Effects of penbutolol: A Synthesis of Findings from 17 Studies

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Original Abstract of the Article

Major findings of the studies

Penbutolol has been shown to effectively reduce portal perfusion in patients with cirrhosis and portal hypertension. 14 This reduction is accompanied by a compensatory increase in hepatic artery blood flow. 14 Penbutolol also significantly decreases heart rate. 14 However, it does not significantly alter total hepatic blood flow or systemic hemodynamics. 14 Penbutolol has also been found to be effective in controlling moderate hypertension. 5 11 17 4 In hypertensive patients, penbutolol has been shown to significantly reduce blood pressure, pulse rate, and plasma renin activity. 9 11 Penbutolol also exhibited a beneficial effect in patients with Raynaud's phenomenon, showing no additional vasoconstrictive effect on digital circulation. 12 Furthermore, studies have compared penbutolol's effects with other beta-blockers, including propranolol and atenolol. Penbutolol has been found to be a more potent beta-blocker than propranolol, with a similar duration of action. 1 Penbutolol has also shown better tolerance compared to atenolol. 2 The study investigating penbutolol's effect on antipyrine clearance showed that penbutolol did not significantly affect antipyrine clearance, unlike propranolol. 8 Moreover, penbutolol was found to be effective in attenuating exercise-induced angina in patients with coronary artery disease. 16

Benefits and Risks

Benefit Summary

Penbutolol offers potential benefits for individuals with cirrhosis and portal hypertension, as it can effectively reduce portal perfusion, leading to improved symptoms and potentially lower risk of complications. 14 Additionally, its effectiveness in controlling moderate hypertension suggests it can be a valuable treatment option for individuals with this condition. 5 11 17 4 Penbutolol also exhibits a lack of significant effects on total hepatic blood flow or systemic hemodynamics, making it a potentially safer option compared to other treatments. Furthermore, its lack of vasoconstrictive effects in patients with Raynaud's phenomenon makes it a suitable choice for managing this condition. 12

Risk Summary

Penbutolol's potential side effects include decreased heart rate, reduced urinary sodium excretion, and increased antidiuretic hormone (ADH) levels after exercise. 10 While generally well-tolerated, some individuals may experience decreased tolerance compared to other beta-blockers. 2

Comparison between Studies

Similarities

Multiple studies consistently demonstrate penbutolol's ability to decrease heart rate and blood pressure. 14 15 10 5 11 17 4 9 16 3 1 2 6 7 8

Differences

While penbutolol consistently exhibits its effect on heart rate and blood pressure, the specific mechanisms and extent of its effects vary among different studies. For example, some studies show a less pronounced reduction in heart rate and cardiac output during exercise, while others highlight its effectiveness in reducing peripheral vascular resistance. Additionally, the comparison with other beta-blockers, such as propranolol and atenolol, reveals differences in potency and tolerance. 1 2

Consistency and Contradictions

Despite consistent findings regarding penbutolol's impact on heart rate, blood pressure, and portal perfusion, some studies show contradictory results. For instance, while some studies suggest penbutolol's better tolerance compared to atenolol, others report decreased tolerance. 2

Practical Considerations

Penbutolol holds promise for managing cirrhosis with portal hypertension and for controlling moderate hypertension. However, its potential impact on heart rate, blood pressure, and sodium excretion necessitates careful monitoring and dosage adjustments based on individual responses and medical needs. 14 10 5 11 17 4 9 16 3

Limitations of Current Research

The current body of research on penbutolol's effects is limited in scope, particularly regarding long-term effects and safety. Further research is needed to fully understand the long-term implications of penbutolol use and its potential efficacy in various conditions. 11

Future Research Directions

Future research on penbutolol should focus on evaluating its long-term efficacy and safety. Additional studies are necessary to investigate its potential role in managing other conditions beyond cirrhosis and hypertension. Furthermore, exploring different dosing strategies and combinations with other medications could optimize its therapeutic potential. 11

