雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Another Therapeutic Option to Treat Calcium Channel Blocker-related Peripheral Edema:Can “switching to efonidipine hydrochloride” be a new option? Kouji Negishi 1 , Tetsuo Takahashi 1 , Kouhei Koyama 1 , Jun Matsumoto 1 , Ken Kongoji 1 , Takahiro Koura 1 1Department of Cardiology, Yokohama Municipal Citizen's Hospital Keyword: 末梢性浮腫 , ジヒドロピリジン系カルシウム拮抗薬 , 塩酸エホニジピン , peripheral edema , dihydropyridine calcium channel blocker , efonidipine hydrochloride pp.641-646
Published Date 2005/6/1
DOI https://doi.org/10.11477/mf.1404100073
  • Abstract
  • Look Inside

Summary

 Peripheral edema, especially leg edema, is a troublesome adverse effect of dihydropyridine calcium channel blocker(DHP-CCB). Efonidipine Hydrochloride, a kind of DHP-CCB which blocks L-and T-type calcium channels, is rarely(less than 1% of the users) associated with peripheral edema. Twenty-seven patients(11 males, 16 females, mean age 70) suffering severe CCB-related leg edema(including 22 diuretics users and 20 with ACE inhibitor and/or angiotensine receptor blocker) were selected. They could not discontinue DHP-CCB because of refractory hypertension or coronary spasm. We switched the DHP-CCBs(they had taken) to efonidipine hydrochloride and observed the effects on cheir clinical symptoms. In all 27 patients, the edemas diminished or disappeared. In 7 patients, diuretics were no more necessary to control their leg edema. Systolic (146±4, 145±3mmHg: p=0.78)and diastolic blood pressure(81±3, 78±3mmHg: p=0.29), heart rate(74±2, 72±2/min: p=0.053) and the values of serum creatinine(1.38±0.28,1.38±0.26mg/dl: p=0.97) and blood urea nitrogen(24±3, 29±5mg/dl: p=0.37) were unchanged by the switching. Left ventricular end diastolic(49±1, 49±1 mm: p=0.67) and end systolic dimension(32±2, 33±2mm: p=0.17), fractional shortening(0.35±0.02, 0.34±0.02: p=0.61) by echocardiogram in 11 patients and values of BNP(brain natriuremic peptide) (73±17, 75±17pg/ml: p=0.60) measured in 13 patients, were also unchanged. There were no cardiac or extracardiac adverse events associated with the switching. But in two patients, the systolic blood pressure increased by more than 20mmHg and antihypertensive drugs were added, while in another two patients, the systolic blood pressure decreased by more than 20mmHg and the dose of efonidipine hydrochloride was reduced in one case.

 Conclusions: Switching from other kinds of dihydropyridine calcium channel blockers to efonidipine hydrochloride improved peripheral(especially leg) edema without any severe adverse events. This effect was not induced through improvement of cardiac function. This method may be a therapeutic option for intolerable leg edema before withdrawal of dihydropyridine calcium channel blocker.


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

関連文献

もっと見る

文献を共有