RecruitingPhase 4ACTRN12614000461695

Assessment of the Effects of Cardiopulmonary Phenotype on Oral and intravenous (IV) Frusemide Pharmacokinetics

An investigation of the change in concentration time profile for the diuretic drug frusemide when administered orally and intravenously to individuals with oedema associated with pulmonary hypertension or compensated and decompensated congestive heart failure.


Sponsor

Flinders University

Enrollment

20 participants

Start Date

May 5, 2014

Study Type

Interventional

Conditions

Summary

While there is currently a paucity of evidence to guide this practice, frusemide is routinely administered IV to patients presenting to Flinders Medical Centre (FMC) with either decompensated heart failure or pulmonary hypertension on the basis that expert opinion considers oral frusemide ineffective for managing these conditions. This study will assess the impact of congestive cardiac failure (acutely decompensated and compensated) and pulmonary hypertension on the oral and intravenous (IV) pharmacokinetics of frusemide, and determine whether altered pharmacokinetics may explain the variability and perceived lack of efficacy of oral frusemide in managing these conditions. It is hypothesised that these conditions will differentially affect the rate of oral frusemide absorption (i.e. the time to maximal concentration / response will be delayed), but that neither will affect the extent of absorption (i.e. bioavailability will remain unchanged). By improving the understanding of the impact of these conditions on frusemide pharmacokinetics, this study will form a framework to facilitate future research here at FMC to deliver more personalised and optimised dosing of frusemide that may combine oral and IV routes of administration, which will provide more effective management of symptoms, while reducing the time to hospital discharge.


Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

This study is looking at how a water tablet (diuretic) called frusemide is absorbed by the body in patients with different types of heart or lung conditions — specifically decompensated heart failure, pulmonary hypertension, and compensated heart failure — compared to each other. By understanding how these conditions affect how the body absorbs the drug taken by mouth, researchers hope to develop better, personalised dosing strategies. You may be eligible if: - You are 18 years of age or older - You are being treated for decompensated congestive heart failure OR pulmonary hypertension by a specialist at Flinders Medical Centre - You meet specific clinical criteria for your condition as determined by your doctor (e.g. confirmed reduced heart function, swelling, or elevated lung pressures) You may NOT be eligible if: - Your systolic blood pressure is below 90 mmHg - Your kidney function is severely reduced (creatinine above 300 microg/L) - You are on IV vasodilators or inotropic agents (other than digoxin) - You have known heart disease or high blood pressure (for the pulmonary hypertension group only) Talk to your doctor about whether this trial might be right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

On Day 1, in patients that are clinically considered be suffering from oedema secondary to acutely decompensated congestive heart failure or pulmonary hypertension, following the administration of an

On Day 1, in patients that are clinically considered be suffering from oedema secondary to acutely decompensated congestive heart failure or pulmonary hypertension, following the administration of an IV bolus dose of frusemide (typically 40mg), a series of blood (5mL) and urine samples will be collected at t= 0, 1, 2, 3, 4, 5 and 6hrs for analysis of frusemide concentrations. On Day 2 (acutely decompensated phase) following the administration of an oral bolus dose of frusemide (double the Day 1 IV dose; typically 80mg), a series of blood (5mL) and urine samples will be collected at t= 0, 1, 2, 3, 4, 5 and 6hrs for analysis of frusemide concentrations. In patients presenting with oedema secondary to acutely decompensated heart failure, five to seven days later, on Day E-1 when the patient is clinically considered to no longer be acutely decompensated (i.e. they have returned to compensated heart failure) following the administration of an IV bolus dose of frusemide (typically 40mg), a series of blood (5mL) and urine samples will be collected at t= 0, 1, 2, 3, 4, 5 and 6hrs for analysis of frusemide concentrations. On Day E (compensated phase) following the administration of an oral bolus dose of frusemide (double the Day E-1 IV dose; typically 80mg), a series of blood (5mL) and urine samples will be collected at t= 0, 1, 2, 3, 4, 5 and 6hrs for analysis of frusemide concentrations.


Locations(1)

Flinders Medical Centre - Bedford Park

SA, Australia

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ACTRN12614000461695


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