โดย kenijikoong » 13 ธ.ค. 2011, 21:52
การเกิด D/I ระหว่าง Enalapril กับ Rifampicin
1) Interaction Effect: decreased enalapril effectiveness
2) Summary: In a case report, the addition of rifampin in a patient stabilized on enalapril resulted in an increase in blood pressure and a reduced enalapril area under the concentration-time curve by about 30%. More studies are required to evaluate this interaction and its potential mechanisms [504].
[504]
3) Severity: moderate
4) Onset: delayed
5) Substantiation: probable
6) Clinical Management: Monitor for continuing blood pressure control after the addition or withdrawal of rifampin, adjusting the enalapril dose to regain control. Substitution of an alternative ACE inhibitor or a different class of antihypertensive agent may be required for blood pressure control.
7) Probable Mechanism: increased metabolism of enalapril
8) Literature Reports
a) Concomitant administration of oral rifampin and oral enalapril resulted in a reduction in the hypotensive efficacy of enalapril in a 35-year-old male with hypertension and brucellosis [503]. The patient was maintained on chronic therapy with enalapril 15 mg twice a day while rifampin 300 mg twice a day was added in a regimen with streptomycin and oxytetracycline for brucellosis. Rifampin appeared to reduce the area under the plasma concentration-time curve (AUC) of enalapril by 30%, therefore, it was suggested that rifampin enhanced the renal clearance of the active metabolite. More studies are required to evaluate this interaction and its potential mechanisms.
