Abstract
Heart failure is one of the leading causes of death in developed countries, and its prevalence is expected to increase further in the coming years. While the pharmacokinetic changes observed in patients with heart failure have been reviewed twice in Clinical Pharmacokinetics, approximately a quarter century has passed since the latest article was published in 1988. Since then, many important classes of agents (e.g. ACE inhibitors, angiotensin receptor antagonists and inotropes) have been introduced for the treatment of heart failure. The aim of the present article is to update the information regarding the pharmacokinetics of these drugs. For this purpose we have made a systematic survey of literature using MEDLINE, EMBASE and Japan Centra Revuo Medicina (in Japanese) and found a total of 111 relevant publications for 58 drugs. Heart failure is a pathophysiological state where the damaged heart, from whatever causes, no longer pumps enough blood for the needs of body tissues at rest or during the normal daily activities. The spectrum of heart failure ranges from acute decompensated heart failure (including circulatory shock) to chronic compensated or decompensated heart failure. Because hypoperfusion of organs may influence drug absorption from the gastrointestinal tract, distribution into tissues and elimination either by the liver or kidneys, it is conceivable that the pharmacokinetics of many drugs may be altered in patients with heart failure. The pharmacokinetic changes of drugs in these patients in the light of a physiologically based pharmacokinetic model are discussed, since this model can interpret altered pharmacokinetics in terms of changes in the binding of drugs in plasma and tissue, blood flow to drug-eliminating organs and intrinsic activity of drug elimination. Pharmacokinetic changes of drugs after intravenous administration are described here in Part 1 and those after oral administration will be discussed in Part 2 in a later issue of the Clinical Pharmacokinetics. Reviewing the retrieved data, it was considered that patients with asymptomatic or compensated chronic heart failure seem to have no or minimal alterations in the pharmacokinetics of parenterally administered drugs as long as there was no concurrent liver and/or kidney dysfunction. In contrast, it was found that the systemic clearance of at least six drugs (i.e. milrinone, carperitide, molsidomine, theophylline, ciclosporin and hydralazine) was reduced after intravenous administration by 50 % or more in patients with acute decompensated heart failure or chronic severe heart failure (New York Heart Association class III or IV) as compared with healthy subjects. Because there is a paucity of information regarding the pharmacokinetics of drugs in patients with severe heart failure, close attention should be paid to monitoring the efficacy of these agents and their associated adverse effects.
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References
Mann DL. Pathophysiology of heart failure. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders; 2011. p. 487–504.
McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–847.
Mann DL. Management of heart failure patients with reduced efection fraction. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders; 2011. p. 543–77.
Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–220.
Fonarow GC, Yancy CW, Hernandez AF, et al. Potential impact of optimal implementation of evidence-based heart failure therapies on mortality. Am Heart J. 2011;161(6):1024–30 e3.
Jessup M, Abraham WT, Casey DE, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119(14):1977–2016.
Gheorghiade M, Filippatos G, Michael Felker G. Diagnosis and management of acute heart failure syndromes. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders; 2011. p. 517–42.
Redfield MM. Heart failure with normal ejection fraction. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders; 2011. p. 586–600.
Smith SJ, Bos G, Esseveld MR, et al. Acute-phase proteins from the liver and enzymes from myocardial infarction; a quantitative relationship. Clin Chim Acta. 1977;81(1):75–85.
Benowitz NL, Meister W. Pharmacokinetics in patients with cardiac failure. Clin Pharmacokinet. 1976;1(6):389–405.
Shammas FV, Dickstein K. Clinical pharmacokinetics in heart failure: an updated review. Clin Pharmacokinet. 1988;15(2):94–113.
Nattel S, Gagne G, Pineau M. The pharmacokinetics of lignocaine and beta-adrenoceptor antagonists in patients with acute myocardial infarction. Clin Pharmacokinet. 1987;13(5):293–316.
Chu JS, Kishion S, Nomura A, et al. Serum alpha 1-acid glycoprotein, sialic acid, and protein binding of disopyramide in normal subjects and cardiac patients. Zhongguo Yao Li Xue Bao. 1997;18(5):408–10.
Roden DM. Pharmacokinetics of amiodarone: implications for drug therapy. Am J Cardiol. 1993;72(16):45F–50F.
