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BMJ Case Reports May 2019Drug-induced gingival overgrowth is a condition caused by side effects of treatment with one of three types of drugs: phenytoin (used in epilepsy treatment),... (Review)
Review
Drug-induced gingival overgrowth is a condition caused by side effects of treatment with one of three types of drugs: phenytoin (used in epilepsy treatment), cyclosporine A (used in transplantology after allogenic organ transplants) and calcium channel blockers (used in the treatment of hypertension). Gingival overgrowth leads to inflammation within the gums and periodontium and can amplify the existing periodontal disease leading to tooth loss. Patients who have undergone kidney transplant are given immunosuppressants to prevent transplant rejection and mostly it is accompanied with calcium channel blockers to treat hypertension associated with kidney transplant. This article reports a case of recent gingival enlargement associated with cyclosporine A and amlodipine given to a kidney transplant patient from the past 11 years.
Topics: Adult; Amlodipine; Cyclosporine; Drug Therapy, Combination; Gingival Overgrowth; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Mycophenolic Acid
PubMed: 31142490
DOI: 10.1136/bcr-2019-229587 -
Spine Sep 2022The effect of amlodipine (AM) on spinal cord injury (SCI) and autophagy was researched by establishing ventral spinal cord cells (VSC4.1) oxygen and glucose deprivation...
STUDY DESIGN
The effect of amlodipine (AM) on spinal cord injury (SCI) and autophagy was researched by establishing ventral spinal cord cells (VSC4.1) oxygen and glucose deprivation model and SCI mice model.
OBJECTIVE
To determine the neuroprotective effects of AM by upregulating autophagy during SCI repair.
SUMMARY OF BACKGROUND DATA
AM, an antihypertensive medication, has been shown in several studies to inhibit neuronal apoptosis and exert neuroprotective effects in various central nervous system diseases. However, its effects on SCI are unexplored. Autophagy could inhibit cell apoptosis, which has been shown to promote SCI repair. However, the role of AM in autophagy remains unclear.
METHODS
We examined the relationship between AM, apoptosis, and autophagy in ventral spinal cord cells and the injured spinal cords of C57BL/6 female mice respectively, following histological, behavioral, microscopic, immunofluorescence, and western blotting analyses.
RESULTS
We found that AM could inhibit motor neuronal apoptosis in vitro. Furthermore, AM promoted locomotor recovery by upregulating autophagy and alleviating apoptosis, neuronal loss, and spinal cord damage after SCI.
CONCLUSION
AM inhibited motoneuronal apoptosis by upregulating autophagy to improve SCI recovery.
Topics: Amlodipine; Animals; Apoptosis; Autophagy; Female; Mice; Mice, Inbred C57BL; Neuroprotective Agents; Rats; Rats, Sprague-Dawley; Recovery of Function; Spinal Cord; Spinal Cord Injuries; Up-Regulation
PubMed: 34923548
DOI: 10.1097/BRS.0000000000004310 -
Hypertension (Dallas, Tex. : 1979) Nov 2017
Review
Topics: Amlodipine; Antihypertensive Agents; Blood Pressure; Humans; Hypertension; Prognosis; Treatment Outcome
PubMed: 28947617
DOI: 10.1161/HYPERTENSIONAHA.117.10087 -
Critical Reviews in Analytical Chemistry 2021Hypertension is a condition in which blood pressure is elevated to an extent where benefit is obtained from blood pressure lowering. The risk of complications is... (Review)
Review
Hypertension is a condition in which blood pressure is elevated to an extent where benefit is obtained from blood pressure lowering. The risk of complications is proportional to the level that blood pressure raises. Calcium channel blockers are a class of compounds used in the treatment of hypertension. The dihydropyridine (DHP) group, a subclass of the calcium channel blocker works almost exclusively on L-type calcium channels in the peripheral arterioles and reduce blood pressure by reducing total peripheral resistant. Long acting DHP is preferred because they are more convenient for patients and avoid the large fluctuations in plasma drug concentration which are associated with side effects. Amlodipine is the most distinct DHP and the most popular. The drug was patented in the year 1986 and its commercial sale began by 1990. The current article provides a state of art about the analytical and bioanalytical techniques available for the quantification of drug as a single entity and in combined pharmaceutical formulations between 1989 and 2019.
