A step in the global effort to control hypertension: Fixed dose combination antihypertensive drugs

This article discusses the definition, classification and pathogenetic mechanisms of cognitive functions in arterial hypertension. The authors discuss the capabilities of the different classes of antihypertensive drugs in correction of cognitive impairments and prevention of dementia. The authors also discuss the advantages of the angiotensin II receptor blockers in prevention of dementia and in their potential mechanisms of cerebral protection. The article describes in detail the possibilities of valsartan in correction of cognitive impairments associated with arterial hypertension, the advantages of valsartan in comparison with calcium antagonists and its unique neuroprotective mechanisms. We show our own results of the study concerning fixed-dose combination of valsartan and hydrochlorothiazide, and find out that this combination has high antihypertensive and cerebral protection (capacity to improve cognitive function) and effectiveness.

Download Full-text

DoE-Based Analytical Quality Risk Management for Enhanced AQbD Approach to Economical and Eco-Friendly RP-HPLC Method for Synchronous Estimation of Multiple FDC Products of Antihypertensive Drugs

Journal of Chromatographic Science ◽

10.1093/chromsci/bmab123 ◽

2021 ◽

Author(s):

Pintu Prajapati ◽

Ankita Patel ◽

Shailesh Shah

Keyword(s):

Risk Management ◽

Antihypertensive Drugs ◽

Hplc Method ◽

Fixed Dose Combination ◽

Fixed Dose ◽

Analytical Quality ◽

Quality Risk Management ◽

Rp Hplc ◽

Dose Combination ◽

Quality Risk

Abstract According to the literature review, numerous chromatographic methods have been published for estimation of fixed-dose combination products of telmisartan but no reverse-phase high-pressure liquid chromatographic (RP-HPLC) method has been published yet for synchronous estimation of fixed-dose combination (FDC) products of telmisartan to save time, cost and solvent for analysis. Hence, an economical and eco-friendly RP-HPLC method has been developed for synchronous estimation of multiple FDC products of antihypertensive drugs using the quality risk management (QRM) and DoE-based enhanced analytical quality by design approach. The analytical-QRM was started with the identification of potential method risk parameters followed by their risk assessment by risk priority number ranking and filtering. The identified critical method parameters were optimized using the DoE-based central composite design. The method operable design range was navigated and the control strategy was framed for control and mitigation of risk throughout the life-cycle of the developed method. The method was developed using Shimpack Octadecyl silane (ODS) C18 column and acetonitrile-1.0%v/v triethylamine in water (pH 6.0; 45 + 55, %v/v). The developed method was validated as per the International Council for Harmonization Q2 (R1) guideline. The developed method was applied for the analysis of seven different antihypertensive dosage forms. The developed RP-HPLC method can be used as an eco-friendly, robust and economical alternative analytical tool to several published methods for estimation of FDC products of antihypertensive drugs in the pharmaceutical industry.

Download Full-text

IMPACT OF THE TRIPLED FIXED-DOSE COMBINATION OF ANTIHYPERTENSIVE DRUGS ON CARDIAC ORGAN DAMAGE REGRESSION

Journal of Hypertension ◽

10.1097/01.hjh.0000539084.15099.46 ◽

2018 ◽

Vol 36 (Supplement 1) ◽

pp. e45-e46

Author(s):

A. Mazza ◽

L. Schiavon ◽

C. Rossetti ◽

S. Lenti ◽

A.P. Sacco ◽

...

Keyword(s):

Antihypertensive Drugs ◽

Organ Damage ◽

Fixed Dose Combination ◽

Fixed Dose ◽

Dose Combination

Download Full-text

Supersaturating drug delivery systems containing fixed-dose combination of two antihypertensive drugs: formulation, in vitro evaluation and molecular metadynamics simulations

European Journal of Pharmaceutical Sciences ◽

10.1016/j.ejps.2021.105860 ◽

2021 ◽

pp. 105860

Author(s):

Juliana Munari Oliveira Pinto ◽

Aline Franciane Leão ◽

Giovana Carolina Bazzo ◽

Cassiana Mendes ◽

Letícia M.P. Madureira ◽

...

