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Extravagant advertising for xipamide

Abstract

Current 4-page advertisements1 for the diuretic xipamide (Diurexan - Merck) which we discussed last year2 cite “IMPORTANT NEW EVIDENCE (that) it is ‘as effective as many β-blockers but without their side effects, and produces better control of blood pressure throughout the whole day and night’”. This quotation comes from workers at Northwick Park3 and is accompanied by a photograph of the Clinical Research Centre. It is true that in their study the drug appeared to reduce blood pressure to much the same degree as β-blockers throughout the 24-hour cycle. But there is no reason to believe that xipamide differs from any other diuretic in its anti-hypertensive effect. As we noted some years ago, a thiazide diuretic alone can control even severely raised blood pressure in some patients.4 The advertising gives no prominence to the finding at Northwick Park (and elsewhere) that xipamide can cause a disturbing fall in the serum potassium concentration, and might thus be unsuitable for long-term anti-hypertensive therapy. It has still not been shown to have any advantage over other diuretics in the treatment of hypertension,2 and is relatively expensive.

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