Amlopin

Amlodipine is a dihydropyridine calcium-channel blocker with a long duration of action. Doctors use it to treat hypertension and angina pectoris. It acts on the myocardial cells, the cells of the heart's specialized conducting system, and the cells of vascular smooth muscle.

When Amlodipine is given, the main effect is vasodilation. This brings down peripheral resistance, blood pressure and afterload, and it increases coronary blood flow. There is also a reflex increase in coronary heart rate. Together these changes raise the oxygen supply to the myocardium and increase cardiac output.

Amlodipine is Pregnancy Category C. No adequate and well-controlled studies of Amlodipine have been done in pregnant women, so it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

It is not known whether Amlodipine passes into human milk. Because this information is missing, it is recommended that breastfeeding be stopped while Amlodipine is being taken.

For children with hypertension aged 6 to 17 years, Amlodipine Besilate is started at 2.5 mg once daily. If the blood pressure goal isn't reached after 4 weeks, the dose is raised to 5 mg once daily. Doses above 5 mg daily have not been studied in children.

In children under 6 years old, the effect of amlodipine on blood pressure is not known.

In the elderly, the medicine is equally well tolerated at similar doses as in younger patients. Normal dosage regimens are recommended for older people, but any increase in dose should be made with care.

In renal impairment, changes in amlodipine plasma concentrations do not correlate with the degree of impairment, so the normal dosage is recommended. Amlodipine Besilate is not dialysable.

In mild to moderate hepatic impairment, dosage recommendations have not been established. The dose should therefore be chosen cautiously, starting at the lower end of the dosing range. The pharmacokinetics of the medicine have not been studied in severe hepatic impairment. For these patients, treatment should start at the lowest dose (2.5 mg once daily) and the dose should be increased slowly.

Symptoms: Available data suggest that a large overdose of amlodipine could cause excessive peripheral vasodilatation (the blood vessels widen too much) and possibly reflex tachycardia. Marked systemic hypotension, probably prolonged, has been reported, up to and including shock with a fatal outcome.

Management: When amlodipine overdose causes clinically significant hypotension, the patient needs active cardiovascular support. This means frequent monitoring of heart and breathing function, raising the arms and legs, and close attention to circulating fluid volume and urine output. A vasoconstrictor may help restore vascular tone and blood pressure, provided there is no contraindication to using it. Intravenous calcium gluconate may be beneficial in reversing the effects of calcium channel blockade. Gastric lavage may be worthwhile in some cases. In healthy volunteers, charcoal given up to 2 hours after amlodipine 10 mg was shown to reduce how fast the amlodipine is absorbed. Because amlodipine is highly protein-bound, dialysis is not likely to be of benefit.

Keep Amlodipine Besilate, like all medicines, out of reach of children. Store it in a cool and dry place, protected from light.