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Drugs 2010Amlodipine/atorvastatin (Caduet) is a single-tablet, fixed-dose combination of the dihydropyridine calcium channel antagonist amlodipine and the HMG-CoA reductase... (Comparative Study)
Comparative Study Review
Amlodipine/atorvastatin (Caduet) is a single-tablet, fixed-dose combination of the dihydropyridine calcium channel antagonist amlodipine and the HMG-CoA reductase inhibitor atorvastatin. The bioavailability of amlodipine and atorvastatin with a single-tablet, fixed-dose amlodipine/atorvastatin combination was not significantly different to that with coadministered separate amlodipine and atorvastatin tablets. In well controlled clinical trials in patients with hypertension and dyslipidaemia, once-daily amlodipine and atorvastatin (administered as the single-tablet, fixed-dose combination or coadministered as two separate tablets) effectively reduced systolic BP (SBP) and low-density lipoprotein cholesterol (LDL-C) levels, and enabled more patients to achieve BP and LDL-C goals than single-agent or placebo therapy. There was no modification of the effect of amlodipine on SBP when administered in combination with atorvastatin and there was no modification of the effect of atorvastatin on LDL-C when administered in combination with amlodipine. In noncomparative, titration-to-goal, open-label 'real-world' trials, the single-tablet, fixed-dose combination of amlodipine/atorvastatin enabled patients with hypertension and dyslipidaemia to achieve both BP and LDL-C goals. Administration of a single tablet of amlodipine/atorvastatin, compared with coadministration of these agents as two separate tablets, improved patient adherence, according to a retrospective study that utilized prescription refill rates from a large US insurance database. Data from the large, randomized, double-blind, placebo-controlled ASCOT-LLA trial also demonstrated that the combination of amlodipine-based therapy and atorvastatin was effective in preventing cardiovascular (CV) endpoints in hypertensive patients at risk of CV disease (CVD). In summary, amlodipine/atorvastatin offers a convenient and effective approach to improving adherence and managing CV risk in hypertensive patients with dyslipidaemia or at risk of CVD.
Topics: Amlodipine; Anticholesteremic Agents; Antihypertensive Agents; Blood Pressure; Cardiovascular Diseases; Clinical Trials as Topic; Drug Combinations; Dyslipidemias; Heptanoic Acids; Humans; Hypertension; Lipoproteins, LDL; Patient Compliance; Pyrroles; Treatment Outcome
PubMed: 20108992
DOI: 10.2165/11204420-000000000-00000 -
The Annals of Pharmacotherapy Nov 2002To review the efficacy and safety data of amlodipine and the angiotensin-receptor blockers (ARBs), focusing on heart failure, angina, percutaneous coronary intervention... (Comparative Study)
Comparative Study Review
OBJECTIVE
To review the efficacy and safety data of amlodipine and the angiotensin-receptor blockers (ARBs), focusing on heart failure, angina, percutaneous coronary intervention (PCI), and renal protection.
DATA SOURCE
A MEDLINE search (1966-December 2001) was completed using amlodipine, angiotensin-receptor antagonist, losartan, valsartan, candesartan, and telmisartan as key words. English-language articles were identified and included.
STUDY SELECTION AND DATA EXTRACTION
All identified articles were evaluated. Articles representative of the subject matter of our review were included.
DATA SYNTHESIS
Amlodipine and the ARBs lower blood pressure to a similar extent. Amlodipine is an effective antianginal agent, whereas ARBs are not. However, amlodipine is not effective in the treatment of heart failure; ARBs may be useful in this setting. ARBs are also effective in preserving renal function and may provide some protection from restenosis in patients who have had a PCI. The ARBs may also be useful in preventing both diabetic and nondiabetic nephropathy.
CONCLUSIONS
Concomitant disease states should be considered when choosing between an ARB and amlodipine for the management of hypertension.
