When is it better to take amlodipine in the morning or evening. "Amlodipine": what it helps with, instructions for use, analogues, reviews

For the drug Amlodipine, the instructions for use should be studied in detail by each patient before starting treatment. The article provides detailed information about the drug, as well as prices, reviews of use and analogues existing on the market.

Being one of the main representatives of the pharmacological group of calcium channel antagonists, Amlodipine has a vasodilator and antihypertensive effect. In modern cardiology, the drug is often used as part of monotherapy or complex treatment together with other drugs prescribed by a doctor.

Compound

One tablet contains Amlodipine benzilate (besilate) as the active ingredient. Manufacturers produce two types of dosage of the drug:

• Amlodipine 5 mg pure active substance(6.93 mg Amlodipine benzilate);
• Amlodipine 10 mg of pure active substance (13.86 mg Amlodipine benzilate).

The excipients included in the drug are different manufacturers may vary. The most commonly used derivatives are cellulose, starch, calcium phosphates, magnesium stearates, silicon dioxides, and lactose.

Release form

The blood pressure drug Amlodipine is produced in the form of tablets with a dosage of the active substance of 5 or 10 mg. One package from different manufacturers and analogues can contain from 10 to 100 tablets with the same dose of the active substance.

Characteristics of tablets:

• the shape is flat and slightly convex;
• White color;
• no taste or smell;
• line in the center for ease of dividing the tablet.

The drug Amlodipine in tablet form is intended only for internal oral use at a dose prescribed by a cardiologist in accordance with the indications.

pharmachologic effect

International name of the drug: Amlodipine, Amlodipine.

The active substance Amlodipine, according to research and official instructions, belongs to the pharmacological group of drugs - selective antagonists of slow calcium channels. According to its chemical structure, it is a derivative of dihydropyridine. In medicine, Amlodipine (INN) is called a selective peripheral vasodilator.

The mechanism of action of the original drug Amlodipine and its trade names is as follows:

1. Binding of the active substance to dihydropyridine receptors in calcium tubules of cells.
2. A reversible obstacle to the penetration of calcium into cells, primarily blood vessels and the myocardium.
3. Expansion and decrease in tone of the muscle layer of peripheral and, to a lesser extent, central large vessels.

Amlodipine, when taken in therapeutic doses, according to the manufacturer's description, has the following effects:

• reduces blood pressure in blood vessels;
• reduces the heart's need for oxygen by increasing the lumen of blood vessels in the heart - anti-ischemic effect;
• reduces the load on the myocardium;
• increases blood flow to the myocardium, helps enhance nutrition and metabolism in it;
• inactivates increased platelet aggregation in the blood (prevents them from sticking together), prevents the formation of blood clots, and prevents the development of atherosclerosis;
• mild diuretic effect;
• stimulates the excretion of Na from the body;
• reduces myocardial hypertrophy.

If you take Amlodipine when high blood pressure and heart disease, then it causes a gradual decrease in indicators. Therapeutic effect occurs 1-2 hours after oral administration. Duration of action is one day. Blood pressure tablets Amlodipine and analogues, according to the instructions of any manufacturer, are long-acting medications.

After oral administration, the drug is almost completely absorbed. Excreted in urine, bile and breast milk. In case of liver diseases, as well as in old age, the duration of excretion from the body increases, which requires a dose reduction. Pathologies of the kidneys and urinary system do not affect the excretion of the drug.

Indications for use

Indications for use of Amlodipine are as follows:

1. Arterial hypertension.
2. Stable angina.
3. Ischemic heart pathology.
4. Vasospastic form of angina.
5. Pathologies of the heart and blood vessels - post-infarction period, circulatory failure, obliterating endarteritis, cardiomyopathy, atherosclerosis, thrombosis, cardiac surgery - as a means of preventing myocardial hypertrophy, transition acute conditions in chronic, reducing mortality due to heart attacks, strokes, atherosclerosis.
6. Acute kidney failure in complex treatment with the aim of dilating renal vessels.

The use of medicine for high blood pressure and other pathologies will normalize indicators and improve a person’s quality of life with the least side effects.

Contraindications

Contraindications for use are the following:

• allergic reactions to the components of the drug;
• hypotension, characterized by a decrease in systolic pressure below 89 mmHg;
• acute heart attack;
• state of shock;
• children under 17 years of age;
• first trimester of pregnancy;
• heart block.

Conditions that require use with caution under the constant supervision of a doctor:

• pregnancy in the 2nd and 3rd trimesters;
• lactation;
• heart failure;
• valve stenosis;
• after heart surgery;
• in patients with a pacemaker;
• after a stroke.

If there are contraindications to prescribing the drug, the doctor must select an effective substitute for Amlodipine from another pharmacological group.

Instructions for use

After the examination, the doctor will select the optimal effective dose the drug, as well as the frequency and duration of administration.

Dosage regimen for arterial hypertension:

The initial dosage of the drug is 5 mg in the morning. According to indications, it is allowed to increase the amount of Amlodipine to 10 mg over 7-14 days. The daily dose can be divided into several doses only as directed by the doctor. The exception is the elderly and people with pathologies of the liver and gallbladder. For them, the initial daily dosage is no more than 2.5 mg with a slow increase.

The maximum dose of the active substance per day cannot be higher than 10 mg. Violation of this recommendation leads to dangerous side effects and symptoms of overdose.

Dosage regimen for different forms of angina:

For cardiac pathologies, the daily dose of Amlodipine at the beginning of treatment does not exceed 5 mg. The increase in dosage must be gradual over 10-14 days. The drug has a cumulative and prolonged effect, so a rapid increase in dose leads to pronounced side effects. The maximum daily amount of active substance allowed for use is no more than 10 mg.

If there are no effects from the therapy, after 5-7 days from the start of treatment, the doctor should change the drug to drugs from another group - adrenergic blockers, ACE inhibitors or angiotensin receptor antagonists. Replacement of Amlodipine, including in case of edema, should be made only taking into account the patient's condition.

For all indications, the drug is prescribed in the form of tablets orally. It is important to take the drug with at least 100 ml of clean water. Swallow the tablet without chewing. The medicine is taken in the morning, unless otherwise directed by the doctor. Food does not have a significant effect on the metabolism of the active substance; it is recommended to take Amlodipine after meals to avoid negative effects on the stomach and intestines.

Important! Self-medication is unacceptable.

Overdose

Signs of overdose - the main symptoms indicating an overdose of the drug are the following:

• persistent decrease in pressure;
• dizziness;
• headache;
• impaired orientation in space;
• general weakness;
• prostration;
• increased heart rate.

If such symptoms are detected, it is important to consult a doctor who will adjust the dose or discontinue the drug.

If there are symptoms of overdose, it is important to take the following measures in a timely manner:

• gastric lavage;
• use of sorbents;
• control of lung and heart function;
• monitoring of pressure indicators;
• introduction of plasma substitutes when excreting a large amount of urine to prevent dehydration;
• administration of drugs that increase blood pressure as prescribed by a doctor.

Providing assistance to the patient and timely contacting a doctor will avoid dangerous complications.

Side effects

Taking Amlodipine may be accompanied by the occurrence of unwanted side effects from different organs and systems. The severity of side effects can significantly worsen the patient’s condition and become a reason to start taking analogues and replace them with drugs from other groups.

As side effects may be the following:

• skin manifestations: rashes, erythema, itching, redness on the skin of the chest and face;
• disorders of the musculoskeletal system: pain in bones, joints and muscles;
• disorders in the cardiovascular system: low blood pressure, tachycardia, heart rhythm disturbances, acute form of heart failure when taking high doses;
• work disorders gastrointestinal tract: attacks of nausea, abdominal pain, peristalsis disorders, decreased enzyme synthesis in the liver, signs of jaundice;
• disorders of urinary functions: swelling, especially in the legs and feet, increased urine production;
• neurological disorders: lack of strength, appetite, impaired visual acuity, headaches, dizziness, impaired spatial orientation, tingling sensation in the arms and legs, frequent mood swings, parkinsonism (rare);
• respiratory disorders: shortness of breath;
• sexual dysfunctions: impotence in men and decreased libido in women.

Interaction with other drugs

When using Amlodipine together with other drugs, the following interactions are possible:

• inhibition and inactivation (reducing activity and eliminating effects);
• potentiation, increased activity.

It is important to take into account such ways of influencing drugs on Amlodipine when choosing a dose and drawing up a complex treatment regimen.

Medicines that moderately potentiate the activity of Amlodipine:

Amlodipine is compatible with these drugs, so it is rational to include it in the treatment of patients. It is important to select the correct dose, since irrational use often results in severe hypotension. Taking dietary supplements (FF "Vertex") can also effectively complement the action of Amlodipine.

Drugs that enhance the activity of Amlodipine:

• nitrates - Nitroglycerin;
• antiarrhythmic drugs - Novocainamide;
• antagonists of slow calcium channels - derivatives of Verapamil, Diltiazem;
• cardiac glycosides are alkaloids. When used together, a sharp bradycardia develops - slowing down heart rate.

Drugs that inactivate the drug - non-steroidal anti-inflammatory drugs (NSAIDs) - Nimesulide, Ibuprofen, Paracetamol, Meloxicam. In case of urgent need to take them, they should be used with an interval of at least 4-5 hours between doses.

Use during pregnancy and lactation

The use of Amlodipine during pregnancy in the first trimester is contraindicated. The teratogenic (negative) effect of the active substance on the formation of the fetus, especially the fingers, has been established. In the remaining trimesters, the use of the drug is not contraindicated. Taking the drug is possible only when the effectiveness and need for it significantly outweigh the risks for the unborn child. It is important that the doctor selects the correct dosage regimen, ensuring maximum safety.

During breastfeeding the drug is used with caution according to the same principles as during pregnancy: if the benefits outweigh the risks or the threat from the mother’s disease is very great. There is no need to stop feeding the baby while taking Amlodipine.

Important! The drug is excreted in breast milk. When feeding a child, he may experience undesirable reactions in the form of skin rashes, itching, redness of the face, chest, increased heart rate. stool disorders.

Use with alcohol

The use of Amlodipine and alcohol is not recommended. Low compatibility ethyl alcohol and the drug can lead to increased activity of the active substance, as well as lead to severe adverse reactions, signs of overdose, and increased intoxication.

With minimal doses of alcohol in a person’s blood, there are no significant changes in the metabolism of the drug. High doses of alcohol are more likely to provoke adverse reactions during treatment.

