Cab 5 mg

Description

Indications

Essential Hypertension: Amlodipine is effective as a standalone treatment for hypertension. It can also be used in combination with other antihypertensive medications.

Chronic Stable Angina: Used for the long-term management of stable angina, Amlodipine is effective as monotherapy or in combination with other antianginal drugs.

Vasospastic Angina: Suitable for treating confirmed or suspected vasospastic angina, either alone or alongside other antianginal medications.

Use this medication only as prescribed by a registered physician.

Pharmacology

Amlodipine is a long-acting dihydropyridine calcium-channel blocker used to treat hypertension and angina. It exerts its effects by influencing myocardial cells, the heart’s conduction system, and vascular smooth muscle cells. Amlodipine primarily induces vasodilation, reducing peripheral resistance, blood pressure, and cardiac afterload while enhancing coronary blood flow. This results in increased myocardial oxygen supply and improved cardiac output.

Dosage & Administration

For Hypertension: The usual starting dose is 5 mg once daily, with a maximum recommended dose of 10 mg per day. Elderly patients or those with hepatic impairment may start with 2.5 mg daily, particularly when used with other antihypertensive drugs.

For Angina (Chronic Stable or Vasospastic): A dosage range of 5 to 10 mg daily is recommended, with lower doses preferred for elderly patients or those with hepatic impairment. Most patients require a 10 mg daily dose for optimal efficacy.

Administration: Amlodipine can be taken with or without food.

Use this medication only as prescribed by a registered physician.

Drug Interactions

• Potentially Hazardous Interactions: Limited data is available on the use of Amlodipine in patients with severely impaired left ventricular function. As with other calcium-channel blockers, concurrent use with beta-blockers should be avoided in such cases.
• Digoxin: Clinical studies have shown no significant interaction between Amlodipine and Digoxin.
• Cimetidine: Research indicates no clinically relevant interactions between Amlodipine and Cimetidine.
• Warfarin: Amlodipine does not significantly affect Warfarin’s impact on prothrombin time.
• Food: Food intake does not alter Amlodipine’s absorption rate or extent.

Contraindications

Amlodipine is contraindicated in individuals with hypersensitivity to dihydropyridine derivatives. It is also not recommended for use in pregnant women.

Side Effects

Common side effects associated with Amlodipine’s vasodilatory action include dizziness, flushing, headaches, hypotension, and peripheral edema. Other possible side effects include gastrointestinal disturbances, increased urination frequency, lethargy, eye pain, and depression. In rare cases, angina symptoms may worsen at the start of treatment, and an excessive drop in blood pressure could lead to myocardial or cerebral ischemia, or transient blindness. Hypersensitivity reactions may cause rashes, fever, or liver function abnormalities.

Pregnancy & Lactation

Amlodipine is classified as Pregnancy Category C. There are no well-controlled studies in pregnant women; therefore, it should only be used if the potential benefits outweigh the risks to the fetus. It is unknown whether Amlodipine is excreted in breast milk, so discontinuation of nursing is advised if treatment is necessary.

Precautions & Warnings

Caution is advised when prescribing Amlodipine to patients with hepatic impairment, as well as during pregnancy and breastfeeding.

Use in Special Populations

• Children (6-17 years old): The recommended starting dose for pediatric patients with hypertension is 2.5 mg once daily, which may be increased to 5 mg daily if blood pressure control is inadequate after four weeks. Doses above 5 mg daily have not been studied in children.
• Children Under 6 Years Old: The safety and efficacy of Amlodipine in patients below six years have not been established.
• Elderly Patients: Amlodipine is well-tolerated in both elderly and younger patients. However, dosage increases should be made cautiously.
• Renal Impairment: As Amlodipine plasma levels are not significantly affected by renal impairment, dose adjustment is unnecessary. Amlodipine is not dialyzable.
• Hepatic Impairment: Patients with mild to moderate hepatic impairment should start with a lower dose and increase cautiously. Severe hepatic impairment requires careful titration, starting at 2.5 mg daily.

Overdose Effects

Symptoms: Overdose may lead to severe peripheral vasodilation, reflex tachycardia, and significant hypotension, potentially resulting in shock.

Management: Treatment includes cardiovascular support with continuous monitoring of cardiac and respiratory functions. The patient’s extremities should be elevated, and fluid balance should be closely monitored. If necessary, vasoconstrictors may help restore vascular tone and blood pressure. Intravenous calcium gluconate can counteract calcium-channel blockade effects. Gastric lavage may be considered in some cases. Activated charcoal administered within two hours of ingestion can reduce Amlodipine absorption. As Amlodipine is highly protein-bound, dialysis is unlikely to be beneficial.

Therapeutic Class

Calcium-channel blockers

Storage Conditions

Store in a cool, dry place away from direct light and moisture. Keep out of reach of children.