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  • Title: Exposure of the elderly to potential nephrotoxic drug combinations in Belgium.
    Author: Smets HL, De Haes JF, De Swaef A, Jorens PG, Verpooten GA.
    Journal: Pharmacoepidemiol Drug Saf; 2008 Oct; 17(10):1014-9. PubMed ID: 18763247.
    Abstract:
    PURPOSE: To count in the Belgian ambulatory prescription database Pharmanet, the number of elderly people treated with ACE inhibitors (ACEI) and/or angiotensine receptor blockers (ARB) (+/-diuretics +/- beta-blockers) who eventually also received a prescription of non-steroidal anti-inflammatory drugs (NSAID) or spironolactone. METHOD: All prescriptions dispensed in community pharmacies are collected in the Pharmanet database. The data of 2005 were used. Two age groups were studied: 65-79 years (label 1) and 80+ years (label 2). The following chronic treatments (subgroups) were studied: (A) ACEI/ARB; (B) ACEI/ARB + diuretics; (C) ACEI/ARB + spironolactone; (D) ACEI/ARB + beta-blocker + diuretic and (E) ACEI/ARB + beta-blocker + spironolactone. RESULTS: In 2005, 7.3% of Belgian population was chronically treated with ACEI/ARB. Twenty-five per cent of 65-79 year-old-patients (subgroup A1) and 36.15% of 80+ year-old-patients (subgroup A2) received ACEI/ARB. At least one package of NSAID or spironolactone was prescribed to subgroup A1 in 25.44 and 5.80%, respectively, and to subgroup A2 in 22.04 and 9.89%, respectively. In all studied subgroups and age categories, NSAID were coprecribed in more than 20-35% of cases. CONCLUSIONS: NSAID are frequently prescribed in elderly patients treated with ACEI or ARB in combination with diuretics. Severe renal adverse effects may result in this high-risk population.
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