Description overdue on 24.06.2012

Antihypertensives.   The active ingredient is a derivative of dihydropyridine. The principle is aimed at blocking the effects of slow calcium channels. The drug has a hypotensive, antianginal effects . The basic substance is bound to the dihydropyridine receptors, exerts a blocking effect on calcium channels, retards the transmembrane passage of calcium ions into the cell (in vascular smooth muscle is somewhat larger than in karliomiotsitah). Antianginal effects achieved amlodipine extension arteriole, peripheral arteries, coronary arteries, angina reduces the severity of myocardial ischemia. Under the action of the active ingredient is an expansion of the lumen of arterioles, coronary artery and unaffected in ischemic areas of the myocardium, prevents the formation of constriction of the coronary arteries (by smoking). The hypotensive effect of the drug is dose-dependent. Single dose of medication for hypertension can achieve a clinically significant drop in blood pressure during the day. The drug has no effect on ejection fraction left ventricle Does not cause decrease in exercise tolerance, does not cause a sharp drop in blood pressure. The drug has a cardioprotective, antiatherosclerotic effects   in CHD. Amlodipine speeds glomerular filtration rate , Inhibits platelet aggregation, does not cause a reflex increase in heart rate, has a weakly pronounced natriuretic effect. Microalbuminuria is not increased in patients with diabetic nephropathy . The drug has no effect on plasma lipids, metabolic processes. The effect of a single dose of amlodipine is observed after 2 hours and lasts hours. Amlodipine is available in tablet form, in the form of capsules.

Indications:

Amlodipine is used for arterial hypertension, vasospastic angina , Angina, decompensated form of chronic heart failure, myocardial ischemia painless option.

Contraindications:

Amlodipine is not applicable in case of intolerance dihydropyridines at pregnancy , Severe hypotension during, breastfeeding. With aortic stenosis, arterial hypotension, acute myocardial infarction, renal disease, children under the age of majority, in CHF   mitral stenosis , Elderly patients with sick sinus syndrome, GOKMP Amlodipine used with caution.

Side effect:

The digestive tract:   dry mouth, yellowness of the skin, nausea, increased levels of liver enzymes, vomiting, dyspepsia . pancreatitis , Bloating, diarrhea, constipation , Gingival hyperplasia, epigastric pain, eating disorders. Nervous system: convulsions , Mood changes, drowsiness, headache, depression, nervousness, insomnia, malaise, fatigue, asthenia, tremor, paresthesia, hyperesthesia, amnesia , Agitation, apathy , Ataxia. Cardiovascular system: ventricular tachycardia , Edema, arrhythmia, "tides" of blood to the face, palpitations, chest pain, drop in blood pressure, migrenb, arrythmia, auricular flutter , Worsening of heart failure, orthostatic hypotension, a rise in blood pressure. Urogenital:   polyuria, pollakiuria, nocturia , Pain during urination, sexual dysfunction, potency disorders, dysuria. Musculoskeletal system:   myasthenia, arthrosis, arthralgia , Myalgia. Skin:   alopecia, dermatoxerasia, purpura, dermatitis. Also may develop conjunctivitis, rash, pruritus, diplopia , Disorders of visual perception, gynecomastia, ringing in the ears, fever, xerophthalmia, accommodation disturbances , Parosmiya, rhinitis, cough, sticky sweat, nasal bleeding, hyperglycemia, thirst , Increased sweating, taste perversion of perception.

Overdose:

It is accompanied by tachycardia, excessive drop in blood pressure, peripheral vasodilatation . Requires gastric lavage, control of diuresis and bcc appointment enterosorbents, intravenous administration of dopamine, calcium gluconate Supporting and symptomatic therapy. Hemodialysis is recognized as ineffective.

Mode of application:

Amlodipine is taken orally, the starting dosage is 5 mg. Amount of drug is gradually increased within two weeks to a maximum - 10 mg once daily. Supporting daily dosage for hypertension is 2, 5-5 mg. When vasospastic angina pectoris, angina prescribe a single dose of 5-10 mg per day. In order to prevent angina attacks shows the daily intake of 10 mg amlodipine. Patients with kidney disease, low birth weight, short stature appoint 2, 5 mg per day, to achieve the anti-anginal effect - 5mg. The initial dose is in CHF 2, 5 mg per day dose was gradually increased to 10 mg per day with a good tolerability of the medicament.

Special instructions:

Reliable information about the safety of amlodipine for lactating and pregnant women do not have. Treatment requires monitoring at the dentist for prevention and timely diagnosis gingival hyperplasia Their bleeding and pain. The drug has no effect on plasma concentrations of cholesterol, triglycerides Glucose, Uric acid , Urea nitrogen, cholesterol. For the drug is not characteristic of the syndrome of "cancellation", but patients are advised to gradually reduce the dosage of the drug prior to its cancellation.

Drug Interactions:

Indomethacin (blockade of prostaglandin synthesis of renal system, the delay of sodium ions), sympathomimetic Estrogens Alpha-adrenostimulyatorov, NSAIDs weaken the severity of the hypotensive effect. Inhibitors of microsomal oxidation increase the risk of side effects due to the increase of the concentration of the drug in the blood, the opposite effect is observed at the reception inducers of microsomal enzymes . Nitrates, "loop" diuretics, verapamil, beta-blockers, thiazide diuretics ACE inhibitors increase the severity of the hypotensive and antianginal effects. Antipsychotic drugs, alpha 1-blockers, quinidine, amiodarone, BCCI increase the hypotensive effects of amlodipine. Warfarin, cimetidine and digoxin did not affect the pharmacokinetic parameters. When you receive drugs lithium registered an increase of neurotoxicity (tinnitus, ataxia, diarrhea, nausea, tremors, vomiting). Calcium reduces the effectiveness of BCCI. Quinidine, procainamide reinforce the negative inotropic effects.