Amlotop: instructions for use
ATX code: C08CA01 (Amlotop).
Medicinal form: flat-cylindrical tablets of white or grayish-white color, with a risk and a facet.
Clinico-pharmacological group: blocker of slow calcium channels of the second generation.
Pharmacotherapeutic group: antihypertensive, antianginal.
Actively active substance: amlodipine besylate.
Excipients: microcrystalline cellulose, lactose monohydrate, aerosil (colloidal silicon dioxide), impellose (croscarmellose sodium), calcium stearate.
The dihydropyridine derivative has a blocking effect on calcium channels, reduces the transmembrane transition of calcium ions to smooth muscle vascular cells. Its ability to expand coronary vessels is due to the expansion of arteries and arterioles, a reduction in overall peripheral vascular resistance.
The hypotensive effect of amlodipine besylate is due to direct vasodilating action. In patients with hypertension, a clinically significant decrease in blood pressure is noted for 24 hours. Orthostatic hypotension develops quite rarely. Reduces the degree of hypertrophy of the left ventricular myocardium, does not affect cardiac contractility and conductivity, does not lead to a reflex increase in the heart rate. Under the influence of the drug, which has a weak natriuretic effect, the glomerular filtration rate is increased and aggregation of platelets is inhibited.
In patients with CHF III-IV st. Not ischemic etiology when using Amlotop, the development of pulmonary edema is possible.
The drug is slowly adsorbed from the digestive tract. The average absolute bioavailability is 60-65%, reaches the maximum serum concentration in 6-12 hours after administration. To achieve an equilibrium Css concentration, 7-8 days of therapy are required.
Binding to plasma proteins is 90-97%.
Half-life is 35-50 hours. 10% of the drug is excreted by the kidneys unchanged, about 60% - in the form of metabolites, 20-25% - along with bile, through the intestine. The total clearance is 500 ml / min. Half-life in advanced patients, as well as in patients with severe hepatic and chronic heart failure, increases to 65 hours. The drug penetrates the blood-brain barrier, while hemodialysis is not removed. Excreted in breast milk.
Indications for use
- Arterial hypertension;
- Stable exertional angina ;
- Vasospastic angina pectoris (Princmetal).
At treatment of an initial degree of a stenocardia and an arterial hypertensia - 5 mg once a day. If necessary, the dose increases to 10 mg / day.
The maintenance dose for arterial hypertension is 5 mg / day, once.
Vasospastic angina and angina pectoris are 5-10 mg / day, once.
From the side of the central nervous system : dizziness, fatigue, headaches, drowsiness, general malaise, sleep disturbance, emotional lability, depressive state, increased anxiety, increased sweating. It is rare enough migraine, ataxia, amnesia, convulsions .
From the gastrointestinal tract : nausea, vomiting, abdominal pain, stool disorders, flatulence, anorexia, thirst, drying out of the oral mucosa. Very rarely - increased appetite, gingival hyperplasia, cholestatic jaundice, hepatitis, pancreatitis .
From the side of the lymphatic and hematopoietic system : thrombocytopenia, thrombocytopenic purpura, and leukopenia (very rarely).
From the cardiovascular system : palpitations, flushing of the face, development of peripheral edema, excessive lowering of blood pressure, vasculitis , orthostatic hypotension, worsening of the course of chronic heart failure, shortness of breath, heart rhythm disturbance, fainting, chest pain, pulmonary edema, myocardial Myocardium.
On the part of the excretory system : painful urge to urinate, polyuria, dysuria, nocturia, pollakiuria.
From the respiratory system : runny nose, shortness of breath, cough.
On the part of the reproductive system : impotence, gynecomastia.
From the musculoskeletal system : arthralgia, myalgia, muscle cramps, back pain, myasthenia gravis, arthrosis.
From the skin : itching, rashes, hives , erythema multiforme, angioedema, alopecia.
From the sense organs : visual disturbances, ringing in the ears, conjunctivitis , pain in the eyes.
Other : hyperglycemia, decreased or increased body weight, nasal bleeding, chills, cold sweat.
Interaction with other drugs
With simultaneous use of inhibitors of microsomal oxidation, the concentration of Amlotop increases, and when microsomal enzymes are taken, the concentration decreases.
NSAIDs, alpha-adrenostimulators, sympathomimetics and estrogens weaken the hypotensive effect of the drug. Beta-adrenoblockers, diuretics, nitrates, antipsychotic drugs, slow calcium channel blockers and ATP inhibitors increase the vasodilator and hypotensive effect.
The pharmacokinetics of Amlotop are not affected by warfarin, digoxin, cimetidine.
With simultaneous use with lithium drugs, nausea, vomiting, stool, tinnitus, tremor, and ataxia are possible.
The effect of using Amlotop can reduce potassium preparations.
Drugs that extend the QT interval can increase the negative ionotropic effect.
- Hypersensitivity to the components of the drug;
- Glucose-galactose malabsorption, lactose intolerance, lactase deficiency;
- Cardiogenic shock;
- Pronounced arterial hypotension (up to 90 mm Hg);
- Unstable angina (with the exception of vasospastic);
- Clinically significant aortic stenosis;
- Pregnancy and lactation;
- Age to 18 years.
During treatment, the patient should adhere to a special diet, constantly monitor body weight and sodium intake. People of low height and / or low body weight, patients with severe renal insufficiency and persons of advanced age are prescribed lower doses of the drug. For elderly patients with increasing the dose requires constant medical supervision.
At the termination of treatment the dosage decreases gradually.
When driving vehicles and working with various mechanisms, special precautions are required.
Terms of implementation
Amlotop tablets refer to prescription drugs, i.e. Are released on prescription.
Store in a dark place, protected from light and moisture, inaccessible to children, at a temperature not exceeding 25 ° C.
The drug is suitable for use for 3 years from the date of release. Do not use the product beyond the expiry date printed on the package.
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Prices for Amlötop
Amlotop tablets 5 mg, 30 pcs. - from 112r.