アンジオテンシン変換酵素阻害薬の血中濃度および薬理効果に及ぼす食事の影響

概要

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It has been reported that food ingestion reduces the bioavailability of captopril, an angiotensin-converting enzyme (ACE) inhibitor, in both healthy subjects and hypertensive patients, but does not affect markedly its antihypertensive efficacy. Nevertheless, an advice, "captopril should be taken one hour before meals" has been remarked in 'Information for patients, of 'Physicians, Desk Reference, and 'Patient Consultation, of 'USP Dispensing Information 11th edition (1991)'. However, such direction for use is not suitable for keeping the patient medication compliance, because captopril is frequently prescribed with other medicines taken usually after meals in Japan. Furthermore, the food induced reduction of the bioavailability of cilazapril, delapril and perindopril in nine ACE inhibitors besides captopril has been reported. It is shown that the antihypertensive efficacy of these ACE inhibitors as well as captopril is not affected by food ingestion. From these findings, in order to improve the patient compliance, we recommend that ACE inhibitor should be taken after meals in the direction for medication.
日本医療薬学会の論文
1992-08-20