Analogues

Amlodipine-based drugs are produced by various pharmaceutical companies:

Farmak, Zentiva, Canonfarm, Astrapharm, Biocom, Borimed, Teva, Prana, Perineva, KVZ, KRKA, etc. Often the name of the manufacturer is indicated in the trade name of the drug.

Important! The names of the active substance and the trade name may differ. In any case, we are talking about drugs with the same composition.

Amlodipine analogues and synonyms are the following drugs:

Amlodipine-cardio, Amlodipine-KV, Norvasc, Vero-Amlodipine, Vazodipine, Amlocor, Amlopril, Vazotal, Normodipine, Stamlo, Tenox, Emlodin.

Best before date

The drug is suitable for use for no more than three years from the date of release.

Terms of sale and storage

Dispensed from a pharmacy only with a doctor's prescription. For Amlodipine, your doctor must write a prescription for Latin indicating the international name of the active substance.

The tablets should be stored in places protected from light, out of reach of children. The air temperature in the room is from 5 to 25⁰С.

special instructions

The drug affects blood clotting. Before any kind surgical interventions, including dental care, it is important to notify your doctor about taking Amlodipine. The drug does not have a significant effect on blood biochemical parameters. It is not recommended to abruptly discontinue the drug.

Discontinuation of the drug is carried out by gradually reducing the dose over 7-10 days.

Before starting treatment, your doctor should explain when it is best to take Amlodipine - in the morning or in the evening. The schedule and duration of the appointment is selected individually.

Price

The cost of the drug differs and depends on the manufacturer. The domestic drug costs from 35 to 150 rubles. The imported analogue of Amlodipine is more expensive. Prices vary from 100 to 300 or more rubles per package.

Pressure surges are one of the most common problems of modern people. Therefore, every person is looking for the most effective and safe medicine intended to normalize blood pressure. One of the most common modern 3rd generation drugs is Amlodipine, the instructions for use of which should be studied in detail, and also find out at what pressure it is used.

Composition of the drug

The drug is available in the form of tablets that contain the main active substance – amlodipine besylate. In addition to it, the medicine also contains auxiliary components:

• lactose;
• calcium stearate;
• croscarmellose sodium.

White tablets, coated with a colorless film, are sold in sheets packaged in a large cardboard pack. You can buy Amlodipine at any pharmacy. For Russia the price is approximately 40 rubles. As for Ukraine, this drug can be purchased at average price 15 UAH

Instructions for use

Most often, Amlodipine is used to normalize blood pressure. It is taken by people suffering from hypertension. The drug is also prescribed for the following diseases and ailments:

• treatment of hypertension initial stage development;
• with irregular, single surges in blood pressure;
• with stable angina;
• with spasms of blood vessels.

Amlodipine helps lower high blood pressure and also improves functioning of cardio-vascular system. Therefore, if a patient has a rapid heartbeat along with high blood pressure, then the drug will bring the body to a normal state.

Important to remember! Before using Amlodipine, you should consult a specialist! Only he can prescribe the drug, because self-treatment can cause complications, and if the dosage is incorrect, unpleasant side effects.

Reception features

This medicinal product contains potent substances. Therefore, during treatment with Amlodipine, you must adhere to the following rules:

1. During the appointment, you should monitor your weight and also see a dentist. The medicine may cause excess weight or severe bleeding gums.
2. Do not stop taking the drug abruptly. This may trigger renewed attacks of high blood pressure, and a high pulse may also be observed.
3. During the treatment period, it is better for people whose professional activities involve increased care and responsibility to take a vacation. This drug causes constant drowsiness or dizziness.
4. In patients with liver failure, Amlodipine should be taken under regular specialist supervision.

The relatively low cost of the drug allows it to be used by all segments of the population. However, you should consult your doctor before use.

How to use

Depending on the problems with blood pressure, the dosage is prescribed differently:

1. Infrequent increases in blood pressure. This indicator can be reduced by taking 1 tablet once a day. It is better to take the tablet in the morning, as it begins to act after a couple of hours. If there is no improvement in the condition, you need to increase the dosage to 2 tablets per day, taking them once. With long-term use of the drug, the dose should be reduced to 0.5 tablets per day. The course of treatment is 1 week. An increase in duration can only be prescribed by a specialist.
2. Arterial hypertension. People suffering from this disease need to take Amlodipine 0.5 tablets per day. This treatment has a supportive effect on the body. You should take the drug in this mode constantly.
3. Impaired functioning of the cardiovascular system. For heart disease, experts recommend taking 1 tablet once a day. If improvement is not observed for a long period of time, then you can increase the dose to 2 tablets for a while. How long should I take this drug? Most often, doctors recommend using it on an ongoing basis for heart problems.

Important to remember! The duration of treatment with Amlodipine is determined only by a specialist! The patient should regularly visit the doctor, who will evaluate the state of health during the period of therapy and the advisability of continuing to take the pills.

Side effects

If you take this drug excessively, a person may experience the following ailments:

1. From the cardiovascular system: swelling of the upper and lower extremities, pain in the heart area, shortness of breath with minor exertion, increased or decreased heartbeat.
2. From the central nervous system: rapid fatigue, dizziness with loss of consciousness, sleep disturbances, causeless irritability, anxiety, apathy.
3. From the gastrointestinal tract: nausea with vomiting, painful sensations in the lower part abdominal cavity, constipation or diarrhea, constant thirst, exacerbation of gastritis.

The patient may also have problems with intimate life, painful urination, allergic rashes on the skin, increased body temperature.

Important to remember! You should adhere to the dosage prescribed by your doctor! This will help protect the body from the above side effects.

Contraindications for use

This drug is strictly contraindicated in the following cases:

• during pregnancy – the active component of Amlodipine negatively affects the development of the fetus;
• breastfeeding period;
• at diabetes mellitus;
• with low blood pressure;
• persons under 18 years of age;
• for lactose intolerance, as well as hypersensitivity to other components of the drug.

Also, if a patient experiences severe allergic reactions after consuming Amlodipine, such treatment should be stopped and consult a specialist about the use of similar drugs.

Norvasc or Amlodipine - which is better?

Norvasc is a drug whose active substance is amlodipine. If you compare this imported medicine with Amlodipine, there is no significant difference in the effect on the body. Norvasc is several times more expensive than the domestic analogue, but in terms of the degree of purification and concentration of the active substance, the foreign drug has an advantage.

A package of Norvasc costs on average 400 rubles in Russia. In Ukraine it can be purchased for approximately 130 UAH. Therefore, many people suffering from regular increases in blood pressure cannot afford such treatment and choose Amlodipine.

Analogues of the drug

In addition to Norvasc, modern pharmacology offers many more drugs similar in composition and effect on the body:

1. Duactin. This medicine is available in capsules. Prescribed for hypertension, as well as for chronic palpitations. The advantage is the minimum number of contraindications for use.
2. Tenox. Used when severe forms hypertension and chronic angina. The drug is not suitable for persons suffering from acute heart failure.
3. Normodipin. In a short time it normalizes high blood pressure and improves the functioning of the cardiovascular system. Contraindicated in people who have suffered acute myocardial infarction.
4. Emlodin. Enough inexpensive analogue Amlodipine. It is strictly forbidden to use in severe hypotension, as well as in cases of impaired functioning of the left ventricle.

Regardless of the choice of a particular drug when high blood pressure, you need to agree on its dosage and advisability of use with a specialist.

To obtain the effect of therapy with antihypertensive drugs, it is necessary to observe the timing of their administration. This will reduce the likelihood of side effects and make you feel good. Great importance taking medications correctly is important for patients with difficult-to-control hypertension who are taking multiple antihypertensive medications. Therefore, you need to figure out when it is better to take blood pressure pills in the morning or in the evening.

Today, most cardiologists advise patients to take antihypertensive medications in the morning. After all, patients often experience increased blood pressure in the morning and normalization in the evening.

In patients who have a history of hypertension with diabetes mellitus or renal failure, these pressure fluctuations are impaired. In such cases, cardiologists recommend using antihypertensive drugs in the evening.

There is a rule for taking long-acting antihypertensive drugs. These include ACE inhibitors: Enap, Enaprylin and others. To determine the optimal time for taking it, doctors advise observing changes in blood pressure throughout the day.

If hypertension occurs mainly in the evening hours, then the medicine is taken in the morning. If your blood pressure rises in the morning, it is recommended to take ACE inhibitors (angiotensin-converting enzyme) before bed.

If hypertension occurs randomly, then daily dose can be divided into 2 doses in the morning and evening. For drugs short acting there is no such rule. They are taken in case of a sharp rise in blood pressure as emergency therapy.

Cardiologists have long agreed that the timing of antihypertensive medications affects their effectiveness and the incidence of side effects. After all, a morning dose can lead to nausea, dizziness and weakness throughout the day.

This issue is of particular importance for the millions of people who suffer from difficult-to-control hypertension. They are divided into 2 groups:

• Patients take more than 2 antihypertensive drugs, but the pressure does not decrease to normal values.
• Patients whose blood pressure rises only at night. This condition is called nocturnal hypertension.

The use of new drugs to lower blood pressure for such patients leads to increased costs of therapy, side effects and undesirable drug interactions.

Scientists from Spain decided to look into this issue. A study was conducted involving 661 patients with hypertension.

Half of the patients had to take medications in the morning immediately after waking up, the rest - before going to bed. The use of a specific group of antihypertensive drugs was not required. The following were excluded from the number of subjects:

• Pregnant women;
• Persons who have abused alcohol or drugs in the anamnesis;
• Patients who work at night;
• HIV-infected persons;
• Patients with diabetes mellitus and secondary hypertension.

The study found that patients who took antihypertensive medications before bed had lower blood pressure during the day and during sleep. Also in this group, the risk of developing cardiovascular pathologies (heart attack, cardiac arrest) decreased, and overall mortality decreased.

Canadian scientists came to similar results. They proved that taking ACE inhibitor drugs before bedtime, indicated for hypertension or after a heart attack, increases the effectiveness of therapy several times.

If the drug was taken in the morning on an empty stomach, the effectiveness of the drug is comparable to taking a placebo. Canadian scientists have found that at night, patients with hypertension produce a hormone that causes expansion and damage to the heart. Taking ACE inhibitors before bed can reduce the activity of this substance, protecting the heart muscle.

Concor: instructions for use

Concor is a popular medicine for high blood pressure, coronary disease heart disease, angina pectoris, chronic heart failure. This original drug High Quality, the active ingredient of which is bisoprolol. Below you will find instructions for use written in accessible language. Read the indications for use, contraindications, side effects. Find out how to take Concor - before or after meals, in the morning or in the evening, what your pulse and blood pressure should be, and how to safely stop taking it. The article provides detailed answers to 19 questions that patients often ask. Find out how Concor tablets differ from Concor Cor. The article also provides a list of cheap analogues of these drugs.

