Pharmacokinetics and efficacy of carvedilol in hypertensive patients with chronic renal failure and hemodialysis patients.

The efficacy, safety, and pharmacokinetics of carvedilol were investigated in an open trial performed on 13 hypertensive patients with chronic renal failure and six additional patients requiring hemodialysis. In hypertensive renal failure patients, treatment with carvedilol (5 mg/day) for 1 week produced a significant decrease in blood pressure (from 172/101 to 146/84 mm Hg) but did not change the heart rate. The pharmacokinetics of carvedilol did not change with repeated administration, and there was no accumulation of this drug. In hemodialysis patients with hypertension, the pharmacokinetics of carvedilol after a single dose of 10 mg did not vary between dialysis and nondialysis days, and blood pressure decreased significantly on both days. In addition, there was no accumulation of carvedilol during a 4-week trial of therapy, and blood pressure was decreased significantly from 170/93 to 145/83 mm Hg. There were no side effects and no abnormal laboratory findings noted during the trial. These results indicate that carvedilol is an effective and safe agent for hypertensive patients with chronic renal failure and for hemodialysis patients with hypertension and that dosage adjustments are probably not required in these clinical situations.