Composition
1 tablet contains:
Active ingredient:
amlodipine besylate (in terms of amlodipine) – 5 mg.
Auxiliary substances:
Ingredients: calcium stearate,
potato starch,
lactose (milk sugar),
magnesium stearate,
microcrystalline cellulose.
30 pcs. of 5 mg
Pharmacological action
Amlodipine, a dihydropyridine derivative, is a second-generation slow calcium channel blocker that has antianginal and antihypertensive effects. Binding to dihydropyridine receptors, it blocks calcium channels, reduces the transmembrane transition of calcium ions into the cell (to a greater extent in vascular smooth muscle cells than in cardiomyocytes).
Antianginal action is caused by the expansion of coronary and peripheral arteries and arterioles: with angina reduces the severity of myocardial ischemia; expanding peripheral arterioles, reduces the total peripheral vascular resistance; reduces preload on the heart, myocardial oxygen demand.
Dilates the main coronary arteries and arterioles in unchanged and ischemic areas of the myocardium, increases oxygen supply to the myocardium (especially in vasospastic angina); prevents the development of coronary artery spasm (including caused by smoking). In patients with angina pectoris, a single daily dose increases exercise tolerance, delays the development of another angina attack and “ischemic” depression of the ST segment; reduces the frequency of angina attacks and nitroglycerin consumption. Amlodipine has a long-term dose-dependent hypotensive effect, which is due to the direct vasodilating effect on vascular smooth muscles. In patients with arterial hypertension, a single daily dose of amlodipine provides a clinically significant reduction in blood pressure (BP) for 24 hours (in the patient’s “lying” and “standing”positions).
Reduces the degree of left ventricular myocardial hypertrophy, has anti-atherosclerotic and cardioprotective effects in CHD. It has no effect on myocardial contractility and conduction, inhibits platelet aggregation, increases glomerular filtration rate, and has a weak natriuretic effect. In diabetic nephropathy, it does not increase the severity of microalbuminuria. It does not adversely affect the metabolism and concentration of blood lipids. The time of onset of the therapeutic effect is 2-4 hours, the duration is 24 hours.
Indications
- Arterial hypertension (monotherapy or in combination with other antihypertensive agents).
- Stable angina pectoris of tension.
- Prinzmetal angina pectoris (monotherapy or in combination with other antianginal agents).
Use during pregnancy and lactation
No teratogenicity of amlodipine was detected in an animal study, but there is no clinical experience of its use during pregnancy and lactation.
Therefore, amlodipine should not be prescribed to pregnant and lactating women, as well as women of childbearing age, if they do not use reliable methods of contraception.
Contraindications
- Hypersensitivity to amlodipine, other dihydropyridine derivatives, and other components of the drug.
- Severe arterial hypotension (systolic blood pressure less than 90 mm Hg).
- Collapse.
- Cardiogenic shock.
- Unstable angina (with the exception of Prinzmetal angina).
- Severe aortic stenosis.
- Age up to 18 years (efficacy and safety have not been established).
- Lactose intolerance, lactase deficiency, or glucose-galactose malabsorption.
- Pregnancy.
- Lactation period.
Use the drug with caution if: : liver function disorders, sinus node weakness syndrome (severe bradycardia, tachycardia ), chronic heart failure of non-ischemic etiology of NYHA functional class III-IV, aortic stenosis, mitral stenosis, hypertrophic obstructive cardiomyopathy, acute myocardial infarction (and within 1 month after), and the elderly.
Side effects
From the cardiovascular system: often – palpitations, peripheral edema (swelling of the ankles and feet); infrequently-excessive decrease in blood pressure, orthostatic hypotension, vasculitis; rarely-development or aggravation of chronic heart failure; very rarely-rhythm disorders ( bradycardia, ventricular tachycardia, atrial fibrillation), myocardial infarction, chest pain, migraine.
From the central nervous system: often-headache, dizziness, increased fatigue; infrequently-malaise, fainting, neuropsychiatric asthenia, hypesthesia, paresthesia, peripheral neuropathy, tremor, insomnia, emotional lability, unusual dreams, nervousness, depression, anxiety; rarely-convulsions, apathy, agitation; very rarely-ataxia, amnesia.
From the side of hematopoietic organs: Â very rarely – thrombocytopenia, leukopenia, thrombocytopenic purpura.
Respiratory system disorders: infrequently-shortness of breath, rhinitis; very rarely – cough.
From the digestive tract: often – nausea, abdominal pain; infrequently – vomiting, changes in bowel movements (including constipation, flatulence), indigestion, diarrhea, anorexia, dryness of the mucous membrane of the mouth, thirst; rare – gingival hyperplasia, increased appetite; very rarely – gastritis, pancreatitis, hyperbilirubinemia, jaundice (usually cholestatic), increased activity of “liver” transaminases, hepatitis.
From the genitourinary system: infrequently-pollakiuria, painful urination, nocturia, impotence; very rarely-dysuria, polyuria.