Topics: Amlodipine; Blood Pressure; Calcium Channel Blockers; Humans; Hypertension; Pharmaceutical Preparations
PubMed: 32506944
DOI: 10.1080/10408347.2020.1772036 -
Management of Hypertension With a Fixed-Dose (Single-Pill) Combination of Bisoprolol and Amlodipine.Clinical Pharmacology in Drug... Jan 2017Hypertension is currently one of the greatest global health care challenges. Although many effective drugs are available, combinations of 2 or more medications are often...
Hypertension is currently one of the greatest global health care challenges. Although many effective drugs are available, combinations of 2 or more medications are often required to meet clinical targets. Combination therapy has several advantages over monotherapy: lower doses of each drug can be used to achieve therapeutic goals; lower doses may lead to fewer adverse events, facilitating patient adherence; and using multiple drugs with different modes of action may be more effective in treating multifactorial diseases, including hypertension. Adherence is an important consideration when requiring patients to self-administer multiple medications; as the number of concurrent medications increases, patient adherence tends to decrease. Recent evidence suggests that fixed-dose combinations (FDCs) may be more effective than free-dose combinations, as they provide all necessary medications in a single convenient tablet/single-pill combination. Among combinations of hypertension medications, a β-blocker such as bisoprolol with a calcium channel blocker such as amlodipine is an effective combination therapy for hypertension, with distinct and complimentary modes of action. With advantages over free-dose combinations, the FDC of bisoprolol/amlodipine is thus an effective and convenient treatment for hypertension, allowing more patients to achieve their therapeutic goals, while potentially reducing the burden of hypertension on health care systems.
Topics: Amlodipine; Antihypertensive Agents; Bisoprolol; Clinical Trials as Topic; Drug Combinations; Humans; Hypertension; Patient Compliance; Treatment Outcome
PubMed: 27653022
DOI: 10.1002/cpdd.309 -
Journal of the Indian Medical... Apr 2007S-amlodipine is the only vaso-active enantiomer of amlodipine. This article reviews the published data in nearly 5000 patients. Randomised controlled trials of...
S-amlodipine is the only vaso-active enantiomer of amlodipine. This article reviews the published data in nearly 5000 patients. Randomised controlled trials of S-amlodipine at half the dose of racemate in the treatment of hypertension, have shown it to be as effective as racemic amlodipine. The postmarketing surveillance studies (n = 4089) of S-amlodipine confirmed its antihypertensive efficacy and showed that the incidence of peripheral oedema is negligible with S-amlodipine compared to racemic amlodipine. Further, the patients with peripheral oedema who were switched over from racemic amlodipine to S-amlodipine resolved their oedema associated with the racemate, while sustaining the blood pressure control. Subgroup analyses showed S-amlodipine to be effective and safe in elderly hypertensives and isolated systolic hypertension patients. A clinical study in normotensive angina patients confirmed the anti-anginal efficacy of S-amlodipine at half the dose of racemate. Fixed-dose combinations of S-amlodipine with atenolol and S-amlodipine with hydrochlorothiazide have been shown to be effective and well tolerated in clinical practice. In the light of its efficacy and favourable tolerability profile, S-amlodipine used alone or in combination with other antihypertensive or anti-anginal drugs, is a valuable treatment option in the management of hypertension and angina.
Topics: Amlodipine; Angina Pectoris; Antihypertensive Agents; Humans; Hypertension; Molecular Conformation; Stereoisomerism
PubMed: 17822186
DOI: No ID Found -
Xenobiotica; the Fate of Foreign... Aug 2019This study investigates the effect of epigallocatechin-3-gallate (EGCG), a major ingredient of green tea, on the pharmacokinetics of amlodipine in rats. The...
This study investigates the effect of epigallocatechin-3-gallate (EGCG), a major ingredient of green tea, on the pharmacokinetics of amlodipine in rats. The pharmacokinetics of orally administered amlodipine (1 mg/kg) with or without EGCG pretreatment (30 mg/kg/day for 10 days) were investigated. Plasma concentrations of amlodipine were determined by using a sensitive and reliable liquid chromatography with tandem mass spectroscopy (LC-MS/MS) method. The effects of EGCG on the metabolic stability of amlodipine were investigated by using rat liver microsome incubation systems. The results indicated that when the rats were pretreated with EGCG, the C of amlodipine increased from 16.32 ± 2.57 to 21.44 ± 3.56 ng/mL (p < 0.05), the T decreased from 5.98 ± 1.25 to 4.01 ± 1.02 h (p < 0.05), and the AUC increased from 258.12 ± 76.25 to 383.34 ± 86.95 μg h L (p < 0.05), which suggested that the pharmacokinetic behavior of amlodipine was affected after oral co-administration of EGCG. Additionally, the metabolic half-life was prolonged from 31.3 ± 5.6 to 52.6 ± 7.9 min (p < 0.05) with the pretreatment of EGCG. It can be speculated that the drug-drug interaction between EGCG and amlodipine might occur, which might have resulted from the metabolism inhibition of amlodipine by EGCG when they were co-administered.