Instructions for use

pharmachologic effect	Bisoprolol, the active ingredient in Concor, protects the heart from the “accelerating” effect of adrenaline and other catecholamines. Thanks to this, blood pressure and pulse rate decrease. Heart rate becomes more stable. People taking Concor reduce the risk of a first and second heart attack, as well as other complications of hypertension. Bisoprolol has the property of selectivity - it affects the heart muscle, but has almost no effect on the bronchi, pancreas, skeletal muscles. This reduces its side effects compared to older beta blockers.
Pharmacokinetics	Each Concor tablet is valid for a whole day, so you can take this medicine once a day. Full effect reduction in blood pressure manifests itself only 2 weeks after the start of treatment. Concor is not a pill fast action. They are intended for long-term treatment. Can be taken on an empty stomach or after meals. Food does not affect the effectiveness of this medicine. It is advisable to take it at the same time every day. Bisoprolol is excreted from the body by the liver and kidneys in a ratio of approximately 50/50.
Indications for use	Concor tablets of 5 and 10 mg of bisoprolol have the following indications for use: arterial hypertension, coronary heart disease, stable angina, chronic heart failure. The drug Concor Cor, containing a reduced dosage of bisoprolol 2.5 mg, is prescribed only for chronic heart failure. For the treatment of hypertension, the dosage of bisoprolol 2.5 mg per day is considered too low. There is also a medicine called Concor AM, which simultaneously contains two active ingredients - bisoprolol and amlodipine. Its only indication for use is arterial hypertension.

Watch also a video about the treatment of coronary artery disease and angina pectoris

Contraindications	Acute heart failure, as well as chronic heart failure in the decompensation stage. Bradycardia - pulse below 60 beats per minute. Severe peripheral circulatory disorders - problems with the arteries in the legs. Bronchial asthma or severe chronic obstructive pulmonary disease. AV block II and III degrees. Sick sinus syndrome (SSNS). Pheochromocytoma. Metabolic acidosis is a shift in the body's acid-base balance towards increased acidity.
special instructions	Take Concor daily, even when your blood pressure and health are normal. In people who voluntarily stop taking medications prescribed to them for hypertension and cardiovascular diseases, the pressure sometimes increases greatly due to the rebound. This can cause a hypertensive crisis, heart attack or stroke. If you want to reduce the dosage or stop taking any medication, discuss it with your doctor. Once you start treatment with Concor, it would be wise to refrain from driving or driving other dangerous machinery for 1-2 weeks until your body gets used to it.
Dosage	The recommended dosage for high blood pressure is 5-10 mg per day. You can start with 2.5 mg per day, and later increase the dosage, making sure that the patient tolerates the treatment well. The official maximum daily dose is 20 mg, but it is rarely prescribed. For heart failure, they usually start with 1.25 mg of bisoprolol, and later increase the dose to 2.5 mg per day. Concor Cor tablets are well suited for this. If an even higher daily dose of beta blocker is required, it is increased gradually by 1.25 mg each time. For patients with hypertension not complicated by heart failure, the daily dose can be increased in increments of 2.5 mg.
Side effects	Concor causes side effects less frequently than the older beta blockers atenolol and propranolol (Anaprilin). It usually does not increase blood glucose levels, uric acid and “bad” cholesterol. Bradycardia is possible - a drop in heart rate below 55-60 beats per minute. Symptoms of heart failure may worsen. If you choose the wrong dose of bisoprolol and other medications for hypertension, your blood pressure may drop too low. Hypotension causes dizziness, weakness, and headache. Patients often complain of nausea, diarrhea, or constipation. At the beginning of treatment with beta blockers, your health may worsen. It is worth waiting 1-2 weeks until the body adapts and these symptoms will go away.
Pregnancy and breastfeeding	Concor is rarely prescribed during pregnancy, only when serious illnesses, if the doctor decides that the benefit to the mother and fetus is higher than the possible risk. It has been suggested that beta blockers may reduce blood flow to the placenta and negatively affect fetal development. Therefore, you should not take Concor without permission during pregnancy. Doctors are advised to carefully monitor the fetus, as well as the condition of the child in the first days after birth. He may have a very low heart rate and low blood glucose levels. It is not known whether bisoprolol is secreted in breast milk. This medicine is not recommended for women who are breastfeeding.
Interaction with other drugs	It is not recommended to take verapamil, diltiazem, as well as ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) at the same time as Concor. Bisoprolol may interact negatively with many medications for cardiovascular disease. Discuss details with your doctor. Tell him about all the medications, dietary supplements and herbs you are taking. Concor is often prescribed along with other high blood pressure pills. If the dosage is chosen incorrectly, hypotension may occur. Its symptoms are described above in the “Side Effects” section. Do not take bisoprolol at the same time as other beta blockers.
Overdose	Symptoms: very low pulse (bradycardia), severe heart rhythm disturbances, low blood pressure (hypotension), bronchospasm, acute heart failure, low blood sugar (hypoglycemia). To raise the heart rate, doctors administer dopamine intravenously, as well as other stimulants. For bronchospasm, medications that relax the bronchi are prescribed. Glucagon is used to increase blood sugar. An overdose of Concor is most dangerous for patients with chronic heart failure. If its symptoms worsen, then medications are used that increase the strength of heart contractions.
Release form	The tablets are heart-shaped, biconvex, with a dividing line on both sides, film-coated. They are in blisters made of PVC and aluminum foil. Blisters are packed in cardboard boxes. Tablets of 5 mg bisoprolol are light yellow in color. Bisoprolol 10 mg tablets are light orange in color. Concor Cor tablets 2.5 mg bisoprolol - white.
Storage conditions and periods	Store out of reach of children, at a temperature not exceeding 25°C. The shelf life of the drug Concor is 5 years, Concor Cor is 3 years. Do not use after the expiration date stated on the package.
Compound	The active ingredient is bisoprolol. Excipients - anhydrous calcium hydrogen phosphate, fine corn starch, anhydrous colloidal silicon dioxide, MCC, crospovidone, magnesium stearate, hypromellose, macrogol, dimethicone, yellow iron oxide dye, titanium dioxide.

How to take Concor

Take Concor only as prescribed by your doctor and in the dosage he or she prescribes. Do not prescribe this medication for yourself or try to adjust the dosage yourself. Perhaps over time the doctor will decide to lower or increase the dosage of the drug. You should regularly visit your doctor every few weeks for follow-up examinations and consultations. Concor should be taken every day, regardless of how you feel and your blood pressure.

Do not stop taking this medicine because your blood pressure has returned to normal. Patients who voluntarily stop medications may experience a hypertensive crisis, heart attack, stroke, or decompensated heart failure. This may result in disability or death. If you want to reduce the dosage or stop taking any medications, discuss this with your doctor. Until you get his approval, stick to the same daily pill regimen.

Concor can be taken before or after meals, as is convenient for you. Eating does not affect the rate of absorption or potency of this medication. Try to take your blood pressure pills at the same time every day. Concor needs to be taken for a long time, perhaps even for life. This medicine is not addictive and does not have any negative influence on metabolism. It begins to act no earlier than after 1-2 weeks of daily use, so it is not suitable for situations where emergency assistance is needed.

Can I take Concor in the evening, at night?

Concor can be taken at night, but it is still better to do it in the first half of the day. In most patients, blood pressure does not rise in the morning or afternoon, but in the evening. Bisoprolol tablets do not begin to act immediately, but only a few hours after administration. The medicine taken in the first half will act in full force just in the evening.

If your blood pressure rises in the evening, you have a headache, feel sick or have other symptoms hypertensive crisis, then it’s too late to take Concor. We need other medications that work faster. Study the article “Hypertensive crisis: urgent Care"and do what it says.

Sometimes there are patients whose blood pressure rises at dawn and in the mornings, and not in the evenings, like everyone else. Perhaps 24-hour blood pressure monitoring showed that you are one of those rare people. In this case, it is more beneficial for you to take Concor in the evening or at night.

Can I split the tablet in half?

The Concor tablet can be divided in half, but cannot be crushed or chewed. The tablets should not be divided into 4 parts. If you need to take bisoprolol 1.25 mg per day for heart failure, then buy Concor Cor tablets and divide them in half. For hypertension, it is not recommended to take 1.25 mg of bisoprolol per day, even together with other blood pressure pills. This dose is considered too low. It is unlikely that it will protect you from myocardial infarction and other consequences of hypertension.

Is it possible to drink Concor with low blood pressure?

Stop taking Concor if your “upper” systolic blood pressure drops below 100 mmHg. Art., you feel dizzy and weak due to hypotension. If the “upper” systolic pressure remains above 100 mmHg. Art. and you feel fine - continue taking the medicine. At next visit Ask your doctor if you should reduce the dosage of your hypertension pills. But do not stop taking them without permission.

What should your pulse be when taking this medicine?

You should strive for a resting heart rate of 55-60 beats per minute. At this heart rate, you have the lowest risk of dying from a myocardial infarction or decompensated heart failure. A competent doctor will first prescribe Concor in a low dose for daily use, and then gradually increase the dosage until the patient’s resting pulse drops to the specified values. target values. Of course, the dose of bisoprolol can be increased only if the patient tolerates this drug well. You should not achieve an optimal heart rate at the expense of severe side effects from the medication.

How to cancel Concor?

Concor should be discontinued slowly and carefully, otherwise there may be a significant increase in blood pressure by “ricocheting”, pulse surges and heart rhythm disturbances. Stopping it too quickly is deadly and can lead to a heart attack or stroke. First you need to slightly reduce the daily dose, then monitor your well-being and heart rate for several days. If everything is in order, reduce the dose further. And so gradually completely stop taking this medicine. Wait at least 3 days, or even a whole week, before reducing the dosage again. One day is not enough.

Unfortunately, there is no single scheme for discontinuing Concor tablets and other bisoprolol preparations. Foreign sites write that cancellation should take at least one week. You can reduce the dosage by 1.25 mg or by half each time. If you don't want to take risks, then use the regimen 5 mg - 3.75 mg - 2.5 mg - 1.25 mg - 0. A faster and riskier option: 5 mg - 2.5 mg - 0. Discuss stopping the beta blocker with a doctor who sees many patients and has enough experience.

Concor: analogues

Analogues of the drug Concor are other drugs whose active ingredient is bisoprolol. They can be Russian (the cheapest), as well as foreign-made, more expensive. Concor is an original medicine that is considered the highest quality among bisoprolol preparations. These tablets have not the lowest, but also not the highest price. They are available even to pensioners. If you switch to analogues, you will save a small amount of money every month. This may reduce the effectiveness of treatment and increase side effects. Since Concor tablets have an affordable price, you can safely take the original medicine.

