Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an open multicenter trial (uncontrolled study) in 4,247 patients (49.1% male, 50.9% female; aged 17-89 years) with mild, moderate, or severe hypertension, the antihypertensive efficacy and in particular the tolerability of verapamil slow-release (SR) 240 mg (Isoptin RR) were studied. The dosage of the drug was adjusted to the therapeutic response; in 88.7% of the patients it was titrated according to the study protocol: 63.2% received constantly one SR tablet throughout the 6-week treatment period; in 15.6% the dosage was increased to one and a half tablet after 2 weeks, and in 9.9% to one tablet b.i.d. after a further 2 weeks. Monotherapy with verapamil SR 240 mg normalized diastolic blood pressure (less than or equal to 90 mm Hg) in 90% of the patients with mild hypertension, 77% of those with moderate, and 61% of those with severe hypertension. It was evident that blood pressure reduction was more pronounced the higher the baseline value. Cardiac and extracardiac tolerability of verapamil SR 240 mg was good. Mean heart rate was slightly reduced, none of the patients developed a second- or third-degree atrioventricular block. Side effects were reported by 480 of the 4,247 patients (11.3%). As expected, constipation (4.03%) was the predominant adverse reaction, followed by dizziness (3.65%), headache (1.54%), and other (less than 1%). In 217 patients (5.1%) therapy was discontinued prematurely, in 139 (3.27%) because of side effects.
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PMID:Efficacy and safety of verapamil SR 240 mg in essential hypertension: results of a multicentric phase IV study. 247 86

In the treatment of angina pectoris a double-blind evaluation of verapamil (Cordilox) at two dose levels-namely, 80 mg thrice daily and 120 mg thrice daily-propranolol (Inderal) 100 mg thrice daily, and isosorbide dinitrate (Vascardin) 20 mg thrice daily has been made against a placebo. The assessment was based on relief from daily attacks of angina on effort and the response to a whole-body exercise test. We can find no statistically significant difference between the effects of verapamil (120 mg three times a day) and propranolol (100 mg three times a day) in the treatment of angina of effort. Both of these preparations are more effective than a placebo both in the reduction of daily attacks (P < 0.01) and in the prolongation of exercise test (P < 0.05). Isosorbide dinitrate (20 mg three times a day) appears to be no more effective than a placebo in the treatment of angina on effort, but 14 out of 32 patients experienced headache of such severity that even when the dose was reduced to 10 mg thrice daily this drug therapy had to be withdrawn. Both propranolol (100 mg three times a day) and verapamil (120 mg three times a day) had a significant lowering effect on the diastolic blood pressure as measured with the patient standing (P < 0.01).
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PMID:Double-blind evaluation of verapamil, propranolol, and isosorbide dinitrate against a placebo in the treatment of angina pectoris. 457 Jun 71

Isoptin SR was used in 65 essential hypertensive patients. 240mg Isoptin SR (German Knoll Pharmaceutical company) per day was used in group A (35 cases) for 6 weeks, and in group B (30 cases) for 24 weeks, BP in group A and B decreased obviously in the first and second week after treatment. Marked effective rate and total effective rate were 65.7% and 74.3% respectively in group A, and 70.0% and 83.3% in group B. There were no significant changes of HR in group A before and after treatment while there was a decrease of HR in group B (P < 0.001). Left atrium (LA) decreased after 6 weeks in group A with an obvious increase of E/A ratio. There was significant decrease in LA, increase in E/A ratio, regression of IVS, LVPW and LVMI, but no changes in SV, CO, LVEF after 24 weeks of treatment of Isoptin SR in group B. E/A ratio was very sensitive and occurred earliest both in group A and group B. Side effects such as headache, dizziness, constipation, insomnia, peripheral oedema, sinus bradycardia occurred mainly in the first week of treatment. These symptoms disappeared gradually in the course of continued administration of Isoptin SR.
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PMID:The effect of Isoptin SR on blood pressure, heart function and hypertrophy of left ventricle of hypertensive patients. 808 92

