Cab 5 mg

Description

Indications

Amlodipine is prescribed for the following conditions:

• Essential Hypertension: Used as monotherapy or in combination with other antihypertensive agents for effective blood pressure control.
• Chronic Stable Angina: Helps manage chronic stable angina, either alone or in combination with other antianginal medications.
• Vasospastic Angina (Prinzmetal’s Angina): Indicated for suspected or confirmed vasospastic angina, either as a standalone treatment or in combination with other antianginal drugs.

(Take this medication as per the guidance of a registered physician.)

Pharmacology

Amlodipine is a long-acting dihydropyridine calcium-channel blocker that works by relaxing vascular smooth muscle, leading to vasodilation and a reduction in peripheral resistance, blood pressure, and cardiac afterload. This enhances coronary blood flow and increases myocardial oxygen supply, improving overall cardiac output. Amlodipine affects myocardial cells, the heart’s specialized conduction system, and vascular smooth muscle cells, contributing to its effectiveness in treating hypertension and angina.

Dosage & Administration

• Hypertension: The usual starting dose is 5 mg once daily, with a maximum recommended dose of 10 mg once daily.
  • Elderly patients or those with hepatic impairment may start with 2.5 mg once daily, especially when used in combination with other antihypertensive drugs.
• Angina (Chronic Stable or Vasospastic): Typically, 5 to 10 mg once daily, with lower doses recommended for elderly patients and those with liver dysfunction. Most patients require 10 mg daily for optimal results.
• Administration: Amlodipine can be taken with or without food.

(Take this medication as per the guidance of a registered physician.)

Drug Interactions

• Beta-Blockers: Caution is advised when combining amlodipine with beta-blockers, particularly in patients with significantly impaired left ventricular function.
• Digoxin: No significant interaction was found between amlodipine and digoxin in clinical studies.
• Cimetidine: Amlodipine does not interact with cimetidine.
• Warfarin: Clinical studies indicate that amlodipine does not significantly impact warfarin’s effect on prothrombin time.
• Food: Does not alter the rate or extent of amlodipine absorption.

Contraindications

Amlodipine is contraindicated in patients with:

• Hypersensitivity to dihydropyridine calcium-channel blockers.
• Pregnancy, unless the benefits outweigh the potential risks.

Side Effects

Common side effects associated with vasodilation include:

• Neurological: Dizziness, headache, flushing, lethargy, mental depression.
• Cardiovascular: Hypotension, peripheral edema, increased heart rate.
• Gastrointestinal: Nausea, increased frequency of urination.
• Other: Eye pain, skin rashes, fever.

Rarely, ischemic chest pain may worsen at the beginning of treatment, and in some cases, a sudden drop in blood pressure may lead to cerebral or myocardial ischemia or temporary vision loss.

Pregnancy & Lactation

• Pregnancy: Classified as Category C—should only be used if the benefits justify potential risks to the fetus.
• Lactation: It is unknown whether amlodipine is excreted in breast milk. As a precaution, breastfeeding should be discontinued during treatment.

Precautions & Warnings

• Use with caution in patients with hepatic impairment and elderly patients.
• Special care is needed in pregnant and breastfeeding women.

Use in Special Populations

• Children (6 to 17 years): Initial dose of 2.5 mg once daily, which may be increased to 5 mg daily if blood pressure remains uncontrolled after 4 weeks. Doses beyond 5 mg daily have not been studied in pediatric patients.
• Children under 6 years: The effects of amlodipine on blood pressure in this age group are not well established.
• Elderly Patients: Tolerated well at standard doses, but dosage increases should be done cautiously.
• Renal Impairment: No significant changes in plasma concentration of amlodipine; standard dosing is recommended. Amlodipine is not dialyzable.
• Hepatic Impairment: Patients with mild-to-moderate liver disease should start at 2.5 mg once daily, with cautious dose titration. The pharmacokinetics of amlodipine in severe hepatic impairment are not well studied, so it should be initiated at the lowest dose and increased cautiously.

Overdose Effects

Symptoms: Excessive doses may lead to severe peripheral vasodilation, reflex tachycardia, and profound hypotension, potentially leading to shock and fatal outcomes.

Management:

• Monitor cardiac and respiratory functions, maintain circulating fluid volume, and elevate extremities.
• Vasoconstrictors may be used to restore vascular tone and blood pressure, if no contraindications exist.
• Intravenous calcium gluconate may help reverse calcium-channel blockade effects.
• Gastric lavage may be considered.
• Activated charcoal, if administered within 2 hours, can reduce amlodipine absorption.
• Dialysis is unlikely to be beneficial due to high protein binding of amlodipine.

Therapeutic Class

• Calcium-Channel Blockers

Storage Conditions

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