Document Detail


The fixed combination of verapamil SR/trandolapril.
MedLine Citation:
PMID:  11249535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fixed verapamil SR/trandolapril combinations 180/1 mg and 180/2 mg (Tarka, Knoll AG) have a significantly superior antihypertensive effect compared to equal dosages of either agent alone. Verapamil SR/trandolapril 180/2 mg combination produces the best dose-response ratio of different dose combinations of these two drugs. Combination therapy has the most pronounced effect on blunting the early morning rise in blood pressure. Thus, verapamil SR/trandolapril combination therapy may be an appropriate treatment option in patients with moderate essential hypertension, particularly in those who have a tendency toward the early morning rise in blood pressure. The adverse effect profile of the fixed combination of verapamil SR/trandolapril includes the typical side effects of its monocompounds. The fixed combination of verapamil SR/trandolapril is also effective and safe in the treatment of hypertension in the elderly. The fixed low-dose combination therapy with verapamil SR/trandolapril 180/2 mg is a suitable treatment option for patients with moderate essential hypertension and Type 2 diabetes mellitus, because it improves parameters of carbohydrate metabolism and uricaemia and does not alter the lipid profile. The insulin-sensitising effect of angiotensin converting enzyme (ACE) inhibitor monotherapy with its theoretical risk of hypoglycaemia is completely neutralised in the combination with verapamil SR. Comparative studies have shown that the low-dose combination of verapamil SR/trandolapril may be a suitable alternative to combinations containing a thiazide diuretic or a beta-blocking agent for the long-term management of hypertensive patients for whom combination therapy is indicated. The combination of an ACE inhibitor with a non-dihydropyridine calcium channel blocker reduces proteinuria to a greater extent than either agent alone. A combination of an ACE inhibitor and a calcium channel blocker may provide additional benefit in inducing the regression of left ventricular hypertrophy. Combination therapy leads to a significant increase in left ventricular ejection fraction, improvement of wall motion index and increases exercise duration time in patients with coronary heart disease and left heart failure. It also improves the ratio of exercise to rest rate-pressure product and decreases the number of angina attacks. These findings support the hypothesis that the combination of verapamil and trandolapril might be useful in patients with attenuated left ventricular function and angina pectoris. Thus, Tarka is an effective and well-tolerated antihypertensive agent with a good safety profile and positive metabolic effects.
Authors:
J Widimský
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  1     ISSN:  1465-6566     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2001-03-15     Completed Date:  2001-04-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  515-35     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague-Krc, Czech Republic.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  adverse effects,  pharmacokinetics,  therapeutic use*
Antihypertensive Agents / adverse effects,  pharmacokinetics,  therapeutic use*
Blood Pressure / drug effects
Calcium Channel Blockers / administration & dosage,  adverse effects,  pharmacokinetics,  therapeutic use*
Delayed-Action Preparations
Drug Combinations
Humans
Hypertension / complications,  drug therapy*,  physiopathology
Indoles / administration & dosage,  adverse effects,  pharmacokinetics,  therapeutic use*
Verapamil / administration & dosage,  adverse effects,  pharmacokinetics,  therapeutic use*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Delayed-Action Preparations; 0/Drug Combinations; 0/Indoles; 52-53-9/Verapamil; 87679-37-6/trandolapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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