Amlodipine, Atenolol
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Clinical Pharmacology
Tenochek has an antihypertensive effect.
Indications
Arterial hypertension.
Composition
1 tab. contains atenolol 50 mg; Amlodipine 5 mg.
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Dosage and Administration
Tenochek is taken orally with a necessary amount of liquid. In hypertension and angina, the dose is 1 tablet per day. If necessary, the daily dose can be increased to 2 pills per day. The maximum daily dose of 2 pills.
Adverse reactions
Hyperuricaemia, hypokalaemia, impaired glucose tolerance, bradycardia, heart block, orthostatic hypotension, heart failure, cold extremities, intermittent claudication, Raynaud's syndrome, confusion, mood changes, hallucinations, insomnia, nightmares, dry eyes, dyspeptic disorders and visual disturbances , leukopenia, thrombocytopenia, purpura, alopecia, psoriasis, paresthesia, bronchospasm
Contraindications
Hypersensitivity, AV blockade II-III century; CHF (resistant to treatment with cardiac glycosides); bradycardia; cardiogenic shock; hepatic and / or renal failure; bronchial asthma; pregnancy, lactation, child age.
With caution.AV block I Art., Chronic bronchitis, pulmonary emphysema, gout, arterial obliterans, disorders of water and electrolyte balance.
Drug interactions
When applied simultaneously with insulin (or oral hypoglycemic agents), the symptoms of hypoglycemia are masked (due to the action of atenolol).
When combined with Tenochek antihypertensive drugs of other groups, there is a mutual strengthening of the hypotensive effect.
The antihypertensive effect of the drug weakens estrogens, GCS, mineralocorticoids, NSAIDs (due to sodium retention).
With simultaneous use of atenolol and cardiac glycosides increases the risk of developing bradycardia and impaired AV conduction.
With the simultaneous appointment of atenolol with reserpine, methyldopa, clonidine, verapamil, the occurrence of severe bradycardia is possible.
When taken concomitantly with ergotamine and xanthine derivatives, the effectiveness of atenolol decreases.
Simultaneous use with lidocaine can slow the elimination of atenolol and amlodipine from the body and increase the risk of a toxic effect of the drug.
The use together with phenothiazine derivatives promotes an increase in the concentration of active substances in the blood serum.
Phenytoin (with a / in the introduction) and means for / in anesthesia increase the severity of the cardiodepressive action of atenolol.
Allergens used for immunotherapy or allergen extracts for skin tests and iodine radiopaque substances for IV administration increase the risk of severe systemic allergic reactions or anaphylaxis.
Means for general inhalation anesthesia (hydrocarbon derivatives) increase the risk of inhibition of myocardial function and a pronounced decrease in blood pressure.
When combined, amiodarone increases the risk of bradycardia and slowing AV conduction.
Cimetidine increases the concentration of atenolol in the blood plasma (by inhibiting its metabolism).
When combined, Tenoch prolongs the action of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.
Special instructions
With thyrotoxicosis, the drug may mask certain clinical signs of hyperthyroidism (for example, tachycardia). Abrupt cancellation of Tenochek in patients with thyrotoxicosis is contraindicated, as it can enhance the symptoms.
The drug slightly increases the insulin-induced hypoglycemia and does not delay the restoration of glucose concentration in the blood to normal levels.
Selection of the dose in patients with chronic heart failure (compensated) should be carried out with caution.
If surgery is necessary under general anesthesia, the drug should be discontinued 48 hours before the surgery.As an anesthetic one should choose a drug with a possible minimal negative inotropic effect.
With simultaneous use with clonidine, Tenochek's administration is stopped for several days before clonidine in order to avoid the latter's withdrawal syndrome.
Perhaps the increased severity of allergic reactions and the lack of effect of the usual doses of epinephrine in patients with burdened allergic history.
Drugs that reduce the supply of catecholamines (for example, reserpine) can enhance the effect of beta-blockers, so patients receiving this combination of drugs should be kept under constant observation to detect a pronounced decrease in blood pressure or bradycardia.
In the case of elderly patients with severe bradycardia (heart rate less than 50 / min), a significant reduction in blood pressure (systolic blood pressure below 100 mm Hg), AV blockade, bronchospasm, ventricular arrhythmias, and severe liver function impairment, and or cancel Tenochek.
