randdENALAPRIL: in combination withhydrochlorothiazide

The purpose of this investigation was to determine thehypotensive effects of the angiotensin-converting enzyme(ACE) inhibitor, enalapril [MK 421; Merck, Sharp andDohme], when used in combination withhydrochlorothiazide. Firstly, a baseline was establishedfollowing a treatment-free period in 14 patients with mildto moderate hypertension. They then received 14 daystherapy with each of the following treatments inconsecutive order: 20mg enalapril bid; 25mghydrochlorothiazide bid; and the 2 drugs combined atthese dosages.Seated diastolic BP was reduced during enalapril(98mm Hg) or hydrochlorothiazide (97mm Hg)administration compared with baseline on placebo(IO ImmHg). With enalapril + hydrochlorothiazide theBP reduction (to 82mm Hg) was significantly greater thanthat predicted from the additive reductions caused by theindividual drugs. A target diastolic BP of 90mm Hg orless was achieved in 2 patients on enalapril, I onhydrochlorothiazide, and I I patients on the combination.Enalapril + hydrochlorothiazide caused symptomatichypotension in 3 patients, which resolved spontaneouslyin I case and after dosage reduction in the others. Onepatient experienced hyperaesthesia of the oral mucosawith enalapril, both alone and in combination withhydrochlorothiazide. Skin rash, leucopenia andproteinuria did not occur [see also Inpharma 396: 5 (16JuI1983)]V/asscs. P.H. ct al.: Journal of Clinical Pharmacology 23: 227 (May-Jun

1983)

6 INPHARMA 23 Jul 1983 0156_2703/83/0723-0006/0$01.00/0 It> ADIS Press