Palatability of crushed ß-blockers, converting enzyme inhibitors and thiazides

J Clin Pharm Ther. 2012 Oct;37(5):544-6. doi: 10.1111/j.1365-2710.2011.01330.x. Epub 2012 Apr 4.

Abstract

What is known and objectives: A problem that often affects antihypertensive drugs is the lack of formulations appropriate for childhood. Parents, therefore, crush tablets and administer the antihypertensive drug mixed with solid food or a palatable drink. Because palatability is a major modulator of adherence to prescribed medication, the palatability of crushed ß-blockers, converting enzyme inhibitors and thiazides was assessed among adult volunteers.

Methods: The palatability of crushed atenolol, bisoprolol, enalapril, lisinopril, ramipril, chlorthalidone and hydrochlorothiazide was evaluated by means of a facial hedonic scale among 20 volunteers. The calcium channel-blockers amlodipine and lercanidipine whose tastes are disliked and liked, respectively, by children were also tested. A concealed random allocation procedure was used.

Results: The palatability scores assigned to chlorthalidone, hydrochlorothiazide and lisinopril were superior (P < 0·002) to those assigned to atenolol, bisoprolol, enalapril and ramipril. As with children, the palatability score of lercanidipine was superior to that of amlodipine (P < 0·002). The scores assigned to the various agents were similar in women and in men and were age-independent.

What is new and conclusion: Pulverized atenolol, bisoprolol, enalapril and ramipril are poor tasting. From the perspective of palatability, pulverized chlorthalidone, hydrochlorothiazide and lisinopril are preferable.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / administration & dosage*
  • Adrenergic beta-Antagonists / chemistry
  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
  • Angiotensin-Converting Enzyme Inhibitors / chemistry
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / chemistry
  • Calcium Channel Blockers / administration & dosage
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Taste*
  • Thiazides / administration & dosage*
  • Thiazides / chemistry
  • Young Adult

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Thiazides