A loading‐maintenance regimen for more rapid initiation of the effect of guanethidine

Abstract

A regimen has been devised for achieving the pharmacologic effects of guanethidine relatively rapidly, using the concept of loading and maintenance doses based on the kinetics of guanethidine elimination. This regimen was tested in 6 hypertensive patients with creatinine clearances greater than 69 ml/min in balance on a 10‐mEq sodium diet. Reduction of blood pressure in the standing position was achieved with guanethidine 150 to 525 mg administered over a period of 1 to 3 days. Maintenance doses ranging from 20 to 65 mg daily were calculated from the loading dose, assuming an approximation of a one‐compartment model with a daily loss of 1/7 of the drug from the body. Satisfactory control of the standing blood pressure was maintained during 7 days following the guanethidine load without side effects.