Keyword(s):

Drug Delivery ◽

Drug Delivery Systems ◽

Antihypertensive Drugs ◽

Delivery Systems ◽

Fixed Dose Combination ◽

Fixed Dose ◽

In Vitro Evaluation ◽

Dose Combination

Download Full-text

Effect of a fixed-dose combination of perindopril arginine/amlodipine on the level and variability of blood pressure according to its office visit-to-visit measurements and self-measurements at home: A subanalysis of the PREVOSHODSTVO (SUPERIORITY) program

Terapevticheskii arkhiv ◽

10.17116/terarkh201789829-36 ◽

2017 ◽

Vol 89 (8) ◽

pp. 29-36

Author(s):

O D Ostroumova

Keyword(s):

Blood Pressure ◽

Combination Therapy ◽

Patient Group ◽

Antihypertensive Drugs ◽

Office Visit ◽

Fixed Dose Combination ◽

Uncontrolled Hypertension ◽

Fixed Dose ◽

Dose Combination

Aim. To study the effect of a fixed-dose combination of perindopril arginine/amlodipine (prestans) on the goal levels and variability of blood pressure (BP) according to its office visit-to-visit measurements and self-measurement (OVVM and SM) in a subgroup of 483 people from the population of the Russian observational SUPERIORITY program, most cases of whom are given the combination replacing the previously ineffective mono- and combination antihypertensive therapy (AHT). Subjects and methods. The subanalysis included data on 483 patients (34% men) aged 57.9±10.8 years with uncontrolled hypertension, who were both untreated and treated with antihypertensive mono- or combination therapy using a free or fixed-dose combination of 2—3 antihypertensive drugs and in whom the physicians decided to use prestans to correct AHT. The follow-up period was 24 weeks. Results. At the end of the investigation, the patients received prestans in the following doses: 5/5 mg (34% of the patients), 10/5 mg (39.5%), 5/10 mg (3.9%), and 10/10 mg (22%). In the analyzed patient group, the baseline BP was 160.8±8.8/92.6±7.4 mm Hg and dropped to 125.9±7.9/77.8±5.0 mm Hg at 24 weeks (p

Download Full-text

Antihypertensive Efficacy of a Triple Fixed-Dose Combination of Perindopril, Indapamide, and Amlodipine: Clinical Effectiveness in Ambulatory Practice (Results of the PETRA Study)

Kardiologiia ◽

10.18087/cardio.2018.11.10199 ◽

2018 ◽

Vol 58 (11) ◽

pp. 63-71

Author(s):

E. V. Privalova ◽

A. S. Lishuta

Keyword(s):

Combination Therapy ◽

Antihypertensive Drugs ◽

Fasting Blood Glucose ◽

Antihypertensive Efficacy ◽

Fixed Dose Combination ◽

Fixed Dose ◽

Final Visit ◽

Open Label ◽

Ambulatory Bp Monitoring ◽

Dose Combination

Most patients with arterial hypertension (AH) for successful long-term blood pressure (BP) control require combination of antihypertensive drugs acting on various target organs. Accumulated experience shows that about 30 % of patients require combination therapy with 3 drugs from different pharmacological classes. Efficacy of BP control in real clinical practice with the use of various doses of perindopril, indapamide, and amlodipine as components of taken once-daily triple fixed combination was assessed in the 3-months prospective observational open-label PETRA study. In this study data of office BP measurements and 24-hour ambulatory BP monitoring (ABPM) were obtained from 11209 ambulatory patients (47.6 % women) with AH. Initial mean office BP (BPmoff) was 156.58±16.10 / 91.56±9.33 mm Hg, AH duration – 9.48±7.19 years. After switching to triple fixed dose combination of perindopril, indapamide, and amlodipine BPmoff decreased by 24.81±15.47 / 11.41±9.90 mm Hg (p<0.0001). Doses of perindopril, indapamide, and amlodipine in combination at the final visit were 5 / 1.25 / 5, 10 / 2.5 / 5, and 10 / 2.5 / 10 mg. 24-hour ambulatory BP monitoring (ABPM) was carried out in 76 patients. Mean 24-hour BP lowed from mean 155.51±17.43 / 85.28±11.48 down to 134.63±12.51 / 77.83±8.99 mm Hg (p<0.0001). Clinically relevant improvement of a number of parameters of metabolism occurred after 3 months of the study (in particular, lowering of levels of total and low-density lipoprotein cholesterol [–8.6 and – 11.4 %, respectively], triglycerides [–12,1 %], fasting blood glucose [–6.6 %]). Thus, results of the PETRA study confirmed 24-hour long antihypertensive efficacy of triple fixed dose combination of perindopril, indapamide, and amlodipine. This drug combination can present novel possibility in treatment of patients with AH who have not achieved target BP values on preceding dual combination therapy and fully corresponds with the single pill concept for formation of adherence to therapy.

Download Full-text