A well-known Russian cardiologist in a private conversation categorically did not recommend taking medications for hypertension and cardiovascular diseases produced in Russia and the CIS countries. See more details here. In medical journals you can find many articles proving that Biprol and other Russian analogues help no worse than the original drug Concor. You should not trust these articles, because they are all published for money. If you take analogues, then it is better to choose foreign-made tablets.

The medicines listed in the table above are not necessarily manufactured in the same country in which their manufacturer is registered. Many pharmaceutical companies transfer production to the territory of the Russian Federation and CIS countries. This negatively affects the quality of the drugs. Before purchasing from a pharmacy, check the country of origin of the medicine using the barcode on the package.

Analogs of the drug Concor Cor are tablets of 2.5 mg of bisoprolol. They are produced by both domestic and foreign companies. However, there are fewer of these drugs available than the regular Concor tablets. Because their sales market is much smaller. In the “Indications for use” section you read that Concor Cor is prescribed only for chronic heart failure. And for the treatment of hypertension, the dosage of the active substance in these tablets is considered too low.

The drug Concor AM simultaneously contains two active ingredients in each tablet - bisoprolol and amlodipine. It is sometimes prescribed for high blood pressure. At the time of preparation of this article, no analogues of this medicine were found. Concor AM is not recommended for the treatment of heart failure because it is too strong a medicine.

Frequently asked questions and answers

Below are answers to questions that patients often have about the drug Concor, its compatibility with other drugs for hypertension and cardiovascular diseases.

Bisoprolol or Concor: which is better? What are the differences?

Concor is the trade name of the drug, and bisoprolol is its active ingredient. It cannot be said that bisoprolol is better than Concor, or vice versa, because they are the same drug. Pharmacies sell many drugs whose active ingredient is bisoprolol. All these are analogues of the original drug Concor, which is considered to be of the highest quality. Analogues are cheaper than Concor, but the difference in price is not significant, and the efficiency may be completely different. The list of bisoprolol preparations produced in Russia and abroad is given above.

What is the difference between Concor and Concor Core?

Concor are tablets that contain bisoprolol in a dosage of 5 or 10 mg. They are prescribed for high blood pressure, coronary heart disease, angina pectoris and chronic heart failure. Concor Cor are tablets that contain bisoprolol in a reduced dosage of 2.5 mg. Their only indication for use is chronic heart failure. For the treatment of hypertension and coronary heart disease, the dosage of bisoprolol 2.5 mg per day is considered too low. In practice, it helps many patients if Concor Cor is taken along with other medications for high blood pressure. Read more in the article “Treating hypertension with combination medications.”

Are Concor and alcohol compatible?

Concor and other bisoprolol preparations are not compatible with large doses of alcohol. Taking these medications with alcoholic beverages may cause hypotension. Its symptoms are headache, dizziness, palpitations or too low pulse. Dangerous fainting is possible, which people around will mistake for normal alcohol intoxication, although the patient requires emergency medical care to save his life.

However, reasonable drinking is acceptable as long as you can maintain moderation. Concor is a medicine that needs to be taken for a long time, for many years. Few patients would agree to become a teetotaler. Try to completely abstain from alcohol in the first two weeks from the start of treatment, until the body has adapted. During this period, the side effects listed above can cause even small doses of alcohol.

Does Concor increase or decrease blood pressure?

Concor lowers blood pressure and pulse. How strong depends on the dosage, as well as individual characteristics your body. In any case, this drug does not increase blood pressure.

Does Concor affect male potency?

Double-blind, placebo-controlled studies were conducted that proved that Concor and others modern beta blockers do not weaken male potency. Double-blind, placebo-controlled studies are where men didn't know whether they were taking the real medicine or a dummy pill. In such situations, their potency did not deteriorate. Thus, the weakening of potency while taking Concor tablets and other modern medications for hypertension is caused by psychological reasons, and not a deterioration in metabolism.

The main reason for the weakening of potency in men is damage by atherosclerosis to small-diameter vessels through which blood flows into the penis. There are also often consequences of diabetes that is not properly treated or not diagnosed or treated at all. If you stop taking medications for hypertension, your potency will not increase, but the risk of heart attack and stroke will increase significantly. There is a possibility that while taking Concor tablets, potency will increase. Because you will not be bothered by headaches and other symptoms of high blood pressure. Also read the article “Hypertension and impotence”.

Concor and Lozap: are these drugs compatible? What's better?

Concor and Lozap are compatible. They can be taken at the same time if your doctor has prescribed this combination of medications for you. It cannot be said that Concor is better than Lozap, or vice versa, because these drugs belong to different groups, have different mechanisms of action.

Is it possible to take Concor and Amlodipine at the same time?

Concor and Amlodipine are compatible. They can be taken simultaneously for high blood pressure, as prescribed by a doctor. There is even a medicine called Concor AM, which contains bisoprolol and amlodipine in one tablet. Its only indication for use is arterial hypertension. Amlodipine is usually not prescribed for heart failure. Taking one combined drug per day is more convenient than two separate tablets. Please note that Amlodipine often causes swelling and other side effects. Read the detailed article about this medicine.

Is it possible to take Concor and Indapamide together?

Yes, Concor and Indapamide are compatible and can be taken together. Indapamide is a popular medicine for hypertension, which is classified as a diuretic, but in practice is used as a vasodilator. It rarely causes side effects. Indapamide is rarely used for heart failure because its diuretic effect is weaker than other drugs. Do not take either bisoprolol or indapamide without a doctor's prescription.

Concor and Noliprel: is it possible to combine these medications?

Concor and Noliprel can be combined to treat hypertension. Noliprel is a powerful medicine for high blood pressure. It contains two active ingredients in each tablet - perindopril and indapamide. If you add bisoprolol to it, you will treat hypertension with three drugs simultaneously. Noliprel itself often causes hypotension - too low blood pressure. And if you add Concor to it, the risk of hypotension increases. Discuss with your doctor what dosages of medications will be optimal for you - effective, but not too high. Be prepared for the fact that in the first 1-2 weeks from the start of treatment you will experience weakness and fatigue. Dizziness and headache are possible. It is worth waiting for a while until the body adapts and these symptoms will pass. IN initial period treatment, completely avoid alcohol and try not to drive.

Is it possible to take Concor and Cardiomagnyl together?

Concor and Cardiomagnyl can be taken together, but only as prescribed by a doctor. Do not use either drug on your own initiative. IN last years the frequency of aspirin prescriptions for the prevention of heart attack and stroke has decreased significantly. Studies have shown that for people at low risk, Cardiomagnyl tablets and other aspirin preparations for prevention are not useful, but harmful. Make sure your doctor knows the results of these studies before he prescribes Cardiomagnyl for you. Study the instructions for the drug Cardiomagnyl, as well as the article “Aspirin for the prevention of thrombosis“. You can show it to your doctor.

Concor or Atenolol: which is better?

Concor is better than Atenolol, both in terms of treatment effectiveness and side effects. Atenolol worsens the results of blood tests for sugar and cholesterol, and also negatively affects male potency. Drugs whose active ingredient is bisoprolol do not have these problems. Since the mid-2000s, shocking articles have appeared in reputable English-language medical journals that Atenolol does not reduce, but rather increases, the mortality rate of patients with hypertension. Based on these studies, Atenolol today can be considered an obsolete drug. If the doctor continues to prescribe it, it means that he has not followed professional news for many years. Change him to another specialist.

Is it possible to take Concor and Capoten at the same time?

Concor and Capoten are compatible medications. But it is still better not to take Capoten regularly to treat hypertension. These tablets must be taken several times a day, which is inconvenient for patients. There are drugs with a mechanism of action similar to Capoten, which can be taken once a day. Discuss with your doctor which medicine can replace Capoten for daily use. You can keep Capoten in your home medicine cabinet in case of a hypertensive crisis.

Use of the drug Concor

Concor is a popular medicine for hypertension, coronary heart disease, angina pectoris, and chronic heart failure. This is an original drug whose active ingredient is bisoprolol. It is considered the highest quality among all tablets containing bisoprolol. The drug Concor does not have the lowest, but reasonable price, affordable even for domestic pensioners. You can safely take it, not paying attention to analogues that cost less. If you switch to analogues, you will not be able to save significant money, and the effectiveness of treatment may decrease.

Everything you need to know about taking these high blood pressure pills is detailed below. For coronary heart disease and angina pectoris, the doctor tries to select the dosage of Concor medication so that the patient’s resting pulse is 55-60 beats per minute. At this heart rate, attacks of chest pain occur least frequently and the risk of heart attack is lowest. It is not always possible to persuade patients to take a high enough dose of bisoprolol to maintain an optimal heart rate. Patients often complain about the side effects that this medicine causes. In fact, side effects are usually caused by atherosclerosis, as well as psychological reasons.

The use of Concor and other beta blockers for heart failure is not entirely exact science, and in some ways even art. Medicines that lower the pulse rate cannot be prescribed for acute heart failure, as well as for chronic heart failure in the stage of decompensation.

• Causes, symptoms, diagnosis, medications and folk remedies from CH
• Diuretic medications for edema in heart failure: detailed information
• Answers to FAQ o HF - fluid and salt restriction, shortness of breath, diet, alcohol, disability
• Heart failure in the elderly: treatment features

Watch also the video:

A beta blocker may protect the heart muscle from overuse and further wear and tear. But if the dose is too high, the symptoms of heart failure will intensify. An experienced doctor should select the dosage of bisoprolol. If treated appropriately, the administration of beta blockers in addition to ACE inhibitors reduces mortality in patients with heart failure.

For high blood pressure

Concor is often prescribed for high blood pressure. This drug has the benefits that were described above. To effectively treat hypertension, it is better to take several medications at a time in low doses than a single drug in a high dosage. A competent doctor will try not to prescribe a dosage of Concor tablets higher than 5 mg per day. If necessary, the beta blocker is supplemented with ACE inhibitors, calcium antagonists, diuretics or other drugs. It may turn out that even taking 2.5 mg of bisoprolol per day is enough to keep your blood pressure below 135-140/90 mmHg. Art.

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If the doctor says that you need to take Concor and other medications for high blood pressure at the same time, follow his instructions. Taking several pills every day may not be convenient, but it is better than suffering a heart attack, stroke, or kidney failure. Bisoprolol is enough to take once a day. Other modern medicines from hypertension - too. Do not use outdated medications that require taking 2-4 times a day. Concor and other medications are not primary, but additional remedies for high blood pressure. The main treatment for hypertension is the transition to a healthy lifestyle.