Conclusion

Penbutolol shows promise as a therapeutic agent for managing cirrhosis with portal hypertension and moderate hypertension. While it demonstrates a favorable effect on heart rate, blood pressure, and portal perfusion, its potential side effects, particularly on heart rate and sodium excretion, require careful monitoring. The limited research on penbutolol's long-term effects and safety calls for further investigation to fully understand its therapeutic profile and potential applications. Consult your healthcare provider to determine if penbutolol is a suitable treatment option for your specific condition. 14 15 10 5 12 9 11 1 3 2 7 8 6 16 17 4

Literature analysis of 17 papers
Positive Content
16
Neutral Content
1
Negative Content
0
Article Type
10
0
0
0
17
1.

Comparative beta-adrenoceptor blocking effects and pharmacokinetics of penbutolol and propranolol in man.

Author: GiudicelliJ F, RicherC, ChauvinM, IdrissiN, BerdeauxA

Beta-adrenoceptor blocking effect

Penbutolol, a non-cardioselective beta-blocker, was more potent than propranolol in antagonizing exercise-induced tachycardia and reducing peak expiratory flow rate. Its half-life was 4.5 hours. Penbutolol was transformed into an active metabolite after oral administration.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

[Treatment of essential mild-to-moderate arterial hypertension with once-daily penbutolol. Controlled clinical study vs atenolol].

Author: NamiR, MartinelliM, BianchiniC, GennariC

Effective for hypertension
Well tolerated
No significant risks mentioned

Penbutolol, a non-selective beta-blocker with an ISA effect, was as effective as atenolol, a cardioselective beta-blocker without ISA effect, in controlling blood pressure in 40 patients with mild-to-moderate essential hypertension. Penbutolol was better tolerated than atenolol.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Italian

3.

Pharmacodynamic and pharmacokinetic study of oral and intravenous penbutolol.

Author: VedinJ A, WilhelmssonC, MaassL, PetersonL E

Lowers exercise heart rate
Lowers exercise systolic pressure
Well tolerated

Penbutolol is well-tolerated and effectively reduces heart rate and blood pressure after intravenous and oral administration.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Penbutolol or hydrochlorothiazide once a day in hypertension. A controlled study with home measurements.

Author: De PlaenJ F, Vander ElstE, Van Ypersele de StrihouC

Effective for hypertension
Long lasting effect
Well tolerated
Hyperuricemia
Hypokalemia

Penbutolol was more effective in reducing blood pressure than hydrochlorothiazide in 10 hypertensive patients. The hypotensive effect lasted for 24 hours. No significant side effects were reported.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Use of fixed doses of beta blocking drugs in the treatment of hypertension. Randomised study of atenolol and penbutolol.

Author: LameijerL D, VoermansL A, HoutzagersJ J, ChadhaD R

Effective for hypertension
Well tolerated
Bradycardia

Both atenolol and penbutolol were effective in controlling moderate hypertension in 45 patients. Atenolol was associated with more frequent bradycardia, while penbutolol may be useful for patients who experience bradycardia with other beta-blockers.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

[The noninvasive assessment of the effects of penbutolol on liver hemodynamics in cirrhotic patients using angioscintigraphy. A randomized controlled double-blind study].

Author: SantambrogioR, OpocherE, BrunoS, ChiesaA, GaglianoG, RossiS, GrugniM C, ZattaG, BestettiA, VignatiL

Decreases portal perfusion
Safe for cirrhotics

Penbutolol, a new beta-blocker, reduced portal perfusion index by 29% in patients with cirrhosis and esophageal varices, without significantly affecting total hepatic blood flow or systemic hemodynamics.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Italian

7.

Antiarrhythmic effects of L-penbutolol and DL-propranolol. Comparison of the effects of these two drugs on conductivity and excitability in canine heart in vivo.