Topics: Amlodipine; Angina Pectoris; Angiotensin Receptor Antagonists; Antihypertensive Agents; Coronary Restenosis; Heart Failure; Humans; Randomized Controlled Trials as Topic
PubMed: 12398574
DOI: 10.1345/aph.1C102 -
Drugs Sep 1995Amlodipine belongs to the dihydropyridine class of calcium channel blockers. Both short and long term studies indicate that amlodipine effectively lowers mild to... (Review)
Review
Amlodipine belongs to the dihydropyridine class of calcium channel blockers. Both short and long term studies indicate that amlodipine effectively lowers mild to moderately elevated blood pressure and relieves symptoms of angina pectoris. In comparative studies, its antihypertensive efficacy is similar to that of other established agents such as beta-blockers, diuretics, ACE inhibitors and other calcium channel blockers (including the dihydropyridines); limited comparative data are, however, available in patients with angina pectoris. Amlodipine may offer potential in patients with congestive heart failure. Vasodilator adverse events such as oedema, headaches, and flushing are commonly observed with amlodipine. The drug does not appear to cause postural hypotension, reflex tachycardia or cardiac conduction disturbances. Comparative studies suggest that amlodipine is at least as well tolerated as other standard agents. Thus, amlodipine provides an attractive therapeutic option for the treatment of hypertension, and offers potential for patients with angina pectoris. Its beneficial effects in patients with congestive heart failure require confirmation in future studies.
Topics: Amlodipine; Angina Pectoris; Cardiovascular Diseases; Hemodynamics; Humans; Hypertension
PubMed: 8521773
DOI: 10.2165/00003495-199550030-00009 -
American Family Physician Mar 2006
Review
Topics: Amlodipine; Drug Combinations; Heart Diseases; Heptanoic Acids; Humans; Pyrroles; Treatment Outcome
PubMed: 16570743
DOI: No ID Found -
Journal of Cardiovascular Pharmacology 1991A previous article on the safety of amlodipine reviewed data from over 4,000 subjects who participated in clinical trials sponsored by Pfizer Central Research.... (Review)
Review
A previous article on the safety of amlodipine reviewed data from over 4,000 subjects who participated in clinical trials sponsored by Pfizer Central Research. Once-daily amlodipine was shown to be a well-tolerated treatment of hypertension and myocardial ischemia. Although amlodipine is a potent vasodilator, there was a low incidence of side effects such as headache, flushing, and dizziness. Amlodipine was not associated with adverse effects on hematologic or biochemical safety parameters nor on serum cholesterol or triglyceride levels. Amlodipine did not alter electrical conduction in the heart. Amlodipine had a favorable safety profile in comparative trials vs. beta-blockers. The data base of comparative trials vs. other calcium antagonists was small but the toleration of amlodipine was similar to that of verapamil and diltiazem. No data from comparative trials vs. another calcium antagonist of the dihydropyridine class have been available. This article reviews data from recently completed trials vs. nitrendipine and from trials in which amlodipine was used in combination with other agents. Amlodipine was better tolerated than nitrendipine and had a much lower incidence of side effects usually related to vasodilatation. This difference in side-effect profile was especially marked during the first days of treatment. Amlodipine was well tolerated when used in combination with beta-blockers, diuretics, ACE inhibitors, and nitrates. The gradual onset of action and relatively long half-life of amlodipine are the probable cause for the improved toleration in comparison with other dihydropyridines. Besides the low incidence of trivial side effects, increasing clinical experience with amlodipine provides no evidence that amlodipine is a cause of rare but serious adverse effects. It is concluded that amlodipine is an antihypertensive and anti-ischemic agent that has the combined advantages of a good safety profile with once-daily dosage and a smooth onset and long duration of action.
Topics: Amlodipine; Antihypertensive Agents; Calcium Channel Blockers; Drug Therapy, Combination; Humans; Hypertension; Randomized Controlled Trials as Topic
PubMed: 16296714
DOI: 10.1097/00005344-199117001-00020 -
Journal of Medical Toxicology :... Jun 2012Amlodipine is a dihydropyridine calcium channel blocker used in the treatment of hypertension and angina pectoris. Toxic effects reported from amlodipine include... (Review)
Review
INTRODUCTION
Amlodipine is a dihydropyridine calcium channel blocker used in the treatment of hypertension and angina pectoris. Toxic effects reported from amlodipine include hypotension, reflex tachycardia, metabolic acidosis, and pulmonary edema. We report a rare fatality in an infant after ingestion of amlodipine with benazepril, with postmortem blood concentrations.
