Pharmacokinetic and pharmacodynamic interactions between furosemide and hydrochlorothiazide in nephrotic patients.
We examined the response of 8 patients with nephrotic syndrome (creatinine clearance 70.4 +/- 16.0 ml/min) to oral furosemide (F; 40 mg) in the absence (control) and in the presence of oral hydrochlorothiazide (HCT; 100 mg). In the 24-hour period after oral F, HCT was shown to increase urine volume and urinary sodium and chloride excretion. Increment was most significant during the 12- to 24-hour period. Enhancement of the diuresis with HCT was associated neither with a significant increase in the area under the curve of plasma F concentration nor an increase in urinary F excretion. Urinary excretion of glucuronidated F, one of the main metabolites of F, however, was decreased with HCT. In summary, HCT significantly enhanced the response to F in nephrotic patients.
Nakahama
H
H
First Department of Medicine, Osaka University Medical School, Japan.
Orita
Y
Y
Yamazaki
M
M
Itoh
S
S
Okuda
T
T
Yamaji
A
A
Miwa
Y
Y
Yanase
M
M
Fukuhara
Y
Y
Kamada
T
T
D004347:Drug Interactions; D004912:Erythrocytes / Q000032:analysis; D005260:Female; D005665:Furosemide / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000652:urine; D006801:Humans; D006852:Hydrochlorothiazide / Q000032:analysis / Q000494:pharmacology* / Q000652:urine; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011188:Potassium / Q000652:urine; D012964:Sodium / Q000652:urine; D014556:Urine
D006852:Hydrochlorothiazide; D005665:Furosemide; D012964:Sodium; D011188:Potassium