The collection time of the plasma sample included data from before administration of bepridil to up to 6 h after administration. To assess risk factors for achieving plasma bepridil concentrations ≥800 ng/mL at steady state, the eligible patients were divided into two groups based on their bepridil concentrations: ≥800 ng/mL and < 800 ng/mL.
The C/D ratio was calculated using the following equation:
C/D ratio of bepridil = plasma concentration of bepridil (ng/mL) / dose of bepridil (mg/day/kg body weight).
In this study, we defined the polypharmacy group as those who use six or more drugs, whereas the non-polypharmacy group was those who took fewer than six drugs. The relationship between plasma bepridil concentrations ≥800 ng/mL and baseline characteristics, including sex, age, height, body weight, body mass index, serum creatinine, creatinine clearance (Ccr), number of concomitant drugs used, typical inducers of CYPs (phenytoin, carbamazepine, phenobarbital, and rifampicin) [15 (
link)], typical inhibitors of CYPs (erythromycin, clarithromycin, protease inhibitors, and azole antifungals) [15 (
link)], aprindine, a competitive inhibitor of CYP2D6 [12 (
link)], typical inhibitor of P-gp (amiodarone, diltiazem, nicardipine, nifedipine, propranolol, quinidine, cyclosporin, and tacrolimus) [16 (
link)–18 (
link)], and left ventricular ejection fraction (LVEF), were examined. LVEF was measured using echocardiographic equipment provided at each hospital. Ccr was estimated using the Cockcroft–Gault formula [19 (
link)].
The patient’s medical history and duration of bepridil treatment were collected from medical records.
Asai Y., Arihara H., Omote S., Tanio E., Yamashita S., Higuchi T., Hashimoto E., Yamada M., Tsuji H., Kondo Y., Hayashi M, & Yamamoto Y. (2023). Effect of polypharmacy on plasma bepridil concentration in patients with heart failure: a multicenter retrospective study. Journal of Pharmaceutical Health Care and Sciences, 9, 10.