The TEAM trial investigated the effectiveness and tolerance of a fixed combination of the ACE inhibitor and calcium channel blocker (2 mg trandolapril and 180 mg verapamil retard) (preparation Tarka) in an open multicentre prospective study of treatment of moderately severe hypertension (diastolic pressure at the end of the two-week wash-out period 100-115 mm Hg). The trial comprised 163 patients who were treated first for four weeks by a monotherapy with 2 mg trandolapril. After these four weeks patients who attained normal blood pressure proceeded with trandolapril treatment. Hypertensive patients who did not attain normal diastolic pressure levels were treated for another four weeks by a fixed combination of trandolapril and verapamil SR. After four weeks of treatment with trandolapril 62 patients of 163 (37%) had a diastolic blood pressure of less than 90 mm Hg. The fixed combination of trandolapril and verapamil SR reduced the diastolic blood pressure to less than 90 mm Hg in 71.6% of the patients resistant to treatment with 2 mg trandolapril and in another 15.6% of patients it reduced the diastolic blood pressure by 10 mm Hg or more. After two months of treatment 60 patients had a normal blood pressure due to trandolapril (37%) and another 73 patients (45%) treated by a combination of trandolapril and verapamil SR, i.e. a total of 133 patients (82%) who originally suffered from moderately severe hypertension, attained a normal diastolic blood pressure. The mean decrease of diastolic pressure after two months of treatment was 19.5 mm Hg in "non-respondents" to trandolapril monotherapy and 23.6 mm Hg in "respondents". The mean decrease of systolic pressure in "non-respondents" and "respondents" after trandolapril treatment was 19.5 mm Hg and 35.0 mm Hg resp. The fixed combination of trandolapril and verapamil was not only effective but was associated with a minimum of undesirable effects. The incidence of headaches declined significantly. The combination of the above preparations is useful also because both preparations have a cardio- and nephroprotective effect and do not affect the lipid and carbohydrate metabolism. Treatment with a fixed combination of trandolapril and verapamil SR is indicated in moderately severe hypertension not responding to monotherapy, in particular when associated with diabetes, hyperlipoproteinaemia, ischaemic heart disease or left ventricular hypertrophy.
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PMID:[The TEAM study--a study of the effectiveness and tolerance of treatment of essential hypertension with a fixed combination of trandolapril and verapamil]. 982 54

BACKGROUND: In general clinical practice, physicians prescribe calcium channel blockers to a wide range of patients with differing demographic characteristics and hypertension history. This study was undertaken to investigate the effectiveness and safety of sustained-release verapamil (Verelan((R)), verapamil HCl) in patients with essential hypertension, studied under "usual use" conditions. METHODS: In this prospective, open-label, postmarketing surveillance study, 25 089 patients with hypertension received once-daily verapamil therapy for 4 weeks, during which they were evaluated by 8106 physicians at baseline and at two follow-up visits (weeks 2 and 4). In this study, hypertension was defined as an average sitting diastolic blood pressure (DBP) of greater-than-or-equal 90 mm Hg at baseline. Previously diagnosed hypertensive patients with a sitting DBP <90 mm Hg but experiencing untoward effects requiring discontinuation of current antihypertensive therapy were also included. RESULTS: Eighty-five percent (n = 21 446) of the total patients enrolled at baseline completed this office-based trial. Nearly 24% of patients were newly diagnosed hypertensives. At baseline, the mean systolic blood pressure (SBP) and diastolic blood pressure were 161 and 96 mm Hg, respectively. In evaluable patients with mild, moderate, and severe hypertension, as stratified by baseline measurements, treatment with verapamil produced DBP reductions of 12, 19, and 29 mm Hg, respectively. Verapamil treatment produced clinically similar SBP, DBP, and HR (heart rate) reductions across gender and racial groups studied (white, black, Hispanic, and Asian). Only 6.1% of patients failed to complete the study because of any reported adverse experiences (4.5% of patients discontinued because of adverse experiences considered drug related). Constipation (5.0%) and headache (1.1%) were the most commonly reported adverse events. CONCLUSION: In general clinical practice, verapamil is well tolerated and effective in a broad range of hypertensive patients.
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PMID:Large-Scale Postmarketing Surveillance of Hypertensive Patients Treated with Verapamil. 1185 Jun 91