ニフェジピン徐放剤のジェネリック変更後に出現した午前中の低血圧の1症例

A Case of Morning Hypotension Which Appeared after Switching from a Brand Name to a Generic Version of Long-acting Nifedipine

要旨　90歳代男性．虚血性心疾患と高血圧症で当院循環器外来加療中であった．市の健診で血圧低値を指摘され当科午後外来を受診された．しかし外来受診時の血圧はむしろ高値であった．病歴を聴取したところ，降圧薬として処方されていたニフェジピン徐放剤がジェネリック医薬品に変更された後から内服しづらい感じがあるとの訴えがあり，さらに嚥下しづらいため，同薬を噛み砕いて内服しているとのことであった．先発品からジェネリック薬品に変更したことで不適切な内服様式となったことが血圧コントロールの悪化を来したものと考えた．ジェネリック医薬品の使用は多くは有効であるが，変更の際，留意すべき症例もあると考え報告する．

　We recently encountered a case of morning hypotension appearing after switching from a brand name to a generic version of long-acting Nifedipine. The patient was a 90-year-old male. His dropped blood pressure was pointed out in a public health check up by chance. However, his blood pressure measured in hospital was rather high. On interviewing him, we noticed that his drugs were changed from brand-name to the generic version and he felt difficulty in taking generic long-acting Nifedipin. In addition, he had crunched the tablet of long-acting Nifedipine. We concluded that unsuitable intake caused by switching from a brand name to a generic version of the drug was one of reasons for the worsening of blood pressure control. Although most generic drugs are considered to be useful, it is important to carefully observe patients to confirm that an equivalent tolerability is obtained after switching from a brand name drug to a generic drug.