Amlodipine, Atenolol

Brand Ipka

In stock 547 Items

Available since: 2019-09-19

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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.