Can I take Concor if I have diabetes?

Concor for type 2 and type 1 diabetes mellitus is often prescribed for hypertension and heart problems. The main medications for diabetics are ACE inhibitors. But beta blockers also help reduce mortality and delay the onset of a heart attack. Bisoprolol has little effect on metabolism. Most likely, you will not even notice that your blood sugar has changed in any way. You may need to slightly increase your insulin and diabetes pills. Patients with type 2 and even type 1 diabetes benefit from a low-carbohydrate diet. This is a natural way to keep your sugar level stable and reduce the dosage of insulin, pills for diabetes and high blood pressure several times.

After a heart attack

Concor after a heart attack is often prescribed for long-term use. One of the goals of treatment is to reduce overload on the heart muscle. Beta blockers are the main medications for this. Concor occupies one of the leading positions among them. For example, in 2012, the journal Circulation published a publication on English language, proving that bisoprolol after a heart attack is more effective than atenolol. During physical and psychological stress, the adrenal glands secrete adrenaline and other substances that make the heart beat faster and with greater force. Beta blockers reduce the stimulating effect of adrenaline on the heart muscle. This reduces the risk of recurrent heart attack, heart failure, and death from other causes.

There is debate among experts about how long Concor should be taken after a heart attack. Previously, all people who had a myocardial infarction were recommended to take beta blockers for life. Since the mid-2000s, articles began to appear showing that for people who are at low risk of having another heart attack, this is not necessary. Patients at low risk of another heart attack are those who have a normal ejection fraction, normal blood pressure, and no episodes of chest pain. Such patients are unlikely to take bisoprolol for longer than 3 years. But in any case, this or another beta blocker must be taken for at least 1 year after a heart attack. And then discuss with your doctor whether you can stop taking the medicine. If risk factors for recurrent heart attack persist, then beta blockers cannot be stopped.

• Treatment of hypertension in older people

At what blood pressure can Amlodipine be taken?

Pressure surges are one of the most common problems of modern people. Therefore, every person is looking for the most effective and safe medicine intended to normalize blood pressure. One of the most common modern 3rd generation drugs is Amlodipine, the instructions for use of which should be studied in detail, and also find out at what pressure it is used.

• Composition of the drug
• Instructions for use
• Reception features
• How to use
• Side effects
• Contraindications for use
• Norvasc or Amlodipine - which is better?
• Analogues of the drug

How to take Stugeron

Composition of the drug

This medication is available in the form of tablets that contain the main active substance – amlodipine besilate. In addition to it, the medicine also contains auxiliary components:

• lactose;
• calcium stearate;
• croscarmellose sodium.

White tablets, coated with a colorless film, are sold in sheets packaged in a large cardboard pack. You can buy Amlodipine at any pharmacy. For Russia the price is approximately 40 rubles. As for Ukraine, this drug can be purchased at an average price of 15 UAH.

Instructions for use

Most often, Amlodipine is used to normalize blood pressure. It is taken by people suffering from hypertension. The drug is also prescribed for the following diseases and ailments:

• treatment of hypertension at the initial stage of development;
• with irregular, single surges in blood pressure;
• with stable angina;
• with spasms of blood vessels.

Amlodipine helps lower high blood pressure and also improves the functioning of the cardiovascular system. Therefore, if a patient has a rapid heartbeat along with high blood pressure, then the drug will bring the body to a normal state.

Reception features

This medicinal product contains potent substances. Therefore, during treatment with Amlodipine, you must adhere to the following rules:

1. During the appointment, you should monitor your weight and also see a dentist. The medicine may cause excess weight or severe bleeding gums.
2. Do not stop taking the drug abruptly. This may trigger renewed attacks of high blood pressure, and a high pulse may also be observed.
3. During the treatment period, it is better for people whose professional activities involve increased care and responsibility to take a vacation. This drug causes constant drowsiness or dizziness.
4. In patients with liver failure, Amlodipine should be taken under regular specialist supervision.

The relatively low cost of the drug allows it to be used by all segments of the population. However, you should consult your doctor before use.

How to use

Depending on the problems with blood pressure, the dosage is prescribed differently:

1. Infrequent increases in blood pressure. This indicator can be reduced by taking 1 tablet once a day. It is better to take the tablet in the morning, as it begins to act after a couple of hours. If there is no improvement in the condition, you need to increase the dosage to 2 tablets per day, taking them once. With long-term use of the drug, the dose should be reduced to 0.5 tablets per day. The course of treatment is 1 week. An increase in duration can only be prescribed by a specialist.
2. Arterial hypertension. People suffering from this disease need to take Amlodipine 0.5 tablets per day. This treatment has a supportive effect on the body. You should take the drug in this mode constantly.
3. Impaired functioning of the cardiovascular system. For heart disease, experts recommend taking 1 tablet once a day. If improvement is not observed for a long period of time, then you can increase the dose to 2 tablets for a while. How long should I take this drug? Most often, doctors recommend using it on an ongoing basis for heart problems.

Side effects

If you take this drug excessively, a person may experience the following ailments:

1. From the cardiovascular system: swelling of the upper and lower extremities, pain in the heart area, shortness of breath with minor exertion, increased or decreased heartbeat.
2. From the central nervous system: rapid fatigue, dizziness with loss of consciousness, sleep disturbances, causeless irritability, anxiety, apathy.
3. From the gastrointestinal tract: nausea with vomiting, pain in the lower abdominal cavity, constipation or diarrhea, constant thirst, exacerbation of gastritis.

The patient may also experience problems in intimate life, painful urination, allergic rashes on the skin, and increased body temperature.

Contraindications for use

This drug is strictly contraindicated in the following cases:

• during pregnancy – the active component of Amlodipine negatively affects the development of the fetus;
• breastfeeding period;
• for diabetes mellitus;
• with low blood pressure;
• persons under 18 years of age;
• with lactose intolerance, as well as hypersensitivity to other components of the drug.

Also, if a patient experiences severe allergic reactions after consuming Amlodipine, such treatment should be stopped and consult a specialist about the use of similar drugs.

Norvasc or Amlodipine - which is better?

Norvasc is a drug whose active substance is amlodipine. If we compare this imported medicine with Amlodipine, then there is no significant difference in the effect on the body. Norvasc is several times more expensive than the domestic analogue, but in terms of the degree of purification and concentration of the active substance, the foreign drug has an advantage.

A package of Norvasc costs on average 400 rubles in Russia. In Ukraine it can be purchased for approximately 130 UAH. Therefore, many people suffering from regular increases in blood pressure cannot afford such treatment and choose Amlodipine.

Analogues of the drug

In addition to Norvasc, modern pharmacology offers many more drugs similar in composition and effect on the body:

1. Duactin. This medicine is available in capsules. Prescribed for hypertension, as well as for chronic palpitations. The advantage is the minimum number of contraindications for use.
2. Tenox. Used for severe forms of hypertension and chronic angina. The drug is not suitable for persons suffering from acute heart failure.
3. Normodipin. In a short time it normalizes high blood pressure and improves the functioning of the cardiovascular system. Contraindicated in people who have suffered acute myocardial infarction.
4. Emlodin. A fairly inexpensive analogue of Amlodipine. It is strictly forbidden to use in severe hypotension, as well as in cases of impaired functioning of the left ventricle.

Regardless of the choice of a particular drug for high blood pressure, it is necessary to agree on its dosage and advisability of use with a specialist.

When selecting a medication for arterial hypertension (AH) for a patient, doctors often choose Amlodipine and medications with a similar composition.

The instructions for use call amlodipine a medication with antianginal (anti-ischemic) and hypotensive (antihypertensive) action, which allows the use of this drug in the treatment of hypertensive patients with concomitant ischemic diseases. We suggest that you familiarize yourself with the rules for taking Amlodipine tablets and other information related to this medication.

Composition and mechanism of action

According to the instructions for use of the drug Amlodipine, it contains the only active ingredient - amlodipine besilate. The list of auxiliary components, in addition to magnesium and calcium salts, starch and cellulose, contains milk sugar (lactose) - a carbohydrate that can cause an intolerance reaction in people predisposed to this.

In the drug Amlodipine, the mechanism of action of the active substance is based on complementary effects:

• blockade of calcium channels;
• dilation of blood vessels - coronary (heart) and periphery;
• reducing capillary resistance;
• reducing preload on the myocardium and its oxygen demand.

All this helps to reduce the severity of hypertension and ischemia of the heart muscle.

Pharmacological group

The instructions for use indicate the pharmacological group of Amlodipine - (BMKK), as stated in the document, of the second generation. This indicates such characteristics of the drug as:

• more a long period half-life of the drug from the blood (and therefore a longer duration of action);
• more high level tissue specificity of the drug;
• fewer side effects.

Such qualities make it possible to obtain high results from the use of the drug Amlodipine with a minimum of side effects. At least this is what the instructions for use say.

Most medications from the BMCC group have a mild diuretic effect.

Release form

Manufacturers of the drug Amlodipine have chosen the most popular and convenient form of release for patients - tablets. They are usually produced in the form of flattened cylindrical pills in various shades of cream, yellow, pink and white flowers in dosages of 5 and 10 mg.

Which manufacturer is better?

As stated in the complete drug reference book, amlodipine is the basis of a medication that is produced in Germany and is called Norvasc.

When evaluating Amlodipine - which manufacturer is better - reviews often speak in favor of the German drug. But many patients respond positively to Amlodipine, produced in Hungary, Serbia, Belarus, India, Macedonia and the Russian Federation.

Perhaps the whole point is in the individual tolerability of this medicine or in the correct selection of the dose and adherence to the dosage regimen, but it is not easy to select from the manufacturers of Amlodipine which is better. Although you can focus on aspects that do not raise doubts - the more famous the pharmacological company, the usually better quality its products, but the cost of these products can be tens of times higher.

What does it help with and why is it prescribed?

Considering the pharmacodynamics of the drug Amlodipine, what this medication helps with is not difficult to understand. It has antihypertensive and antiischemic effects, which means it helps against hypertension and, one of the manifestations of which is. These diseases require prolonged therapy, for which Amlodipine is prescribed.

Indications

This is also stated in the instructions for use in the section on indications. The list of indications for the use of Amlodipine indicates:

• AG - for therapy both in combination with other hypotonic medications, and as an independent drug;
• stable angina pectoris;
• vasospastic angina (or Prinzmetal), or vasospastic (as a single drug or in combination with certain anti-ischemic medications).