CASE REPORT
An 11-month-old, 10.88-kg boy ingested 10 to 45 mg amlodipine with 40 to 180 mg benazepril. No action was taken initially because the parents believed only one or two capsules had been ingested. A later count revealed a maximum of nine capsules missing. The child was observed at home and vomited once with possible capsule fragments. Forty-five minutes post-ingestion, the child was noted to be suddenly unresponsive and was brought the local emergency department by a private vehicle. Upon arrival (90 min post-ingestion), the child was unresponsive with the following vital signs HR 133 bpm, BP 67/42 mmHg, respiratory rate 40/min, and temperature 97.5°F. Pertinent abnormal laboratory values were HCO(3) 13 mmol/l and glucose 302 mg/dl. The child was placed on oxygen via a non-rebreather mask and was intubated 45 min post-arrival. The patient became progressively bradycardic, and 55 min after arrival, the patient was in asystole with no palpable blood pressure. Resuscitation measures included chest compressions, epinephrine atropine, sodium bicarbonate, and calcium gluconate. Rescue insulin therapy was begun with 4 units IVP followed by 10 units per hour. Resuscitation efforts persisted for 1 h without success. An autopsy revealed pulmonary edema and no gross or microscopic evidence of natural disease. Stomach contents revealed food matter with small white fragments. Analysis of postmortem heart blood showed amlodipine 1,300 ng/ml (therapeutic <20 ng/ml). Benazepril levels were not available.
DISCUSSION
We believe this is the first reported fatality in an infant from amlodipine. While benazepril may have contributed, ACE inhibitors have not been previously associated with rapid cardiovascular collapse.
CONCLUSION
Small doses of amlodipine (0.9 to 4.1 mg/kg) may produce rapid and fatal cardiovascular collapse in an infant.
Topics: Amlodipine; Calcium Channel Blockers; Drug Overdose; Fatal Outcome; Humans; Infant; Male
PubMed: 22271567
DOI: 10.1007/s13181-011-0207-x -
The Journal of the Association of... Mar 2016Gingival overgrowth is a common feature of periodontal diseases. Rarely it occurs as an unwanted side effect of drugs such as anticonvulsants mainly phenytoin,...
Gingival overgrowth is a common feature of periodontal diseases. Rarely it occurs as an unwanted side effect of drugs such as anticonvulsants mainly phenytoin, immunosuppressants like cyclosporine and calcium channel blockers particularly nifedipine. Among calcium channel blockers, nifedipine causes gingival overgrowth in 10% of patients whereas amlodipine-induced gingival overgrowth is very limited. Here we report four cases in hypertensives on amlodipine.
Topics: Adult; Aged; Amlodipine; Antihypertensive Agents; Calcium Channel Blockers; Female; Gingival Overgrowth; Humans; Hypertension; Male; Middle Aged
PubMed: 27731568
DOI: No ID Found -
Drugs 2008Amlodipine, a dihydropyridine calcium channel blocker, and valsartan, an angiotensin II receptor blocker, are established antihypertensive agents. Fixed-dose... (Review)
Review
Amlodipine, a dihydropyridine calcium channel blocker, and valsartan, an angiotensin II receptor blocker, are established antihypertensive agents. Fixed-dose combinations of amlodipine/valsartan are available in several European countries and in the US. Individual dose titration with amlodipine and valsartan is generally recommended before changing to the fixed-dose combination. Amlodipine/valsartan, at approved dosage regimens, achieved significantly greater reductions in mean sitting diastolic and systolic blood pressure (BP) than amlodipine or valsartan monotherapy, or placebo in two randomized, double-blind, factorial trials in patients with mild to moderate hypertension. Approximately 80-90% of patients receiving approved dosages of amlodipine/valsartan achieved a response, defined as a mean sitting diastolic BP <90 mmHg or a >or= 10 mmHg reduction from baseline. Subgroup analyses of data from the two trials showed that the antihypertensive efficacy of amlodipine/valsartan in the elderly, Black patients and those with stage 2 hypertension was consistent with that observed in the overall study population. Marked reductions in BP were also observed in patients whose BP was previously uncontrolled on monotherapy (with various antihypertensives) who were switched (without washout) to amlodipine/valsartan in a phase IIIb-IV study. Amlodipine/valsartan was generally well tolerated in clinical trials. In particular, the incidence of peripheral oedema was significantly lower in patients receiving amlodipine/valsartan than in those treated with amlodipine monotherapy.
