibrate, and placebo in 245 patients with type IIa hyperlipoproteinemia. Eighty-five subjects took colestipol hydrochloride in progressive doses of 15, 20, and 30 g/day; 87 took 2.0 g/day of clofibrate; and 73 took placebo over the six months of study. Colestipol lowered total cholesterol level 20.9% in comparison with clofibrate (14.6%) (statistically significant at months 3, 5, and 6), and lowered low-density lipoprotein cholesterol level 28.8% in comparison with clofibrate (14.8%) (significant at months 2, 4, and 6, all times measured). High-density lipoprotein cholesterol level remained unchanged in all groups. Clofibrate lowered total triglyceride levels 22.5%, compared with an increase of 12.5% in the colestipol group and 11.1% in the placebo group (significant at all time intervals). Colestipol was more effective than clofibrate in lowering the cholesterol fractions associated with increased cardiovascular risk.

Analgesic efficacy of ibuprofen for treatment of primary dysmenorrhea.

Fifty-five women with primary dysmenorrhea were enrolled in a study which each took ibuprofen (400 mg), propoxyphene hydrochloride (64 mg), or a placebo alternately in consecutive menstrual cycles for relief of pain. Fifty-one completed the study during three successive cycles in this triple-blind, crossover, randomized investigation. Ibuprofen was clearly superior to propoxyphene and the placebo in patient preference, degree of relief, and need for supplementary analgesics. In addition, a significantly greater number of patients were able to pursue their normal daily functions during the ibuprofen cycle. Propoxyphene was superior to the placebo but not to the same extent as ibuprofen. Only three side effects were reported during the study, two relative to propoxyphene and one recorded during a placebo cycle. These data show that ibuprofen is an effective agent when used for treatment of dysmenorrhea without organic etiology.

The effect of colestipol hydrochloride on the bioavailability and pharmacokinetics of clofibrate.

Since it has been reported by several authors that colestipol HCl and clofibrate have an additive effect in lowering serum cholesterol levels, it was felt advisable to evaluate the blood levels of clofibrate when given simultaneously with colestipol HCl to see whether there was any evidence for drug interaction between the two products that might dictate a need for separation of their administration time. After concomitant single-dose administration, the serum p-chlorophenoxyisobutyric acid levels, bioavailability parameters, and pharmacokinetic parameters investigated provided no evidence for an interaction and suggested that colestipol and clofibrate can be administered concomitantly or at separated in tervals according to whichever dosage regimen is deemed advisable by the physician.

Long-acting injectable contraceptives.

PIP: 3 injectable preparations of progestogens for female contraception are reviewed: medroxyprogesterone acetate, algestone acetophenide-estradiol enanthate combination, and norethisterone enanthate. Information is presented concerning the absorption, fate and distribution of the preparations, its use as a contraceptive, biochemical and metabolic effects, return of ovarian function and fertility following discontinuance, and current status. Further information is presented for medroxyprogesterone acetate because of its wider use. These topics concern its effect on the mammary gland and other regimens of use.^ieng