Veronese ME, McLean S, Hendriks R. Plasma protein binding of amiodarone in a patient population: measurement by erythrocyte partitioning and a novel glass-binding method. Br J Clin Pharmacol. 1988;26(6):721–31.
Nolan PE, Jr. Pharmacokinetics and pharmacodynamics of intravenous agents for ventricular arrhythmias. Pharmacotherapy. 1997;17 (2 Pt 2):65S–75S; discussion 89S–91S.
Vadiei K, O’Rangers EA, Klamerus KJ, et al. Pharmacokinetics of intravenous amiodarone in patients with impaired left ventricular function. J Clin Pharmacol. 1996;36(8):720–7.
Brazzell RK, Khoo KC, Szuna AJ, et al. Pharmacokinetics and pharmacodynamics of intravenous cibenzoline in normal volunteers. J Clin Pharmacol. 1985;25(6):418–23.
Micromedex® 2.0. Thomson Reuters. http://www.thomsonhc.com/micromedex2/librarian/. Accessed 6 Jun 2012.
Massarella JW, Silvestri T, DeGrazia F, et al. Effect of congestive heart failure on the pharmacokinetics of cibenzoline. J Clin Pharmacol. 1987;27(3):187–92.
Murray KT. Ibutilide. Circulation. 1998;97(5):493–7.
Cropp JS, Antal EG, Talbert RL. Ibutilide: a new class III antiarrhythmic agent. Pharmacotherapy. 1997;17(1):1–9.
CORVERT® (ibutilide fumarate) injection [package insert]. Kalamazoo: Pharmacia & Upjohn Company; 2002.
Tisdale JE, Overholser BR, Sowinski KM, et al. Pharmacokinetics of ibutilide in patients with heart failure due to left ventricular systolic dysfunction. Pharmacotherapy. 2008;28(12):1461–70.
PERDIPINE® (nicardipine hydrochloride) Injection [package insert]. Tokyo: Astellas Pharma, Inc.; 2011.
Graham DJ, Dow RJ, Hall DJ, et al. The metabolism and pharmacokinetics of nicardipine hydrochloride in man. Br J Clin Pharmacol. 1985;20(Suppl 1):23S–8S.
Hirasawa K, Tateda K, Kato J, et al. Clinicopharmacological study of nicardipine hydrochloride: pharmacokinetics and hemodynamics after intravenous infusion in patients with acute heart failure. Jpn Pharmacol Ther. 1995;23(4):901–11.
Smith NA, Kates RE, Lebsack C, et al. Clinical pharmacology of intravenous enoximone: pharmacodynamics and pharmacokinetics in patients with heart failure. Am Heart J. 1991;122(3 Pt 1):755–63.
Sandell EP, Hayha M, Antila S, et al. Pharmacokinetics of levosimendan in healthy volunteers and patients with congestive heart failure. J Cardiovasc Pharmacol. 1995;26(Suppl 1):S57–62.
Jonsson EN, Antila S, McFadyen L, et al. Population pharmacokinetics of levosimendan in patients with congestive heart failure. Br J Clin Pharmacol. 2003;55(6):544–51.
Poder P, Eha J, Sundberg S, et al. Pharmacokinetic-pharmacodynamic interrelationships of intravenous and oral levosimendan in patients with severe congestive heart failure. Int J Clin Pharmacol Ther. 2003;41(8):365–73.
Antila S, Kivikko M, Lehtonen L, et al. Pharmacokinetics of levosimendan and its circulating metabolites in patients with heart failure after an extended continuous infusion of levosimendan. Br J Clin Pharmacol. 2004;57(4):412–5.
Edelson J, Stroshane R, Benziger DP, et al. Pharmacokinetics of the bipyridines amrinone and milrinone. Circulation 1986;73(3 Pt 2):III145–52.
Benotti JR, Lesko LJ, McCue JE, et al. Pharmacokinetics and pharmacodynamics of milrinone in chronic congestive heart failure. Am J Cardiol. 1985;56(10):685–9.
Taniguchi T, Shibata K, Saito S, et al. Pharmacokinetics of milrinone in patients with congestive heart failure during continuous venovenous hemofiltration. Intensive Care Med. 2000;26(8):1089–93.
Kieback AG, Iven H, Stolzenburg K, et al. Pharmacokinetics and hemodynamic effects of the phosphodiesterase III inhibitor saterinone in patients with chronic heart failure. Int J Cardiol. 2003;91(2–3):201–8.
