title: Palatability of crushed ß-blockers, converting enzyme inhibitors and thiazides.
abstract: OBJECTIVE
  A problem that often affects antihypertensive drugs is the lack of formulations appropriate for childhood. Parents, therefore, crush tablets and administer the antihypertensive drug mixed with solid food or a palatable drink. Because palatability is a major modulator of adherence to prescribed medication, the palatability of crushed ß-blockers, converting enzyme inhibitors and thiazides was assessed among adult volunteers.
  
  
  METHODS
  The palatability of crushed atenolol, bisoprolol, enalapril, lisinopril, ramipril, chlorthalidone and hydrochlorothiazide was evaluated by means of a facial hedonic scale among 20 volunteers. The calcium channel-blockers amlodipine and lercanidipine whose tastes are disliked and liked, respectively, by children were also tested. A concealed random allocation procedure was used.
  
  
  RESULTS
  The palatability scores assigned to chlorthalidone, hydrochlorothiazide and lisinopril were superior (P < 0·002) to those assigned to atenolol, bisoprolol, enalapril and ramipril. As with children, the palatability score of lercanidipine was superior to that of amlodipine (P < 0·002). The scores assigned to the various agents were similar in women and in men and were age-independent.
  
  
  CONCLUSIONS
  Pulverized atenolol, bisoprolol, enalapril and ramipril are poor tasting. From the perspective of palatability, pulverized chlorthalidone, hydrochlorothiazide and lisinopril are preferable.
authors.affiliation: Division of Pediatrics, Mendrisio and Bellinzona Hospitals, and University of Bern, Bern, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Zgraggen
authors.forename: P B
authors.initials: PB
authors.lastname: Faré
authors.forename: S A G
authors.initials: SA
authors.lastname: Lava
authors.forename: G D
authors.initials: GD
authors.lastname: Simonetti
authors.forename: E F
authors.initials: EF
authors.lastname: Fossali
authors.forename: C
authors.initials: C
authors.lastname: Amoruso
authors.forename: M G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000737:chemistry; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000737:chemistry; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000737:chemistry; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D013649:Taste; D049971:Thiazides / Q000008:administration & dosage* / Q000737:chemistry; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D049971:Thiazides