Pharmacokinetics of lisinopril, enalapril and enalaprilat in renal failure: effects of haemodialysis

• Published in: British journal of clinical pharmacology Vol. 26; no. 6; pp. 781 - 786
• Main Authors: Kelly, JG, Doyle, GD, Carmody, M., Glover, DR, Cooper, WD
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-1988; Blackwell Science
• Subjects: Adult; Angiotensin-Converting Enzyme Inhibitors - blood; Angiotensin-Converting Enzyme Inhibitors - pharmacokinetics; Antihypertensive agents; Biological and medical sciences; Cardiovascular system; Creatinine - blood; Enalapril - analogs & derivatives; Enalapril - blood; Enalapril - pharmacokinetics; Enalaprilat; Female; Humans; Kidney Failure, Chronic - metabolism; Lisinopril; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Renal Dialysis; Human; Chronic; Urinary system disease; Hemodialysis; Renal failure; Antihypertensive agent; Metabolism; Pharmacokinetics
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/j.1365-2125.1988.tb05319.x

1. Lisinopril and enalapril were administered as 2.5 mg single doses and as eight single daily 2.5 mg doses to separate groups of six patients with chronic renal failure. Patients were receiving regular haemodialysis. 2. In the absence of haemodialysis, the decline in plasma concentrations of lisinopril and enalaprilat was extremely slow and plasma concentrations were generally high. 3. Haemodialysis had large effects on plasma concentrations of lisinopril and enalaprilat. A 4 h period reduced plasma concentrations of both drugs by around one‐ half and often by significantly more than this. Even 1 or 2 h of haemodialysis had significant effects. 4. Haemodialysis plasma clearance was similar for both drugs with mean values of the order of 40 ml min‐1. Clearance did not markedly differ when measured after 1, 2 or 4 h of haemodialysis or after single or multiple doses of lisinopril or enalapril. 5. The design of dosage regimens of both lisinopril and enalapril for patients with severe renal impairment or chronic renal failure should take into consideration the use and effects of haemodialysis.