1998 Volume 31 Issue 1 Pages 45-51
The efficacy and elimination of amlodipine were evaluated in hypertensive hemodialyzed patients (n=19). After 2 to 4 weeks of observation, 2.5 to 7.5 mg/day of amlodipine were administered. The changes in blood pressure (BP) and heart rate (HR) were measured before and after hemodialysis (HD). The serum concentrations of amlodipine just before each HD were measured at 1, 2, and more than 4 or 12 weeks after the start of amlodipine. The clearance and reduction rates of amlodipine by HD were measured at more than 4 or 12 weeks after the initiation of amlodipine. The patients took amlodipine after dinner everyday. The other antihypertensive medications had not been changed throughout the study.
In 15 patients taking 5mg/day of amlodipine, at the observation period BP was 199±4/95±3mmHg. After administration of amlodipine BP significantly decreased at week 1 and remained low throughout the study period (at week 12, 170±5/83±3mmHg; p<0.05). HR significantly decreased from 81±2 to 75±2 beats/min at week 1. After 2 weeks, there were no significant changes in HR. The serum concentrations of amlodipine before HD were 6.8±0.8ng/ml at week 1, 7.1±0.7 at week 2, 8.1±1.0 at more than 4 weeks, and 8.6±1.2 at more than 12 weeks, but there were no significant differences between these values. The clearance values were negative, but reduction rates were between 14 to 18%. The serum concentrations of amlodipine just after HD were significantly lower than those before HD or the calculated predicted values. As a result, amlodipine was thought to be eliminated partially by HD. In conclusion, long-term administration of amlodipine was considered to be effective and safe without accumulation even in hemodialyzed hypertensive patients.