Topics: Amlodipine; Amlodipine, Valsartan Drug Combination; Angiotensin II Type 1 Receptor Blockers; Calcium Channel Blockers; Drug Combinations; Drug Synergism; Humans; Hypertension; Tetrazoles; Valine; Valsartan
PubMed: 18257612
DOI: 10.2165/00003495-200868030-00008 -
Expert Opinion on Drug Safety Sep 2011Despite the availability of a wide range of antihypertensive medications, in European countries the number of patients not reaching blood pressure control target varies... (Review)
Review
INTRODUCTION
Despite the availability of a wide range of antihypertensive medications, in European countries the number of patients not reaching blood pressure control target varies from 59.7% in England to 81.3% in Spain demonstrating substantial unmet need in the effective treatment of arterial hypertension.
AREAS COVERED
The authors conducted a review analyzing clinical efficacy and safety of amlodipine, both alone and in combination with other antihypertensive drugs, including the most important studies about amlodipine in the last 15 years. Readers will have a clearer idea of the use of amlodipine, its indications and contraindications, and they will know if amlodipine is a better or worse choice compared to the other antihypertensive drugs.
EXPERT OPINION
Amlodipine is not inferior to the other antihypertensive drugs in reducing hypertension and has additional biological effects that are not mediated through blood pressure reduction, including antioxidant activity, inhibition of smooth muscle cell proliferation and enhancement in endothelial NO production. Amlodipine, besides being effective on left ventricular hypertrophy, appears beneficial in slowing down the progression of carotid hypertrophy and atherosclerosis, and can be used in patients with angina pectoris, even if the first choice for angina treatment is β-blockers.
Topics: Amlodipine; Animals; Antihypertensive Agents; Clinical Trials as Topic; Drug Therapy, Combination; Humans; Randomized Controlled Trials as Topic
PubMed: 21591999
DOI: 10.1517/14740338.2011.585966 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: Study of the clinical and hemodynamic effects of S-amlodipine in patients with arterial hypertension associated with coronary artery disease, in individuals...
OBJECTIVE
The aim: Study of the clinical and hemodynamic effects of S-amlodipine in patients with arterial hypertension associated with coronary artery disease, in individuals with preserved LV systolic function.
PATIENTS AND METHODS
Materials and methods: The study includes 51 patients with arterial hypertension associated with coronary artery disease, who were treated with S-amlodipine.
RESULTS
Results: This study shows the high clinical effectiveness of the use of S-amlodipine in patients with arterial hypertension associated with coronary artery disease. We reveal that treatment of hypertensive patients with coronary artery disease with S-amlodipine leads to improvement of LV diastolic dysfunction, bringing it closer to normal values.
CONCLUSION
Conclusions: Clinical effectiveness was associated with positive changes in hemodynamics, and was expressed in the normalization of the left ventricle diastolic function parameters, about which indirectly indicates decreasing of end-diastolic pressure.
Topics: Humans; Antihypertensive Agents; Amlodipine; Coronary Artery Disease; Hypertension; Blood Pressure; Calcium Channel Blockers
PubMed: 38112360
DOI: 10.36740/WLek202311114