Tammara B, Trang JM, Kitani M, et al. The pharmacokinetics of toborinone in subjects with congestive heart failure and concomitant renal impairment and/or concomitant hepatic impairment. J Clin Pharmacol. 2002;42(12):1318–25.
Lehtonen LA, Antila S, Pentikainen PJ. Pharmacokinetics and pharmacodynamics of intravenous inotropic agents. Clin Pharmacokinet. 2004;43(3):187–203.
Antila S, Sundberg S, Lehtonen LA. Clinical pharmacology of levosimendan. Clin Pharmacokinet. 2007;46(7):535–52.
Lilleberg J, Antila S, Karlsson M, et al. Pharmacokinetics and pharmacodynamics of simendan, a novel calcium sensitizer, in healthy volunteers. Clin Pharmacol Ther. 1994;56(5):554–63.
Puttonen J, Kantele S, Ruck A, et al. Pharmacokinetics of intravenous levosimendan and its metabolites in subjects with hepatic impairment. J Clin Pharmacol. 2008;48(4):445–54.
Puttonen J, Kantele S, Kivikko M, et al. Effect of severe renal failure and haemodialysis on the pharmacokinetics of levosimendan and its metabolites. Clin Pharmacokinet. 2007;46(3):235–46.
Kivikko M, Antila S, Eha J, et al. Pharmacokinetics of levosimendan and its metabolites during and after a 24-hour continuous infusion in patients with severe heart failure. Int J Clin Pharmacol Ther. 2002;40(10):465–71.
Ohnishi A, Toyoki T, Ohno T, et al. Pharmacokinetics and pharmacodynamics of intravenous OPC-18790 in humans: a novel nonglycosidic inotropic agent. J Clin Pharmacol. 1994;34(2):176–83.
Wargo KA, Banta WM. A comprehensive review of the loop diuretics: should furosemide be first line? Ann Pharmacother. 2009;43(11):1836–47.
Vargo DL, Kramer WG, Black PK, et al. Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide and furosemide in patients with congestive heart failure. Clin Pharmacol Ther. 1995;57(6):601–9.
HANP® (carperitide) for injection [interview form]. Tokyo: Daiichi-Sankyo, Inc.; 2010.
Obata K, Yasue H, Yoshimura M, et al. Clinical effects and pharmacokinetics of alpha-human atrial natriuretic peptide (SUN 4936; carperitide) in patients with acute heart failure. Jpn Pharmacol Ther. 1993;21(4):1103–14.
Kirsten R, Nelson K, Kirsten D, et al. Clinical pharmacokinetics of vasodilators: part II. Clin Pharmacokinet. 1998;35(1):9–36.
Rosenkranz B, Winkelmann BR, Parnham MJ. Clinical pharmacokinetics of molsidomine. Clin Pharmacokinet. 1996;30(5):372–84.
Huber T, Grosse-Heitmeyer W, Rietbrock S, et al. Pharmacokinetics and pharmacodynamics of molsidomine in patients with liver dysfunction due to congestive heart failure. Int J Clin Pharmacol Ther Toxicol. 1992;30(11):491–2.
Jeong CS, Hwang SC, Jones DW, et al. Theophylline disposition in Korean patients with congestive heart failure. Ann Pharmacother. 1994;28(3):396–401.
Leier CV. Regional blood flow in human congestive heart failure. Am Heart J. 1992;124(3):726–38.
Burckart GJ, Fricker FJ, Venkataramanan R, et al. Cyclosporine kinetics in pediatric patients with congestive heart failure. Transpl Proc. 1987;19(1 Pt 2):1528–9.
Crawford MH, Ludden TM, Kennedy GT. Determinants of systemic availability of oral hydralazine in heart failure. Clin Pharmacol Ther. 1985;38(5):538–43.
Kuntz HD, Straub H, May B. Theophylline elimination in congestive heart failure. Klin Wochenschr. 1983;61(21):1105–6.
Spahn H, Knauf H, Mutschler E. Pharmacokinetics of torasemide and its metabolites in healthy controls and in chronic renal failure. Eur J Clin Pharmacol. 1990;39(4):345–8.