Manifestation of stable angina pectoris

At what pressure should I take it?

Since the medication has vasodilating properties, it is worth asking at what pressure Amlodipine is recommended for use according to the instructions for use. But this document does not name specific blood pressure values ​​at which treatment with blood pressure pills Amlodipine is indicated. If we focus on the indications for use, then arterial hypertension is one of the indications for the use of this drug. However, only a specialist can determine whether a patient has arterial hypertension.

You should consult a doctor, who will decide which drug is appropriate in a particular case, at what pressure to take Amlodipine according to the instructions for use for you personally.

Instructions for use

Let's look at other information offered by the instructions for Amlodipine. In what doses, at what time and how to take Amlodipine with high blood pressure, as well as other information.

How to take these tablets?

There is nothing unusual in how to take Amlodipine - the tablet is swallowed whole and washed down with water. It is not necessary to crush the pill, except in situations where a dosage of 2.5 mg is required for initial therapy (for hypertensive patients with impaired liver function).

Before or after meals?

Patients often ask how to take Amlodipine - before or after meals. Although the annotation for Amlodipine says that taking the medicine does not depend on food intake, apparently this point needs clarification.

You can take the medication before, during, and after meals.

In the morning or evening?

There is no attachment to the time - when to take Amlodipine, in the morning or in the evening. The pill is taken once a day (preferably at the same time) and each patient can choose a convenient moment for use independently, taking into account the diuretic effect of the medication.

Dosage

The issue of Amlodipine dosage is of particular importance given the pronounced hypotensive effect medication.

1. The required starting dose should be selected by the attending physician. When treating hypertension, it is usually 5 mg, for which Amlodipine 5 mg tablets are prescribed.
2. You should neither stop taking the medication nor increase its dosage without consulting your doctor. It will be possible to switch to a therapeutic dose (10 mg) no earlier than 14 days after the start of treatment.

Amlodipine 5 mg tablets, instructions for use suggest dividing them in half to obtain the starting 2.5 mg. This dosage is necessary for patients with liver dysfunction.

How long does it take for it to start working?

The instructions for use of Amlodipine indicate how long after the taken medication begins to act - after 2–4 hours. The therapeutic effect of the tablet lasts 1 day.

How long can I take it without a break?

Patients are also interested in information such as how long Amlodipine can be taken without interruption. There is no universal answer here, since the period of continuous use of antihypertensive tablets is determined by the attending physician individually. But patients with hypertension should prepare to take pills constantly. The instructions for use indicate the absence of a “withdrawal syndrome” in Amlodipine (a sharp rise in blood pressure and the manifestation of other symptoms when the drug is discontinued). However, it is recommended to stop taking it gradually, by gradually reducing the dosage over 5–7 days.

Degrees of arterial hypertension

Contraindications

You should familiarize yourself with the list of contraindications for Amlodipine before starting therapy with this medicine, since the side effects of Amlodipine that arise as a result of non-compliance with contraindications pose a danger to the patient’s life. It is forbidden to use these tablets if:

• hypersensitivity to any of the ingredients, including auxiliary ones;
• bearing a child and breastfeeding;
• severity of aortic stenosis;
• unstable angina (except for vasospastic);
• cardio shock;
• state of collapse of any etiology;
• significant (SBP< 90).

Due to the lack clinical trials The use of this medication by the age group under 18 years is also prohibited.

During pregnancy

There is also separate information on the use of Amlodipine during pregnancy in the official instructions for use. It is explained here that in studies on a control group of animals, the drug did not show any teratogenicity ( structural changes, leading to deformities in intrauterine development), nor embryotoxicity (toxic effect on the fetus). However, there is no clinical experience with its use in pregnant or lactating women. Therefore, the instructions for use warn against use not only by these groups of patients, but also by all women of reproductive age with a high risk of unplanned pregnancy.

Side effects

The instructions for use warn of the risk of developing side effects during Amlodipine therapy. Most often they occur when contraindications are not observed, but may not depend on this factor. Undesirable effects occur with varying frequencies, so it is more clear to depict their effects in a table.

Table. What are the undesirable effects of Amlodipine therapy?

Often	Infrequently	Rarely	Occasionally
In the heart and vascular system: swelling of the extremities, rapid heartbeat	Marked drop in blood pressure, orthostatic hypotension	The emergence or worsening of CHF	Arrhythmic disorders (atrial fibrillation, bradycardia, etc.)
In the respiratory system: no frequent	Shortness of breath, rhinitis	No	Cough
In the hematopoietic system: no frequent		No	Thrombocytopenia, leukopenia and other disorders
In the central nervous system: excessive fatigue, dizziness, headache	Anxiety depressive state, strange dreams, emotional lability, asthenia, etc.	Apathy, convulsions	Amnesia, ataxia (motility disorder)
In the gastrointestinal tract: nausea, abdominal (stomach) pain	Vomiting, other dyspeptic disorders, thirst	Increased appetite	Hepatitis, increased transaminase activity, inflammation of the pancreas or gastric mucosa
IN genitourinary system: no frequent	Painful urge to urinate, impotence	No	Increased urination (up to 1.8 liters per day) or, conversely, difficulty urinating
In the musculoskeletal system: no frequent	Pain in the muscles and back, seizures, arthrosis	An autoimmune disease, a pathological muscle fatigue called myasthenia gravis	No

In addition to those indicated in the table unwanted effects Their infrequent manifestations include:

• Problems skin in the form of rashes, itching, dermatitis, extremely rarely - the development of angioedema and other allergic reactions;
• gynecomastia (enlarged mammary glands in men);
• hyperglycemia (increased blood glucose levels);
• conjunctivitis and other eye diseases;
• pronounced change in body weight;
• increased sweating and others, full list which contains official instructions by application.

If undesirable effects occur, you should consult your doctor about the possibility of replacing Amlodipine with analogues of the drug.

Compatibility of the drug with alcohol

The instructions for use do not address the issue of Amlodipine and alcohol. The compatibility of these substances is impossible due to their synergistic effect on the body. Alcohol has a psychotropic effect, slows or increases heart rate, and causes a slight decrease in blood pressure. But this is immediately after taking it.

In the process of assimilation of alcohol, ethanol has a toxic effect on the heart muscle, promotes lipid deposition in myocardial cells, deterioration of its contractile function, and vasospasm. All this leads to arrhythmic disorders, increased blood pressure and other consequences that neutralize treatment with Amlodipine tablets. Alcohol is in no way compatible with them.

Recipe in Latin

Since we are talking about a medication sold by prescription in pharmacies, it would be useful to familiarize yourself with what the prescription for Amlodipine looks like in Latin:

Rp: Tab. Amlodipini 0.005 (0.010)

D.t. d: No. 30 (or No. 10) in tab.

S: 1 tablet 1 time per day.

Doctors have to write so much that only a pharmacy worker can decipher their handwriting. But now patients will be able to figure out what is written in the prescription: in the top line - international name Amlodipine in Latin in the genitive case, the second line is the number of tablets in the package, the third is the method of application.

Reviews from patients who took the drug

Analysis of reviews about Amlodipine is unlikely to please the manufacturers of this medication. In contrast to the assessments of doctors, who are distinguished by restraint, the opinions of patients were divided into diametrically opposed ones.

1. Among those who took Amlodipine according to the instructions for use, there are practically no people who consider the medication to fully comply with the information contained in the instructions. For example, they write that Amlodipine is not indicated for use during a hypertensive crisis, but patients noticed that this medicine very quickly, and most importantly, significantly reduces blood pressure.
2. There are no reviews about the compatibility of Amlodipine and alcohol, which indicates the literacy of patients taking antihypertensive drugs. There can be no talk of any such combination.
3. A small proportion of patients named Amlodipine as an integral part of their daily medication list. They use these pills as prescribed by a doctor after individually selecting the dose of amlodipine. Reviews from patients who took the drug according to an individually selected regimen are usually positive.
4. Most of the patients who have tried this BMCC on themselves are dissatisfied with the severity of the side effects. The most common are: fatigue, severe general malaise, problems with the eyes and joints. Some patients call this medication a “terrible drug.”
5. Negative reviews are also caused by such side effects as itchy skin and rashes. After such undesirable manifestations, patients switched to the drug amlodipine under trade name Norvasc, which is much better tolerated by them.

By the way, doctors write about the same thing. They point out the questionable quality of the medicine, which is 100 times cheaper than the original.

What is the difference and which is better for reducing blood pressure?

What drug should hypertensive patients choose? Most right choice Your doctor will help you do this. But if in this case it turns out that the medication is not suitable for you, what can you replace Amlodipine with? There are several dozen options for replacing and analogues of Amlodipine.

Korean-made white or pinkish Amzaar tablets are a combination of two active ingredients - amlodipine and losartan, respectively BMCC and an angiotensin II inhibitor.

This is a significant difference between the medication and the one under consideration, since complex treatment is traditionally considered more effective. The medicine belongs to the latest quality antihypertensive drugs, which is eloquently evidenced by its high price, but is not a direct analogue of Amlodipine.

White or cream-colored oblong tablets Amlodipine-Prana are produced in the Russian Federation and are a direct substitute for Amlodipine, containing only this active substance in their composition. This is one of the cheapest options for Amlodipine that can replace the original drug.

Easily recognizable by their appearance, white round Amlodipine-Teva tablets are produced by the Hungarian branches of the Israeli pharmaceutical enterprises Teva. You can recognize them by the engraving on one of the sides - “AB 5” (or 10, depending on the dosage of the active ingredient in the pill). This is a direct substitute for the medicine in question.

The Russian drug Amlorus is also a structural substitute for Amlodipine. It is a white, flattened, cylindrical tablet. Amlorus is available in three dosages: 2.5 mg, 5 mg and 10, which is convenient for patients with disorders liver function, for whom small doses are indicated, especially at the initial stage of therapy.

Similar to Amlorus and other Russian pills from Amlotop. They are available in dosages of 5 and 10 mg and look like flattened cylindrical pills with a score in the middle. The excipients also contain lactose, as the instructions for use warn about. They are a direct analogue of Amlodipine.

Another Russian drug, produced in dosages of 5 and 10 mg, is Aprovask. These are whitish cylindrical pills, flattened and divided by a groove in the middle. The composition contains milk sugar and other auxiliary components, which are not much different from the ingredients of similar medications.

The Russian combination medicine Vamloset is interesting for its composition. It contains amlodipine (a calcium channel blocker) and valsartan (an angiotensin II enzyme blocker) and is available in five dosages:

• 5 + 80 mg (round yellowish-brown pills);
• 5 + 160 mg (oval brown-yellow);
• 5 + 320 mg (orange-brown capsules);
• 10 + 160 mg (oval brown-yellow);
• 10 + 320 mg (brown-yellow capsules).

