1. The reproducibility of angiotensin converting enzyme inhibitor induced cough was examined in a double-blind cross over study in patients previously shown to have exhibited this side effect. 2. Ninety-seven patients who had experienced angiotensin converting enzyme inhibitor cough within the last 2 years were challenged with enalapril 20 mg daily for 4 weeks to establish eligibility. Eighty-eight of 97 (91%) patients experienced a repeat of their cough symptoms. Sixty-four patients entered the double-blind part of the study where they were treated with enalapril 20 mg and a renin inhibitor for up to 4 weeks in random order. These periods were separated by a minimum 4 week placebo wash out. 3. Of 59 evaluable patients who received enalapril a second time, 37 (62.7%) experienced cough again. Of 62 patients on the renin inhibitor 16 (25.8%) experienced cough, however as it was not equi-efficacious to enalapril no valid comparison could be made. 4. Angiotensin converting enzyme inhibitor cough is not reproducible within patients, as other factors are involved in the aetiology. Objective testing with blinded assessment together with symptom reporting, would give a more accurate measure of the incidence, and mechanism of this side effect.

Adult↗

PubMed1994

Comparison of the effects of cilazapril in an elderly and nonelderly hypertensive general practice population.

The ACE inhibitor cilazapril was studied in mild to moderate hypertensive patients in general practice to evaluate the effect of age on hypotensive response to low (0.5 and 1 mg) doses. Six hundred and seventy-one patients entered a two week single-blind placebo run-in period and 524 patients were eligible to receive active treatment titrated up to a maximum dose of 5 mg. All patients received 0.5 mg of cilazapril once daily for four weeks. The dose was titrated at monthly intervals to 1, 2.5 and 5 mg once daily if DBP remained > 90 mmHg. If DBP < or = 90 mmHg patients remained at their current dose level until the end of the study. Three hundred and twenty-nine patients < 65 years old and 195 patients > or = 65 years old took active treatment. Binary logistic regression detected no statistically significant difference in response between the two groups (P > 0.2) at low doses of cilazapril. Cumulative response rates (DBP < or = 90 mmHg) for all patients were 24.5%, 40.4%, 54.5% and 62.7% for the escalating dose groups. Cumulative augmented response rate (DBP < or = 90 mmHg and/or reduction in DBP of > or = 10 mmHg) at the 5 mg dose level was 76.7% for all patients. Cilazapril was well tolerated with the pattern of adverse events reflecting those currently documented. A higher proportion of patients than expected responded to the low doses of cilazapril. This effect was not age dependent. These doses are lower than the recommended maintenance doses of 2.5-5 mg in the UK data sheet.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

A comparison of parenteral tenoxicam and diclofenac in the treatment of acute soft tissue injury of the lower limb.

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Acute Disease↗