MINOXIDIL SUCCEEDS WHERE OTHER DRUGS FAIL

... Lowers Blood Pressure In Malignant Hypertension In Patients With Chronic Renal Failure Thirteen acutely symptomatic malignant hypertensive patients (7 women, 6 men) refractory to conventional therapy

treated with minoxidil combined with propranolol and furosemide (frusemide) or dialysis responded favourably.

The 1 white and 12 black patients (aged 17-64 years) started on minoxidil 5mg once a day before breakfast, and

increased the dose by 5mg/day· until BP control was satisfactory. Eleven patients had varying degrees of renal impainnent

(serum creatinine ranging from 2.5/100m1 to lO.Omg/lOOml) and 4 were on dialysis. They had previously received

guanethidine, alphamethyldopa, hydra!lazine, reserpine, propranolol, furoseJTijde, triamterene and hydrochlorthiazide.

After starting minoxidil, in 12 patients mean arterial BP (MABP) fell significantly within 72 hours (p< 0.005). After

20 months therapy (10mg-40mg/day) all now have a favourable response with a mean reduction in MABP of 48mm Hg

and no adverse cardiac disturbances. Renal function improved in patients with mild azotaernia, but peripheral renin

activity rose in all patients. Those patients who had been on guanethidine had a more pronounced lowering of MABP

with minoxidil. One p~tient with pretreatment premature atrial contraction required digoxin to maintain normal

· sinus thythm.

'It is concluded that minoxidil is a safe, fast, and effective agent to achieve rapid and sustained control of MABP in malignant hypertensive states associated with chronic renal insufficiency.'

Mutterperl, R.E. et al.: Journal of Clinical Pharmacology 16: 498 (Oct 1976)

INPHARMA 16th October, 1976 p12