Schwartz S, Brater DC, Pound D, et al. Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide in patients with cirrhosis. Clin Pharmacol Ther. 1993;54(1):90–7.
Frey R, Muck W, Unger S, et al. Pharmacokinetics, pharmacodynamics, tolerability, and safety of the soluble guanylate cyclase activator cinaciguat (BAY 58–2667) in healthy male volunteers. J Clin Pharmacol. 2008;48(12):1400–10.
Frey R, Scheerans C, Blunck M, et al. Pharmacokinetics of the soluble guanylate cyclase activator cinaciguat in individuals with hepatic impairment. J Clin Pharmacol. 2012;52(11):1714–24.
Fillastre JP, Leroy A, Humbert G, et al. Pharmacokinetics of habekacin in patients with renal insufficiency. Antimicrob Agents Chemother. 1987;31(4):575–7.
HABEKACIN® (arbekacin sulfate) injection [package insert]. Tokyo: Meiji Seika Pharma Co., Ltd.; 2011.
Brunton L, Chabner B, Knollman B. Goodman and Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill Professional; 2010.
Burnier M, Fricker AF, Hayoz D, et al. Pharmacokinetic and pharmacodynamic effects of YM087, a combined V1/V2 vasopressin receptor antagonist in normal subjects. Eur J Clin Pharmacol. 1999;55(9):633–7.
Wolf DL, Hearron AE, Metzler CM, et al. The pharmacokinetics and haemodynamic effects of continuous nicorandil infusion in healthy volunteers. Eur J Clin Pharmacol. 1993;45(5):437–43.
Brunton L, Lazo J, Parker K. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill Professional; 2005.
Goodman LS, Limbird LE, Milinoff PB, et al. Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill Professional; 1996.
Haustein KO, Alken RG, Lach HJ, et al. On the pharmacokinetics of pengitoxin and its cardioactive derivative 16-acetyl-gitoxin. Eur J Clin Pharmacol. 1983;25(3):369–73.
Bergstrand R, Vedin A, Wilhelmsson C, et al. Intravenous and oral administration of molsidomine, a pharmacodynamic and pharmacokinetic study. Eur J Clin Pharmacol. 1984;27(2):203–8.
Hardman JG, Limbird LE, Gilman AG. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed. New York: McGraw-Hill Professional; 2001.
Li Y, Tian L, Huang Y, et al. Pharmacokinetic and pharmacodynamic properties of a single intravenous dose of ibutilide fumarate: a phase I, randomized, open-label, increasing-dose study in healthy Chinese men. Clin Ther. 2007;29(9):1957–66.
Malhotra BK, Iyer RA, Soucek KM, et al. Oral bioavailability and disposition of [14C]omapatrilat in healthy subjects. J Clin Pharmacol. 2001;41(8):833–41.
Kostis JB, Garland WT, Delaney C, et al. Fosinopril: pharmacokinetics and pharmacodynamics in congestive heart failure. Clin Pharmacol Ther. 1995;58(6):660–5.
Beermann B, Till AE, Gomez HJ, et al. Pharmacokinetics of lisinopril (IV/PO) in healthy volunteers. Biopharm Drug Dispos. 1989;10(4):397–409.
Till AE, Dickstein K, Aarsland T, et al. The pharmacokinetics of lisinopril in hospitalized patients with congestive heart failure. Br J Clin Pharmacol. 1989;27(2):199–204.
Kostis JB, Klapholz M, Delaney C, et al. Pharmacodynamics and pharmacokinetics of omapatrilat in heart failure. J Clin Pharmacol. 2001;41(12):1280–90.
Kostis JB, Vachharajani NN, Hadjilambris OW, et al. The pharmacokinetics and pharmacodynamics of irbesartan in heart failure. J Clin Pharmacol. 2001;41(9):935–42.
Lo MW, Goldberg MR, McCrea JB, et al. Pharmacokinetics of losartan, an angiotensin II receptor antagonist, and its active metabolite EXP3174 in humans. Clin Pharmacol Ther. 1995;58(6):641–9.
Lo MW, Toh J, Emmert SE, et al. Pharmacokinetics of intravenous and oral losartan in patients with heart failure. J Clin Pharmacol. 1998;38(6):525–32.
Bonde J, Angelo HR, Bodtker S, et al. Kinetics of disopyramide after intravenous infusion to patients with myocardial infarction and heart failure. Acta Pharmacol Toxicol (Copenh). 1985;56(4):278–82.
