title: Pharmacokinetic assessment of an oral enalapril suspension for use in children.
abstract: The angiotensin-converting enzyme (ACE) inhibitor enalapril is commonly used to treat pediatric hypertension. Because some children are unable to swallow tablets or require doses less than the lowest available enalapril tablet, an enalapril suspension was developed. This study examined the relative bioavailability of enalapril suspension (10 mg) (S) compared with 10-mg marketed VASOTEC tablets (T) in 16 healthy adult subjects. The geometric mean ratio (S/T) estimate of urinary recovery of free enalaprilat, the active moiety, was 0.92 (90% confidence interval (CI): 0.80, 1.07). Urinary recovery data indicate that approximately 50% of the dose was absorbed (50% recovered in urine as enalapril plus enalaprilat) with about 30% of the dose recovered as free enalaprilat for both S and T. The geometric mean ratios (S/T) of serum AUC and C(max) were 1.01 (90% CI: 0.90, 1.13) and 0.98 (90% CI: 0.83, 1.16), respectively. Suspension T(max) was slightly shorter (0.5 h) than that for tablet, but this difference is not clinically significant. Both formulations were well tolerated and there were no clinically significant adverse experiences. We conclude that the bioavailability of enalapril oral suspension 10-mg is similar to that of VASOTEC 10-mg tablet. Instructions for compounding enalapril are provided.
authors.affiliation: Department of Drug Metabolism, Merck Research Laboratories, West Point, PA 19486-0004, USA. Ronda_Rippley@Merck.com
authors.forename: R K
authors.initials: RK
authors.lastname: Rippley
authors.forename: J
authors.initials: J
authors.lastname: Connor
authors.forename: J
authors.initials: J
authors.lastname: Boyle
authors.forename: T E
authors.initials: TE
authors.lastname: Bradstreet
authors.forename: E
authors.initials: E
authors.lastname: Hand
authors.forename: M W
authors.initials: MW
authors.lastname: Lo
authors.forename: M G
authors.initials: MG
authors.lastname: Murphy
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics*; D019540:Area Under Curve; D018592:Cross-Over Studies; D004656:Enalapril / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008297:Male; D013535:Suspensions
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D013535:Suspensions; D004656:Enalapril