Dosage variability facilitates more careful individual selection of doses for the treatment of arterial hypertension. This disease is indicated in the instructions for use as the only indication for the use of Vamloset.

A feature of Russian Vero-Amlodipine tablets is the absence of lactose in the auxiliary components, so patients with intolerance to this carbohydrate can be treated with this medication. In all other respects, the drug is similar to the original one.

The active ingredients of Russian-made Dalneva tablets are amlodipine and perindopril (). Available in dosages:

• 5 + 4 mg - round whitish tablets;
• 10 + 4 mg - white or whitish convex capsule-type tablets with a score on one side;
• 5 + 8 mg - white tablets, convex on both sides;
• 10 + 8 mg - whitish tablets with a score on one side.

This combination product does not contain lactose.

A structural analogue of Amlodipine made in India, Kalchek, also does not contain lactose as excipients. This means that it can be safely used in the treatment of patients intolerant of this carbohydrate. Kalchek tablets are round in shape and white in color.

The Hungarian structural analogue of Amlodipine is flat white or yellowish flattened round-shaped tablets Cardilopin. They are available in three dosage options, as evidenced by the engraving on the surface of the tablets:

• 2.5 mg - embossed “251”;
• 5 mg - “252” engraved;
• 10 mg - number “253”.

On the side opposite the numbers on tablets with any dosage, an “E” is engraved.

Ko-Dalneva’s drug is also intended for the treatment of arterial hypertension. No other indications are indicated in the instructions for use of the drug. This is a combined antihypertensive drug consisting of the BMCC amlodipine, the diuretic indapamide and the ACE inhibitor perindopril erbumine. Available in several dosages and does not contain lactose.

Another combination drug produced by the Swiss company Novartis is also available in a polyvariant dosage of three active ingredients: amlodipine, valsartan () and hydrochlorothiazide (diuretic). In the instructions for use, the only indication for use is arterial hypertension; there is no lactose in the composition.

The active ingredients of the Russian drug Lortenza are amlodipine and the angiotensin II receptor antagonist losartan. The tablets are available in several dosage options and have the form of oval pills ranging from white and light yellow to reddish-brown.

When patients ask which is better, Amlodipine or Norvasc, there is only one answer - Norvasc is the original drug with the active ingredient amlodipine. It is produced in Germany and its quality and effectiveness are beyond doubt.

However, the price of this drug is quite high, so not all patients can afford prolonged therapy with this drug.

White, oblong-round tablets of Normodipine contain one active ingredient and are marked with “5” or “10” embossed, depending on the dosage. If you compare Normodipine and Amlodipine, what is the difference, there are not too many differences. One of the few is the absence of lactose in the auxiliary ingredients.

White Prestance tablets have different geometric shapes(including triangular and square) and engraving indicating the dose (4 options in total) of the active ingredients - amlodipine and perindopril - on one surface. The opposite side is occupied by the manufacturer's logo.

According to the instructions for use, amlodipine and telmisartan (angiotensin II receptor antagonist) are the main components of the German drug Twynsta. These are oval tablets, two-layer (white and blue-gray), not coated, smooth on one side and marked “A1” - “A4” on the other. Intended for the treatment of hypertension.

Russian branches of the Slovenian company KRKA produce drugs with the active ingredient amlodipine maleate in dosages of 5 and 10 mg. These are white, round pills with a score line on one side. Indications for use according to the instructions are similar to Amlodipine.

The Indian pharmaceutical industry drug Tenochek contains 2 main ingredients - BMCC and atenolol. These are flat, round pills with a dividing groove on one side. Application: therapy of hypertension and prevention of angina attacks.

The multicomponent drug Triplixam is produced in the Russian Federation and Ireland using the technologies of the French company Servier Laboratories. The basis is amlodipine besilate, the diuretic indapamide and the ACE inhibitor perindopril arginine. Several dosage options. There is no lactose in the composition.

BMKK and ACEI ramipril are a successful combination of active ingredients in the drug Egipres. Available in the form of gelatin capsules from light pink to dark burgundy with a “filling” of white powder and granules. 5 dosage options, no lactose.

For the treatment of essential hypertension (primary hypertension of unknown origin), according to the instructions for use, Indian pills Eucacard are cylindrical in pink and white colors with a mark on one side. 2 dosage options. Contains lactose.

The Hungarian drug Equamer is the first (at the level of evidence-based medicine) poly-tablet with a fixed combination of BMCC, an ACEI (lisinopril) and a statin (rosuvastatin). The pills are available in the form of capsules from light pink to dark purple, in 4 dosage options. Expanded list of indications for use. Contains lactose.

Hungarian Equator tablets are a combined drug (BMCC and ACEI lisinopril) and are available in three dosage options. According to the instructions for use, they are intended for the treatment of essential hypertension. Appearance- whitish round pills with a groove on one side and the marking “A+L” on the opposite.

Exforge tablets complete our fascinating journey through analogues and substitutes of Amlodipine, indicated in the treatment of hypertension. Exforge, according to the instructions for use, contains 2 active ingredients: amlodipine and the angiotensin II antagonist valsartan, does not contain lactose. Available in three dosages in the form of round and oval pills of various shades of yellow, but on one of the flat surfaces of which “NVR” is engraved. Indications for use: hypertension.

What to replace if your legs swell?

During amlodipine therapy, it often turns out that the use of the drug causes swelling in the patient's lower extremities. Then you have to look for something to replace Amlodipine if your legs swell. Below are antihypertensive drugs of other pharmacological groups that can replace the drug, as well as analogues of Amlodipine that do not cause swelling of the lower extremities.

The medicine of the French company Sanofi Avenitis Group - Aprovel - belongs to the pharmaceutical group of angiotensin II enzyme antagonists with the active ingredient irbesartan. It is indicated for the treatment of hypertension and nephropathy in hypertension and diabetes mellitus. Contains lactose.

Lorista

Russian and Slovenian (KRKA companies) Lorista pills belong to combined antihypertensive drugs with 2 active ingredients - the angiotensin II inhibitor losartan and the diuretic hydrochlorothiazide. The auxiliary components contain lactose. Appearance: oval tablets in a gelatin shell, yellowish or greenish-yellow in color. You can replace Amlodipine with these pills, using green or yellow tablets according to the instructions for use if your legs swell from amlodipine. If we compare which is better for lowering blood pressure - Amlodipine or Lorista, then everything is individual, both drugs have both positive and negative reviews.

Lozap, a Slovak and Czech product, which is very popular among hypertensive patients, contains losartan as an active ingredient and belongs to the pharmaceutical group of angiotensin II antagonists. The oblong-convex white tablets do not contain lactose, are available in a dosage of 100 mg, and are divided by a groove in the middle for ease of breaking. When comparing which is better - Lozap or Amlodipine, many patients would probably say - Lozap, but Amlodipine also has its adherents, so it is better to compare based on practical experience.

Lozap Plus tablets from the same company are a combination drug where the active ingredient losartan (50 mg) is combined with the diuretic hydrochlorothiazide (12.5 mg).

These are yellowish, elongated tablets with a dividing groove on both sides; lactose is not present in their composition; the likelihood of developing edema during use is minimal.

The Russian drug directory lists the Turkish-made drug Telzap Plus. This is a combined antihypertensive drug with the angiotensin II antagonist telmisartan and the diuretic hydrochlorothiazide as a base. The instructions for use provide very little information about this medicine.

It is difficult to say which is better - Felodipine or Amlodipine. Both medications are calcium channel blockers, both are indicated for the treatment of hypertension and various types of angina. However, the instructions for use of Felodipine do not indicate such a side effect as edema, which means that it can be used as an analogue of Amlodipine, not swelling legs Although Felodipine is not its direct (structural) substitute.

If the question is: Amlodipine or Lisinopril, which is better, you should carefully study the patient’s medical history for a predisposition to allergic reactions to ACE inhibitors. The angiotensin-converting enzyme inhibitor lisinopril is the basis of this medication and can cause a cough reflex, angioedema and other allergic reactions. At the same time, swelling of the extremities is not included in the list of side effects in the instructions for use of Lisinopril. This means that if the ACEI is well tolerated, lisinopril can be used to replace Amlodipine.

The basis of the French drug Prestarium is the ACE inhibitor perindopril. For this active ingredient, almost all the instructions and warnings set out in the instructions for use for any ACEI are relevant. The list of indications includes hypertension, chronic failure hearts, different types. What is better - Amlodipine or Prestarium? Neither in terms of the active substance, nor even in the pharmacological group, it is not an analogue of Amlodipine, but if necessary (if the legs swell), Prestarium can replace it in antihypertensive therapy.

Another representative of ACE inhibitors is Enalapril with the active ingredient of the same name.

This active ingredient is present in more than 30 trade names of medications of this pharmacological group, therefore it is very popular among hypertensive patients. But if you compare which is better - Amlodipine or Enalapril, you will have to consider all the possible consequences for the patient from using both. In some, amlodipine causes swelling of the legs, in others, Enalapril leads to angioedema or painful cough. So the drug of choice is a purely individual matter.

Lerkamen

Pharmacological enterprises in Germany and the Russian Federation produce round yellow tablets Lerkamen. The basis of this drug is lercanidipine, a selective BMCC with a predominant effect on blood vessels. The medication, according to the instructions for use, is indicated for the treatment of essential hypertension. Contains lactose and is accompanied by a significant list of side effects, including peripheral edema. Therefore, it is not easy for a doctor to answer the question of which is better - Amlodipine or Lerkamen. It is easier to suggest that the patient be treated first with one and then with another medication in order to have good grounds for comparison.

Bisoprolol tablets are produced by both Russian and European manufacturers. The drug belongs to the pharmaceutical group of beta-blockers, it is based on bisoprolol hemifumarate, the drug is indicated for the treatment of hypertension and coronary artery disease. To compare Amlodipine or Bisoprolol, which is better, you will have to try the effects of both drugs on yourself, since even the most praised medication may turn out to be unsuitable for a particular organism. Judging by the instructions for use, the lists of side effects for both of them are impressive in their volume.

Analogues with fewer side effects

Is it really impossible to find an analogue of Amlodipine with fewer side effects without conducting experiments on your own health? Yes, it's not that simple. Although you can resort to little trick and start your search from the most expensive analogues Amlodipine, produced in Israel, Germany, Hungary, Switzerland. Pharmacological enterprises in these countries have long established themselves as producers of high-quality products that are well tolerated by patients. As a rule, the high price of such medications is justified by the minimum of side effects, so there is something to think about.