From the side of the skin: rarely-increased sweating; very rarely-cold sticky sweat, xeroderma, alopecia, dermatitis, purpura, skin discoloration.
Allergic reactions: infrequently – skin pruritus, rash; very rarely-angioedema, erythema multiforme, urticaria.
From the musculoskeletal system: infrequently-arthralgia, muscle cramps, arthrosis, myalgia (with prolonged use), back pain; rarely-myasthenia gravis.
Other services: infrequently-alopecia, tinnitus, gynecomastia, weight gain/loss, visual impairment, diplopia, accommodation disorders, xerophthalmia, conjunctivitis, eye pain, taste distortion, chills, nosebleeds, increased sweating; rarely-dermatitis; very rarely-cold sticky sweat, parosmia, skin pigmentation disorder, hyperglycemia.
Interaction
Inhibitors of microsomal oxidation can increase the concentration of amlodipine in blood plasma, increasing the risk of side effects, and inducers of microsomal liver enzymes can reduce this indicator.
Unlike other BMCs, amlodipine has no clinically significant interaction with nonsteroidal anti-inflammatory drugs, especially Indometacin.
Thiazide and loop diuretics, beta-blockers, verapamil, ACE inhibitors, and nitrates enhance the antianginal or hypotensive effects of amlodipine.
Amiodarone, quinidine, alpha-1-blockers, antipsychotics (neuroleptics), and isoflurane may enhance the antihypertensive effect of amlodipine.
Calcium supplements may reduce the effect of BMCC.
When amlodipine is co-administered with lithium preparations, it is possible to increase the manifestations of neurotoxicity of the latter ( nausea, vomiting, diarrhea, Ataxia, tremor, tinnitus).
Amlodipine does not affect the pharmacokinetic parameters of digoxin and warfarin.
Cimetidine does not affect the pharmacokinetics of amlodipine.
Antiviral agents (ritonavir ) they contribute to an increase in the concentration of BMCC (including amlodipine) in blood plasma.
How to take, course of use and dosage
Inside, regardless of food intake.
For the treatment of arterial hypertension and prevention of tension angina attacks and vasospastic angina:
the initial dose of Amlodipine is 5 mg once a day. If necessary, the daily dose can be increased to a maximum of -10 mg (1 time per day).
Overdose
Symptoms:
marked decrease in blood pressure with the possible development of reflex tachycardia and excessive peripheral vasodilation (risk of severe and persistent arterial hypotension, including shock and death).
Treatment:
gastric lavage, use of activated charcoal (especially in the first 2 hours after an overdose), maintenance of the cardiovascular system, monitoring of heart and lung function indicators, Trendelenburg pose, monitoring of the volume of circulating blood and diuresis. To restore vascular tone – the use of vasoconstrictor drugs (in the absence of contraindications to their use); to eliminate the consequences of calcium channel blockade – intravenous use of calcium gluconate. Hemodialysis is not effective.
Special instructions
Use in patients with liver function disorders: patients with impaired liver function as a hypotensive agent, Amlodipine is prescribed with caution, at an initial dose of 2.5 mg, as an antiangial agent-5%^%mg.
Use in patients with renal insufficiency: no dose adjustment is required in patients with renal insufficiency.
In elderly patients: T 1/2 may increase and creatinine clearance (CC) may decrease. No dose changes are required, but patients should be monitored more closely.
No dose adjustment is required when co-administered with thiazide diuretics, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors.
During treatment with Amlodipine, it is necessary to monitor the body weight of patients and the amount of sodium salt they consume ; an appropriate low-salt diet is prescribed. It is necessary to maintain dental hygiene and regularly visit the dentist (to prevent soreness, bleeding and gum hyperplasia).
The dosage regimen of Amlodipine in elderly patients is similar to that in patients of other age groups. When increasing the dose, careful monitoring of elderly patients is necessary. Despite the absence of “withdrawal” syndrome in BMCC, a gradual dose reduction is recommended before discontinuing treatment.
Amlodipine does not affect the plasma concentrations of potassium, glucose, triglycerides, total cholesterol, low-density lipoproteins, uric acid, creatinine and urea nitrogen in the blood. Abrupt discontinuation of the drug should be avoided due to the risk of worsening angina pectoris. Amlodipine tablets are not recommended for hypertensive crisis.
Patients with low body weight, short stature, and severe hepatic impairment may require a lower dose.
Influence on the ability to drive motor vehicles and manage mechanisms
There have been no reports of Amlodipine’s effects on driving or operating machinery. However, some patients may experience drowsiness and dizziness, especially at the beginning of treatment. If they occur, you should be careful when driving vehicles and engaging in potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.
Storage conditions
Store in a dry place protected from light at a temperature not exceeding 25°C.
Shelf
life is 3 years.
Active ingredient
Amlodipine
Conditions of release from pharmacies
By prescription
Dosage form
Tablets
Purpose
For adults as directed by your doctor
Indications
Angina, Hypertension
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Side effects of Amlodipine pills 5mg, 30pcs.
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