Levamlodipine

Brand Emcure Pharmaceuticals Ltd

In stock 1435 Items

Available since: 2019-09-19

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Clinical Pharmacology

Escordi Cor is a slow calcium channel blocker derived from dihydropyridine. It has antianginal and hypotensive effects. By binding to the dihydropyridine receptors S (-), amlodipine is more potent than the R (+) isomer, blocks calcium channels, reduces the transmembrane transition of calcium ions into the cell (more in vascular smooth muscle cells than cardiomyocytes).

Escordi Cor has a long dose-dependent hypotensive effect. Hypotensive effect due to direct vasodilating effect on vascular smooth muscle. In case of arterial hypertension, a single dose provides a clinically significant reduction in blood pressure for 24 hours (in the position of the patient lying and standing). The onset of the effect is 2-4 hours, the duration of the effect is 24 hours.

Indications

Hypertension I (mild) severity (in combination with other antihypertensive agents or as monotherapy).

Composition

1 tab. contains amlodipine (in the form of besylate) 5 mg.

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Dosage and Administration

The recommended starting dose of Escordi Cora is 2.5 mg 1 time per day. With insufficient therapeutic effect, the dose can be increased to 5 mg 1 time / day.

Adverse reactions

Since the cardiovascular system: palpitations, shortness of breath, marked reduction in blood pressure, fainting, vasculitis, edema (swelling of the ankles and feet), "flushing" of blood to the face, rarely - rhythm disturbance (bradycardia, ventricular tachycardia, atrial fibrillation), pain in chest, orthostatic hypotension, very rarely - development or aggravation of heart failure, migraine.

From the side of the central nervous system: dizziness, headache, fatigue, drowsiness, change of mood; rarely - convulsions, loss of consciousness, hyperesthesia, nervousness, parasthesia, tremor, vertigo, asthenia, malaise, insomnia, depression, extraordinary dreams, very rarely - ataxia, apathy, agitation, amnesia.

On the part of the digestive system: nausea, vomiting, epigastric pain; rarely, increased levels of liver enzymes and jaundice (caused by cholestasis), pancreatitis, dry mouth, flatulence, gingival hyperplasia, constipation or diarrhea, very rarely, gastritis, increased appetite, and disturbed taste.

On the part of the urogenital system: rarely - pollakiuria, painful urge to urinate, nocturia, reduced potency; very rarely - dysuria, polyuria.

For the skin: very rarely - xerodermia, alopecia, dermatitis, purpura, discoloration of the skin.

Allergic reactions: pruritus, rash (including erythematous, maculopapular rash, urticaria), angioedema.

On the part of the musculoskeletal system: rarely - arthralgia, arthrosis, myalgia (with prolonged use); very rarely - myasthenia.

Other: rarely - gynecomastia, polyurikemia, increase / decrease in body weight, thrombocytopenia, leukopenia, hyperglycemia, blurred vision, conjunctivitis, diplopia, eye pain, tinnitus, back pain, dyspnea, nasal bleeding, increased sweating, thirst; very rarely - cold sticky sweat, cough, rhinitis, parosmia, accommodation disturbance, xerophthalmia.

Contraindications

- Prinzmetal angina pectoris;
- severe hypotension;
- collapse;
- cardiogenic shock;
- pregnancy;
- lactation period (breastfeeding);
- children's and teenage age till 18 years (efficiency and safety are not established);
- Hypersensitivity to S (-) amlodipine and other dihydropyridine derivatives.

Drug interactions

Inhibitors of microsomal oxidation increase the concentration of amlodipine in the blood plasma, increasing the risk of side effects, and inducers of microsomal liver enzymes - reduce. The hypotensive effect is weakened by alpha-adrenergic stimulators, estrogens (sodium retention), and sympathomimetics. Thiazide and "loopback" diuretics, beta-blockers, verapamil, ACE inhibitors and nitrates enhance the antianginal and hypotensive effects. Amiodarone, quinidine, alpha1-blockers, antipsychotics (antipsychotics) and slow calcium channel blockers may enhance the hypotensive effect. No effect on the pharmacokinetic parameters of digoxin and warfarin. Cimetidine does not affect the pharmacokinetics of amlodipine. When combined with the use of lithium drugs may increase the appearance of their neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus). Calcium preparations can reduce the effect of slow calcium channel blockers. Procainamide, quinidine, and other drugs that prolong the QT interval increase the negative inotropic effect and may increase the risk of significant prolongation of the QT interval. Grapefruit juice can reduce the concentration of amlodipine in the blood plasma, but this decrease is so small that it does not significantly change the effect of amlodipine.

Special instructions

During the period of treatment with Escordi Cor, control of body weight and sodium intake is necessary, the appointment of an appropriate diet. It is necessary to maintain dental hygiene and frequent visits to the dentist (prevention of soreness, bleeding and gum overgrowth).
In elderly patients, the T1 / 2 and clearance of the drug may be lengthened. The dosing regimen for the elderly is the same as for patients of other age groups. At increase in a dose careful supervision over elderly patients is necessary.
Despite the fact that blockers of slow calcium channels do not have withdrawal syndrome, gradual reduction of doses is recommended before discontinuation of treatment.
Influence on ability to drive motor transport and control mechanisms
In some patients, predominantly at the beginning of treatment, drowsiness and dizziness may occur. When they occur, special precautions should be taken when driving and working with machinery.

Overdosage

Symptoms: marked decrease in blood pressure, tachycardia, excessive peripheral vasodilation.
Treatment: gastric lavage, the appointment of Activated charcoal, maintaining the function of the cardiovascular system, monitoring the performance of the heart and lungs, the elevated position of the limbs, control of the BCC and diuresis. To restore vascular tone - the use of vasoconstrictor agents (in the absence of contraindications to their use). To eliminate the effects of calcium channel blockade - IV the introduction of calcium gluconate. Hemodialysis is not effective.