PMID: 8940868Sep 1, 1996Paper

Influence of rifampicin on antihypertensive effects of dihydropiridine calcium-channel blockers in four elderly patients

Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
H YoshimotoS Saima

Abstract

Rifamicin, an antituberculosis agent, is one of the most potent inducers of hepatic drug-oxidation enzymes. Rifampicin can reduce the efficacy of several therapeutically important drugs (including verapamil and diltiazem) by accelerating systemic elimination or by increasing hepatic first-pass metabolism. Because dihydropyridine calcium-channel blockers are mainly metabolized by the liver, rifampicin may also increase the extraction of these drugs and thereby reduce their antihypertensive effects. Here we report four possible cases of interaction between rifampicin and dihydropiridine calcium-channel blockers. Rifampicin was given to treat tuberculosis in four elderly hypertensive patients whose blood pressure was well-controlled by one or more dihydropiridine calcium-channel blockers (nisoldipine, nifedipine, or barnidipine and manidipine), shortly after the start of antituberculosis therapy, their blood pressures rose. Either much greater doses of dihydropyridines or additional antihypertensive agents had to be given to keep blood pressure under control. After withdrawal of rifampicin, blood pressure fell in all patients and the doses of the antihypertensive agents had to be reduced. These findings indicate that rifampicin ma...Continue Reading

Citations

Jul 22, 2004·American Journal of Therapeutics·Orish E OrisakweNdidi A Ezejiofor
Nov 15, 2003·Journal of Clinical Pharmacology·Mark Alastair BoydIndravadan H Patel
Nov 22, 2011·Hemodialysis International·Bakshish Singh, Gurpreet Singh
Feb 14, 2015·Clinics in Chest Medicine·Eric F EgelundCharles A Peloquin
Apr 14, 2017·Fundamental & Clinical Pharmacology·Elena-Mihaela CordeanuDominique Stephan
Dec 28, 2018·British Journal of Clinical Pharmacology·Yu Eun SunwooJae-Gook Shin
Apr 29, 2020·Clinical Pharmacology and Therapeutics·Fatemeh Hassani-Nezhad-GashtiJanne Hukkanen

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