title: Age and severe adverse drug reactions caused by nifedipine and verapamil. Gruppo Italiano di Farmacovigilanza nell' Anziano (GIFA).
abstract: The association of age with risk for severe adverse drug reactions (SADRs) was studied in 2371 and 862 hospitalized patients taking nifedipine and verapamil, respectively. Nifedipine caused hypotension (n = 22), tachycardia (n = 3), and acute renal failure (n = 1) (total SADR rate, 1.1%, 26/2371). Verapamil caused hypotension (n = 3), bradycardia (n = 9), and atrioventricular blocks (n = 2) (total SADR rate, 1.6%, 14/862). The mean age of patients with and without SADRs was for nifedipine 77.1 +/- 1.7 and 71.8 +/- 0.8 years, respectively (p < 0.05), and for verapamil 73.4 +/- 2.9 and 73.1 +/- 0.4 years, respectively. Sex, length of stay, comorbidity, polypharmacy, intake of slow-release preparations, daily dosage, and new intake of calcium antagonists were examined as potential confounders of the age-SADR association. After adjusting for potential confounders, age was significantly and independently associated with SADRs caused by nifedipine, but not with SADRs caused by verapamil (OR = 1.69, 95% CI = 1.05-2.72 and OR = 1.06, 95% CI = 0.63-1.68 for 10-year increase, respectively). Although nifedipine and verapamil did not have significantly different rates of SADRs, an age-related gradient was found only for nifedipine.
authors.affiliation: Department of Internal Medicine and Geriatrics, Catholic University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pahor
authors.forename: A
authors.initials: A
authors.lastname: Manto
authors.forename: C
authors.initials: C
authors.lastname: Pedone
authors.forename: L
authors.initials: L
authors.lastname: Carosella
authors.forename: J M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: P
authors.initials: P
authors.lastname: Carbonin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects*; D012307:Risk Factors; D014700:Verapamil / Q000009:adverse effects*
chemical_list: D002121:Calcium Channel Blockers; D014700:Verapamil; D009543:Nifedipine