Lima JJ, Haughey DB, Leier CV. Disopyramide pharmacokinetics and bioavailability following the simultaneous administration of disopyramide and 14C-disopyramide. J Pharmacokinet Biopharm. 1984;12(3):289–313.
Kessler KM, Kayden DS, Estes DM, et al. Procainamide pharmacokinetics in patients with acute myocardial infarction or congestive heart failure. J Am Coll Cardiol. 1986;7(5):1131–9.
Tisdale JE, Rudis MI, Padhi ID, et al. Disposition of procainamide in patients with chronic congestive heart failure receiving medical therapy. J Clin Pharmacol. 1996;36(1):35–41.
Kessler KM, Lowenthal DT, Warner H, et al. Quinidine elimination in patients with congestive heart failure or poor renal function. N Engl J Med. 1974;290(13):706–9.
Prescott LF, Adjepon-Yamoah KK, Talbot RG. Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure. Br Med J. 1976;1(6015):939–41.
Thomson PD, Melmon KL, Richardson JA, et al. Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans. Ann Intern Med. 1973;78(4):499–508.
Sawyer DR, Ludden TM, Crawford MH. Continuous infusion of lidocaine in patients with cardiac arrhythmias. Unpredictability of plasma concentrations. Arch Intern Med. 1981;141(1):43–5.
Graffner C, Conradson TB, Hofvendahl S, et al. Tocainide kinetics after intravenous and oral administration in healthy subjects and in patients with acute myocardial infarction. Clin Pharmacol Ther. 1980;27(1):64–71.
MacMahon B, Bakshi M, Branagan P, et al. Pharmacokinetics and haemodynamic effects of tocainide in patients with acute myocardial infarction complicated by left ventricular failure. Br J Clin Pharmacol. 1985;19(4):429–34.
Edgar B, Collste P, Haglund K, et al. Pharmacokinetics and haemodynamic effects of felodipine as monotherapy in hypertensive patients. Clin Invest Med. 1987;10(5):388–94.
Dunselman PH, Edgar B, Scaf AH, et al. Pharmacokinetics of felodipine after intravenous and chronic oral administration in patients with congestive heart failure. Br J Clin Pharmacol. 1989;28(1):45–52.
Shiina A, Hosoda S, Higuchi S, et al. Consecutive intravenous continuous infusion of nicardipine hydrochloride to healthy persons: studies on hemodynamics and pharmacokinetics. Kiso to Rinsho. 1986;20:1114–24.
Gupta SK, Granneman GR, Boger RS, et al. Simultaneous modeling of the pharmacokinetic and pharmacodynamic properties of enalkiren (Abbott-64662, a new renin inhibitor). I: single dose study. Drug Metab Dispos. 1992;20(6):821–5.
Gupta SK, Granneman GR, Packer M, et al. Simultaneous modeling of the pharmacokinetic and pharmacodynamic properties of enalkiren (Abbott-64662, a renin inhibitor). II: a dose-ranging study in patients with congestive heart failure. J Cardiovasc Pharmacol. 1993;21(5):834–40.
Cook JA, Smith DE, Cornish LA, et al. Kinetics, dynamics, and bioavailability of bumetanide in healthy subjects and patients with congestive heart failure. Clin Pharmacol Ther. 1988;44(5):487–500.
Andreasen F, Mikkelsen E. Distribution, elimination and effect of furosemide in normal subjects and in patients with heart failure. Eur J Clin Pharmacol. 1977;12(1):15–22.
Brater DC, Seiwell R, Anderson S, et al. Absorption and disposition of furosemide in congestive heart failure. Kidney Int. 1982;22(2):171–6.
Andreasen F, Hansen U, Husted SE, et al. The pharmacokinetics of frusemide are influenced by age. Br J Clin Pharmacol. 1983;16(4):391–7.
Noormohamed FH, McNabb WR, Dixey JJ, et al. Renal responses and pharmacokinetics of piretanide in humans: effect of route of administration, state of hydration and probenecid pretreatment. J Pharmacol Exp Ther. 1990;254(3):992–9.
Marone C, Rivera B, Zwahlen H, et al. Efficacy and pharmacokinetics of piretanide in patients with congestive heart failure. Eur J Clin Invest. 1989;19(4):378–83.
