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A Multicenter Comparison of Adverse Reaction Profiles of Isradipine and Enalapril at Equipotent Doses in Patients with Essential Hypertension
Author(s) -
Johnson Brian F.,
Eisner Gilbert M.,
McMahon F. Gilbert,
Jain Adesh K.,
Rudd Peter,
Sowers James R.
Publication year - 1995
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1995.tb04092.x
Subject(s) - isradipine , enalapril , medicine , blood pressure , adverse effect , essential hypertension , anesthesia , pharmacology , angiotensin converting enzyme , cardiology , dihydropyridine , calcium
A multicenter, randomized, double‐blind trial compared the safety and efficacy of the dihydropyridine isradipine with the angiotensin‐converting enzyme (ACE) inhibitor enalapril given twice daily for mild hypertension. 160 patients received either isradipine (starting at 1.25 mg twice daily) or enalapril (starting at 2.5 mg twice daily) for 10 weeks. The dosage was increased if the average sitting diastolic blood pressure was > 90 mm Hg. Significantly greater mean reductions in systolic blood pressure were seen after 2, 6, and 8 weeks of isradipine. However, by the end of the trial, 83% of patients receiving isradipine and 78% receiving enalapril showed a decrease of at least 5 mm Hg in sitting diastolic blood pressure to a level below 96 mm Hg. Possible or probable drug‐related adverse effects were reported in 36% of patients showing a good antihypertensive response to isradipine, and in 30% of those who responded to enalapril. There was a trend for a lower frequency of adverse effects in isradipine non‐responders (25%) and a higher frequency in enalapril non‐responders (43%). Pruritus, dizziness, edema, and fatigue were reported more often with isradipine, and cough and changed bowel habits were more common with enalapril. The relationship between the pattern of adverse effects and the extent of blood pressure reduction may be dependent on the mechanism of action of a drug. In responders, isradipine and enalapril showed differing patterns, but a similar overall incidence of adverse effects.