Useful video

From the following video you can learn useful information about hypertension:

Conclusion

1. The instructions for use of Amlodipine call this drug a calcium channel blocker and recommend its use for the treatment of hypertension and various forms of angina.
2. The excipients of this medicine contain lactose, which is an obstacle to use in hypertensive patients with intolerance to this disaccharide.
3. According to the instructions for use, Amlodipine tablets can be taken at any time convenient for the patient, regardless of meals and taking into account the diuretic effect of the drug.
4. Amlodipine tablets are available in several dosages, which allows you to select the most optimal therapeutic dose for each patient individually.

22.10.2018

Blood pressure medicine Amlodipinebelongs to the group of calcium (Ca) channel blockers.

Calcium ions participate in the bioenergetic processes of human body cells, but an excess of ions speeds up cellular metabolism, and therefore the need for oxygen increases.

Due to the activity of cells, a number of negative changes are triggered. Amlodipine prevents calcium ions from entering the cell, maintaining the balance of biochemical processes inside and outside the cells.

Among the advantages of Amlodipine, the ability to dilate blood vessels leading to the heart and in the periphery is noted, which allows reduce load on the heart. The heart muscle needs less oxygen, and vascular resistance decreases. These effects of the drug are important for patients with angina and coronary artery disease.

The next advantage of the medicine that cardiologists rely on is the possibility of persistent reduction pressure, even a single dose of a tablet allows you to smoothly reduce high blood pressure for a day. The duration of action is due to the ability to dilate blood vessels and achieve relaxation of smooth muscles.

Amlodipine is one of the drugs , which reduces high blood pressure, against the background of ischemia, gives an anti-sclerotic effect, protects the heart muscle. The active substance will not increase the heart rate and will not allow platelets to form.

The medicine does not cause adverse reactions to metabolism, plasma lipids, and can be taken by diabetics.

When is Amlodipine prescribed?

Indications for use tablets Amlodipine may be prescribed by a doctor, and a cardiologist or therapist may prescribe the drug when the following conditions are identified:

• hypertension. Appointedat high pressurea separate medicine or complex therapy with diuretics, ACE inhibitors, beta blockers;
• stable angina;
• silent ischemia;
• ischemia due to heart failure;
• dilated cardiomyopathy due to heart failure.

Dosage of the drug and methods of administration

Pills taken orally, without chewing, with water. Considering that food does not affect the rate of absorption of the drug, it can be taken before or after meals. The active substance is absorbed for about 2 hours or more, therefore,reduces blood pressureit is approximately after this period of time. The medicine is taken once a day, preferably in the morning, while monitoring your own well-being.

Patients with hypertension are prescribed to reduce increased pressure 1 tablet (5 mg) once a day. If after a week of taking this regimen it is not possible to achieve a stable decrease in tonometer readings to the desired limits, provided that the drug is well tolerated, the dose raise up to 10 mg per day. This regimen is followed exactly as long as necessary to reduce and stabilize blood pressure.

If blood pressure remains stable within the normal range and does not fluctuate during the day, the doctor will prescribe maintenance therapy with the drug at a dosage of 2.5 - 5 mg once a day. Initially, after taking 10 mg, switch to 5 mg and monitor the condition for a week, then to 2.5 mg and periodically measure the pressure. If the condition is stable, Amlodipine is taken for a long time (years) in a maintenance dosage (2.5 mg). Against the background of hypertension, the pressure begins to jump, this amount of the active substance is not enough, you should consult a doctor. The doctor adjusts the dosage, prescribing 5 mg per day, the course is long.

Patients with arterial hypertension accept pills Amlodipine without breaks, only a doctor can stop taking the medicine if it does not have an effect or it is necessary to undergo a course of therapy with other tablets. In other cases, it is impossible to stop taking the drug, since the effect will be unstable.

Patients with angina pectoris are prescribed to prevent attacks. pills Amlodipine 5 mg per day for 2-3 weeks. This not only normalizes blood pressure, but also improves exercise tolerance. After 2-3 weeks, if the drug is well tolerated, the dose is increased to 10 mg, the course lasts for several more months as prescribed by the doctor.

The goal of this therapy is to prevent attacks.

People with dilated cardiomyopathy due to heart failure are prescribed pills Amlodipine 5 mg per day for 1-3 weeks. If no side effects occur, then take 10 mg per day for several months. If 10 mg of the drug gives adverse reactions, you need to return to taking 5 mg and continue therapy for several months.

Against the background of cardiac ischemia, Amlodipine is started at 2.5 - 5 mg per day. If the dosage is sufficient for a stable condition, then the started therapy is continued for several months. If the effect is felt, but not sufficient, then take 10 g of Amlodipine for several months.

Directions for taking the drug

The daily dose is taken once. If the patient has liver pathologies, treatment begins with 2.5 mg, and maximum dosage for the patient will be 5 mg per day.

On the background combination therapy with Amlodipine, there is no need to reduce the dosage of ACE inhibitors, diuretics and beta blockers. Usually the drug is well tolerated, so even with kidney pathologies and over the age of 65 years, Amlodipine can be safely used without reducing the dosage.

The duration of the course should be determined by the doctor, taking into account the results of the analysis and the effectiveness of the medicine. The patient will be offered functional tests, and a referral for tests and hardware diagnostics will be issued. This will allow you to assess the current picture and determine a further treatment plan. For cardiac pathologies, the drug is taken for several months until the condition stabilizes. For hypertension Amlodipine reducespressure and maintains the condition for several years (possibly for life).

Instructions for use and at what pressure indicates the advisability of taking it, describes in detail the composition, adverse reactions, interactions, etc. But it is not necessary to understand the complex terms found in the description - everything that the patient needs to know from the instructions will be told to him by the doctor who prescribed the medicine.

Patients with angina pectoris should stop taking it slowly as treatment ends, so as not to cause a sudden change in condition from sudden cessation of use. Amlodipine is not suitable for relieving an attack of angina or an attack of hypertension, as is the case in therapy after a heart attack in the first few days.

Women of childbearing age should strictly monitor contraception; the drug should not be taken during pregnancy. If the patient's body weight is less than 40 kg, then the dosage will be 2.% mg initially, then 5 mg per day as maintenance therapy.

Amlodipine during pregnancy and breastfeeding

Taking Amlodipine has a negative effect on the fetus in the womb. There are no clinical data on the use of the drug in pregnant women; it is unknown exactly how the medicine affects the child. Admission is theoretically possible, but the potential risk is difficult to establish. In such situations, the advisability of prescribing a medication is seriously assessed if its benefits are much more important than the harm it can cause.

The same can be said about breastfeeding - is Amlodipine able to pass into breast milk. There is only information that other medications included in the group of Ca-channel blockers can pass into the milk of a nursing mother. We are talking about medications: Nimodipine, Nifedipine, Isradipine.

Therefore, if the doctor considers it necessary to prescribe Amlodipine to a nursing mother, the child must be switched to artificial formulas, fortunately, they are available in different price categories and types.

Concentrating on the background of tablets

At the very beginning of treatment while taking Amlodipine, the patient may feel dizzy and drowsy.

This is important to know for people whose activities involve driving vehicles, operating machines, and other activities that require the ability to concentrate, focus, and keep complex processes under control.

If the drug is well tolerated, you can operate machinery with caution.

Overdose

If the medicine is taken excessively by mistake, the following symptoms may occur:

• serious drop in pressure;
• strong heartbeat, increasing as pressure drops;
• expansion of small peripheral vessels against the background of a persistent decrease in pressure with the risk of transition to shock and death.

To eliminate the consequences of an overdose, you need to do a gastric lavage with a weak solution of potassium permanganate. It’s good if you can do this within 2 hours of the incident. After washing for an hour, you need to take one of the sorbents - Activated carbon, Polysorb, Polyphepan, Enterosgel.

Then you can move on to symptomatic treatment that can restore the normal functioning of systems and organs. Helps normalize vascular tone intravenous administration Dopamine, and calcium gluconate is administered to maintain heart function.

Interaction of Amlodipine with other drugs

According to the instructions and recommendations of specialists, when Amlodipine is used together with Ca-channel blockers, the pressure-lowering effect of the former is enhanced. The same can be said about the combination of Orlistat and inhalation anesthesia. These combinations cannot be called safe; they can cause a hypertensive crisis.

If you take estrogens or sympathomimetics while taking amlodipine, sodium is retained in the body, and blood pressure does not decrease so well. Concomitant use of Amlodipine with lithium carbonate causes tinnitus, vomiting, diarrhea, and ataxia.

Contraindications

According to research data and many years of experience in taking the medicine, we can talk about contraindications:

• collapse;
• a serious form of hypotension when the blood pressure monitor shows less than 90 mmHg;
• unstable angina;
• cardiogenic shock;
• pregnancy;
• aortic stenosis in severe form;
• minor age;
• lactation;
• lactose intolerance and drug components.

The drug is prescribed with caution to patients with severe bradycardia, liver problems, tachycardia, heart failure in chronic form. It is not recommended to prescribe the medicine for mitral, aortic stenosis, acute infarction, cardiomyopathy. In some cases, doctors choose an analogue of Amlodipine.

Adverse reactions while taking Amlodipine

Like other drugs, Amlodipine can cause side effects. Common ones include:

• While taking the drug, shortness of breath, rapid heartbeat, a significant decrease in blood pressure, and even fainting are possible. Sometimes blood rushes to the face and swelling is observed. Migraines, chest pain, and heart rhythm disturbances rarely occur;
• Among the adverse reactions of the nervous system, headache, drowsiness, excessive fatigue, and dizziness are most often detected. Rarely, anxiety, depression, sleep problems, fainting and tremors occur;
• to take the drug digestive system may react with nausea, including vomiting, and pain in the gastrointestinal tract. Sometimes dry mouth, problems with bowel movements, and bloating are detected;
• the genitourinary system may react to the drug with pain when urinating, decreased libido;
• Skin reactions may include dermatitis, alopecia, and xeroderma. Your skin tone may change slightly. Rashes, skin itching, angioedema are possible;
• While taking Amlodipine, manifestations of arthrosis, arthralgia, and myalgia are possible.

Rare adverse reactions include leukopenia, fluctuations in the patient's weight in any direction, and gynecomastia. There is deterioration in visual function, eye pain and conjunctivitis.There have been cases where the drug has caused nosebleeds, ringing in the ears and excessive sweating.

Possible cough, rhinitis, change taste sensations. If adverse reactions do not go away and cause serious discomfort, the doctor will select an analogue of the drug.