Barr WH, Smith HL, Karnes HT, et al. Torasemide dose-proportionality of pharmacokinetics and pharmacodynamics. Prog Pharmacol Clin Pharmacol. 1990;8:29–37.
Kieback AG, Baumann G. Saterinone, a phosphodiesterase (PDE) III inhibitor and α1-adrenergic antagonist. Cardiovasc Drug Rev. 1999;17:374–83.
Mueck W, Frey R. Population pharmacokinetics and pharmacodynamics of cinaciguat, a soluble guanylate cyclase activator, in patients with acute decompensated heart failure. Clin Pharmacokinet. 2010;49(2):119–29.
Ludden TM, Shepherd AM, McNay JL, et al. Hydralazine kinetics in hypertensive patients after intravenous administration. Clin Pharmacol Ther. 1980;28(6):736–42.
Iida S, Kinoshita H, Holford NH. Population pharmacokinetic and pharmacodynamic modelling of the effects of nicorandil in the treatment of acute heart failure. Br J Clin Pharmacol. 2008;66(3):352–65.
Fung HL. Pharmacokinetics and pharmacodynamics of organic nitrates. Am J Cardiol. 1987;60(15):4H–9H.
Armstrong PW, Armstrong JA, Marks GS. Pharmacokinetic-hemodynamic studies of intravenous nitroglycerin in congestive cardiac failure. Circulation. 1980;62(1):160–6.
Mao ZL, Stalker D, Keirns J. Pharmacokinetics of conivaptan hydrochloride, a vasopressin V(1A)/V(2)-receptor antagonist, in patients with euvolemic or hypervolemic hyponatremia and with or without congestive heart failure from a prospective, 4-day open-label study. Clin Ther. 2009;31(7):1542–50.
Ochs HR, Schuppan U, Greenblatt DJ, et al. Reduced distribution and clearance of acetaminophen in patients with congestive heart failure. J Cardiovasc Pharmacol. 1983;5(4):697–9.
Jacqz-Aigrain E, Montes C, Brun P, et al. Cyclosporine pharmacokinetics in nephrotic and kidney-transplanted children. Eur J Clin Pharmacol. 1994;47(1):61–5.
Kates RE, Leier CV. Dobutamine pharmacokinetics in severe heart failure. Clin Pharmacol Ther. 1978;24(5):537–41.
Korth-Bradley JM, Rubin AS, Hanna RK, et al. The pharmacokinetics of etanercept in healthy volunteers. Ann Pharmacother. 2000;34(2):161–4.
Soran O, Feldman AM, Schneider VM, et al. The pharmacokinetics of etanercept in patients with heart failure. Br J Clin Pharmacol. 2001;51(2):191–2.
Leuenberger U, Kenney G, Davis D, et al. Comparison of norepinephrine and isoproterenol clearance in congestive heart failure. Am J Physiol. 1992;263(1 Pt 2):H56–60.
Patel IH, Soni PP, Fukuda EK, et al. The pharmacokinetics of midazolam in patients with congestive heart failure. Br J Clin Pharmacol. 1990;29(5):565–9.
Graffner C, Hoffmann KJ, Johnsson G, et al. Pharmacokinetic studies in man of the selective beta 1-adrenoceptor agonist, prenalterol. Eur J Clin Pharmacol. 1981;20(2):91–7.
Sainsbury EJ, Fitzpatrick D, Ikram H. Pharmacokinetic and plasma-concentration-effect relationships of prenalterol in cardiac failure. Eur J Clin Pharmacol. 1985;28(4):397–403.
Slaughter RL, Lanc RA. Theophylline clearance in obese patients in relation to smoking and congestive heart failure. Drug Intell Clin Pharm. 1983;17(4):274–6.
Gardner MJ, Tornatore KM, Jusko WJ, et al. Effects of tobacco smoking and oral contraceptive use on theophylline disposition. Br J Clin Pharmacol. 1983;16(3):271–80.
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Ogawa, R., Stachnik, J.M. & Echizen, H. Clinical Pharmacokinetics of Drugs in Patients with Heart Failure. Clin Pharmacokinet 52, 169–185 (2013). https://doi.org/10.1007/s40262-012-0029-2
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DOI: https://doi.org/10.1007/s40262-012-0029-2