Determination of the calcium antagonist benidipine hydrochloride in plasma by sensitive radioimmunoassay.

A sensitive radioimmunoassay of the 1,4-dihydropyridine calcium channel blocker (+/-)-(R*)-2,6-dimethyl-4-(m-nitrophenyl)-1,4-dihydropyridine-3,5-dicarb oxylic acid (R*)-1-benzyl-3-piperidinyl ester, methyl ester hydrochloride (benidipine hydrochloride, KW-3049) has been developed. Antiserum against KW-3049 was produced in rabbits by immunization with an immunogen prepared by conjugating a derivative of KW-3049 to bovine serum albumin. This antiserum was found to specifically bind to [3H]-KW 3049, while the recognition to [3H]-nitrendipine, another well-known dihydropyridine calcium channel blocker, was less pronounced. With the antiserum, [3H]-KW-3049 and dextran coated charcoal, this radioimmunoassay could detect 39 approximately equal to 500 pg/tube of KW-3049 in a buffer system, and 156 to 5000 pg/ml of KW-3049 in plasma by using 0.5 ml of the plasma which was pretreated with MeOH for deproteinization and extracted with diethyl ether under alkaline condition. To assess the specificity of the radioimmunoassay, the inhibition of [3H]-KW-3049 binding to the antiserum by the presumable metabolites was examined. Though three of these presumable metabolites could slightly inhibit the binding of [3H]-KW-3049, they were not detected in rat and dog plasma at 0.5 h after oral administration of KW-3049. Plasma levels of KW-3049 in rats receiving a single oral dose (1 mg/kg) determined by the radioimmunoassay show good agreement with those obtained by gas chromotography.

Clinical and laboratory effects of nifedipine in Raynaud's phenomenon.

The calcium channel blocking drug nifedipine was shown to be more effective than placebo as a treatment for Raynaud's phenomenon. Given in a dose of 10 mg four times a day it was well tolerated and reduced both the frequency and the severity of vasospastic attacks. There was, however, a large individual variation in response and while approximately half the patients showed marked improvement others showed no improvement at all. Patients with idiopathic Raynaud's phenomenon responded more favourably than those with systemic sclerosis. Nifedipine was shown to inhibit mitogen-induced lymphocyte proliferation but only in patients who responded to the drug clinically. Calcium channel blocking drugs may therefore have potential as immunoregulatory agents.

Experience with immunological tests in drug-induced hepatitis.

Nine patients are reported who developed hepatic injury following the administration of therapeutic agents. The drugs incriminated were prajmalium bitartrate (4 patients), quinidine (3 patients), procainamide and nifedipine (one patient each). In all patients the clinical features indicated an allergic process, which in three cases was substantiated by positive response to reexposure. The detection of immunologic processes in our patients by various in vitro methods supports the assumption that immune mechanisms may be involved in the production of drug-induced hepatic disease and confirm allergy.