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PEDIATRICS |
From the University Hospitals of Cleveland, Cleveland, Ohio (Dr. Blumer); Children's Hospital Medical Center, Cincinnati, Ohio (Dr. Daniels); Baylor College of Medicine, Houston, Texas (Dr. Dreyer); Children's Hospital Research Foundation, Columbus, Ohio (Dr. Batisky, Dr. Walson); and Pfizer Global Research & Development, Ann Arbor, Michigan (Dr. Roman, Dr. Ouellet)
Quinapril pharmacokinetics were studied in infants and children using a
novel study design that allowed substitution of quinapril for one dose of the
current chronic angiotensin-converting enzyme (ACE) inhibitor treatment. A
total of 24 patients ranging in age from 2.5 to 82 months who were receiving
an ACE inhibitor held their usual treatment on the study day and received a
0.2-mg/kg dose of quinapril syrup. Blood samples were collected through 24
hours postdose, and plasma was analyzed for quinapril and its active
metabolite, quinaprilat. Quinapril was rapidly converted to quinaprilat.
Quinaprilat concentrations generally peaked 1 to 2 hours postdose and declined
with a mean half-life of 2.30 hours. Dosing on a mg/kg basis resulted in
quinaprilat AUC and Cmax values that were generally comparable
across the age range of patients in this study. The overall mean
AUC0-
was 993 ngh/mL (range: 533-1523), and
mean Cmax was 260 ng/mL (range: 70.0-445.5). Quinaprilat CL/F
correlated well with body size (body surface area or weight) and creatinine
clearance (mL/min). Pharmacokinetic results after a 0.2-mg/kg dose in infants
and children are comparable to those observed following a 10-mg dose in
adults.
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