With the development of depression on the background of the drug is recommended to stop therapy.
If necessary, on / in the introduction of verapamil, this introduction should be done no less than 48 hours after the last dose of Tenochek.
With the use of atenolol, it is possible to reduce the production of tear fluid, which is important for patients using contact lenses.
It is necessary to discontinue the drug before the study of the concentration in the blood and urine of catecholamines, vanillyl almond acid; antinuclear antibody titers.
In smokers, the effectiveness of beta-blockers below.
Control of laboratory parameters
It is necessary to control heart rate and blood pressure (at the beginning of treatment - daily, then once every 3-4 months), blood glucose concentration in patients with diabetes mellitus (1 time every 4-5 months). In the elderly, it is recommended to evaluate the function of the kidneys (1 time in 4-5 months).
The patient should be trained in the method of counting heart rate and instructed on the need for medical consultation with a heart rate less than 50 beats. / min
Influence on ability to drive motor transport and control mechanisms
Tenochek should be prescribed with caution to patients engaged in potentially hazardous activities, because of the possible reduction in concentration.
Overdosage
Symptoms: severe bradycardia, AV block II and III degree, increase in symptoms of heart failure, marked reduction in blood pressure, bronchospasm, hypoglycemia.
Treatment: symptomatic. Hemodialysis is not effective.
- Brand name: Tenochek
- Active ingredient: Amlodipine, Atenolol
- Dosage form: pills, coated.
- Manufacturer: Ipka
- Country of Origin: India
Studies and clinical trials of Amlodipine, Atenolol (Click to expand)
- Simultaneous determination of atenolol and amlodipine in tablets by high-performance thin-layer chromatography
- Synergism of atenolol and amlodipine on lowering and stabilizing blood pressure in spontaneously hypertensive rats
- Pharmacokinetics and safety of olmesartan medoxomil in combination with either amlodipine or atenolol compared to respective monotherapies in healthy subjects
- Synergistic effects of atenolol and amlodipine for lowering and stabilizing blood pressure in 2K1C renovascular hypertensive rats
- Effects of combination therapy with atenolol and amlodipine on blood pressure control and stroke prevention in stroke-prone spontaneously hypertensive rats
- Comparative effects of atenolol-based and amlodipine-based antihypertensive therapy on QT dispersion in hypertensive subjects
- Differential response to amlodipine and atenolol mono-therapy for hypertension by ethnic group
- Acute Hemodynamic Effects of Amlodipine 15 Days After a Myocardial Infarction in Normotensive Patients Treated with Atenolol
- Monotherapy with amlodipine or atenolol versus their combination in stable angina pectoris
- Amlodipine versus atenolol in essential hypertension
- Effects of ranolazine with atenolol, amlodipine or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized, controlled trial
- Value of the Addition of Amlodipine to Atenolol in Patients With Angina Pectoris Despite Adequate Beta Blockade
- Amlodipine Versus Diltiazem as Additional Antianginal Treatment to Atenolol
- Comparison of controlled-onset, extended-release verapamil with amlodipine and amlodipine plus atenolol on exercise performance and ambulatory ischemia in patients with chronic stable angina pectoris
- Atenolol versus amlodipine versus isosorbide-5-mononitrate on anginal symptoms in syndrome X
- The combination of atenolol and amlodipine is better than their monotherapy for preventing end-organ damage in different types of hypertension in rats
- G33 - Sexual activity in hypertensive males treated with amlodipine or atenolol: A cross-over study
- Trial finds ranolazine increases exercise tolerance in people with severe angina receiving atenolol, amlodipine or diltiazem
- Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial
- Effect of amlodipine compared to atenolol on small arteries of previously untreated essential hypertensive patients
- Haemodynamic comparison of amlodipine and atenolol in essential hypertension using the quantascope
- Simultaneous Determination of Atenolol-Amlodipine and Haloperidol–Trihexyphenidyl in Combined Tablet Preparations by Derivative Spectroscopy
- Comparison of the effects on central blood pressure of a combination of atorvastatin with amlodipine-based or atenolol-based antihypertensive therapy: An ascot-lla substudy
- Effect of amlodipine, atenolol and their combination on myocardial ischemia during treadmill exercise and ambulatory monitoring