Author: YamadaK, ToyamaJ, NimiN, SugenoyaJ, OhnoM, SugiyamaS

Effective for arrhythmia

L-penbutolol and dl-propranolol both prolonged A-V conduction and reduced excitability of ventricular muscle in anesthetized dogs. L-penbutolol was less potent in prolonging A-V conduction than dl-propranolol. Both drugs prevented lowering of ventricular tachycardia threshold in acute ischemia.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Penbutolol and propranolol: a comparison of their effects on antipyrine clearance in man.

Author: BaxN D, JonesR W, LennardM S, TuckerG T, WoodsH F

Decreased antipyrine clearance

Propranolol decreased antipyrine clearance, while penbutolol did not. This effect of propranolol was not consistent with in vitro data suggesting a relationship between lipid solubility and inhibition of metabolism.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Effects of penbutolol and metoprolol on blood pressure, plasma catecholamines and renin activity in hypertensive patients.

Author: HanssonB G, DymlingJ F, ManhemP, HökfeltB

Lowered blood pressure
Reduced plasma renin activity
Reduced pulse rate

Both penbutolol and metoprolol reduced blood pressure and heart rate, but penbutolol had a greater effect on renin and aldosterone.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Effects of penbutolol on plasma atrial natriuretic peptide and antidiuretic hormone levels before and after exercise: a double-blind comparison against placebo.

Author: VerhoM, FärberG, KirstenR, NelsonK

Blood pressure decrease
Penbutolol effect
Pulse rate decrease

Penbutolol suppressed the exercise-induced increase in plasma atrial natriuretic peptide levels and decreased fractional sodium excretion, suggesting its potential role in regulating fluid and electrolyte balance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

A double-blind study of the peripheral vasoconstrictor effects of the beta-blocking drug penbutolol in patients with Raynaud's phenomenon.

Author: HoltiG

No vasoconstrictor effect

Penbutolol did not produce any additional vasoconstrictor effect on digital circulation in 10 hypertensive patients with Raynaud's phenomenon.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

Angioscintigraphic assessment of hemodynamic effects of penbutolol in cirrhotics with portal hypertension. A double-blind, randomized, controlled study.

Author: SantambrogioR, BrunoS, OpocherE, GaleottiF, ZattaG, GrugniM, MacriM, PisaniA, TaroloG, SpinaG

Reduced portal perfusion

Penbutolol, a new beta-blocker, decreased portal perfusion index in cirrhotic patients with esophageal varices without significantly affecting total hepatic blood flow or systemic hemodynamics.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Central haemodynamic effects of beta blockers in hypertension. A comparison between atenolol, metoprolol, timolol, penbutolol, alprenolol pindolol and bunitrolol.

Author: Lund-JohansenP

Reduces blood pressure
Reduces heart rate

Seven beta-blockers were compared for their chronic haemodynamic effects. All drugs reduced heart rate, cardiac output, and blood pressure, with a greater effect seen in drugs without intrinsic sympathomimetic activity.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Haemodynamic dose-response effects of i.v. penbutolol in angina pectoris.

Author: SilkeB, VermaS P, HussainM, NelsonG I, OkoliR C, TaylorS H

Attenuates exercise-induced angina
Treats angina
Cardiac performance depression

Penbutolol, a new beta-adrenoceptor antagonist, demonstrated a linear decrease in heart rate and small increase in pulmonary artery occluded pressure in 10 patients with coronary artery disease. It attenuated exercise-induced angina with a modest depression of cardiac performance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Penbutolol (Hoe 893d) in primary hypertension. Blood pressure effects, tolerance and plasma concentrations.

Author: OhmanK P, AsplundJ, LandahlS, LianderB

Treats hypertension
Dermatitis
Liver enzyme elevation

Penbutolol, a long-acting non-selective beta-adrenoceptor blocking agent, was found to be effective in treating primary hypertension in 23 patients. The drug significantly reduced blood pressure in 18 patients, but side effects such as dermatitis and elevated liver enzymes were observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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