Topics: Amlodipine; Animals; Catechin; Herb-Drug Interactions; Male; Microsomes, Liver; Rats, Sprague-Dawley
PubMed: 30182817
DOI: 10.1080/00498254.2018.1519732 -
The Journal of the Association of... Mar 2017Recently, blood pressure variability (BPV) has gained focus owing to its role in predicting cardiovascular (CV) outcomes. Additionally, alterations in BPV contribute to... (Review)
Review
Recently, blood pressure variability (BPV) has gained focus owing to its role in predicting cardiovascular (CV) outcomes. Additionally, alterations in BPV contribute to the progression of end organ damage and trigger vascular events in hypertensive patients. Therefore, amelioration of BPV is considered a potentially important target and different classes of drugs are used to achieve the desired blood pressure (BP) goal. Based on several studies and clinical trials, treatments with CCB such as amlodipine have been found to be most effective in the management of BPV in hypertensive patients with diabetes. Growing evidence substantiates the role of amlodipine in significant reduction of BPV, thus, lowering the risk of diabetes related complications. This review sheds light on the importance of BPV reduction and the effectiveness of amlodipine in preventing cardiovascular morbidity and mortality in hypertensive patients with diabetes.
Topics: Amlodipine; Blood Pressure; Calcium Channel Blockers; Diabetes Complications; Diabetes Mellitus; Humans; Hypertension
PubMed: 28462546
DOI: No ID Found -
International Journal of Clinical... Jun 2020Background Amlodipine is a widely used antihypertensive agent for the treatment of paediatric hypertension, but the commercially available tablets are not suitable to... (Clinical Trial)
Clinical Trial
Background Amlodipine is a widely used antihypertensive agent for the treatment of paediatric hypertension, but the commercially available tablets are not suitable to treat young patients, who need lower, flexible dosages and a liquid formulation. Objective To determine the pharmacokinetic properties of amlodipine and the acceptability of a standardised, extemporaneous oral solution. Method A newly developed liquid formulation of amlodipine was administered to hypertensive children between the age of 6 months and 11 years. Using a limited sampling strategy, population PK analysis was performed using nonlinear mixed effects modelling. Results Nine children, with a median age of 2.9 years (IQR 1.8-8.4), receiving stable amlodipine therapy in a median dose of 0.15 mg kg day (IQR 0.11-0.18), were switched to study medication. The population pharmacokinetic model was able to accurately predict the clearance of amlodipine in the study population. Based on the final model, clearance was reduced by 31.2% (RSE: 10%) in females. Patient reported outcomes on taste from a five-point hedonic scale were available for five patients, who scored the taste from positive to slightly negative. Conclusion The results from the PK study and the acceptability assessment show that the amlodipine oral solution presented in this study offers an appropriate treatment option for young children.
Topics: Administration, Oral; Amlodipine; Antihypertensive Agents; Body Weight; Child; Child, Preschool; Female; Hospitals, Pediatric; Humans; Hypertension; Infant; Male; Metabolic Clearance Rate; Netherlands; Sex Factors; Solutions
PubMed: 32378123
DOI: 10.1007/s11096-020-01000-9 -
Journal of Medical Economics Apr 2020To evaluate the cost-effectiveness of olmesartan/amlodipine fixed-dose combination vs olmesartan and amlodipine free combination, amlodipine single drug, and... (Meta-Analysis)
Meta-Analysis
To evaluate the cost-effectiveness of olmesartan/amlodipine fixed-dose combination vs olmesartan and amlodipine free combination, amlodipine single drug, and valsartan/amlodipine fixed-dose combination in the treatment of hypertensive patients from payer perspective in China. A Markov model was constructed, which included five health states of hypertensive patients who are aged 35-84 years at baseline and free of cardiovascular disease. Clinical data were obtained from a network meta-analysis. Epidemiology data, adverse events (AEs), cost, and utility data were obtained from the literature. The cost associated with AEs was estimated based on the cost of same symptoms of hypertensive patients in an electric medical record database. The model projected quality-adjusted life years (QALYs) gained, total costs per patient in a 20-year time horizon, and incremental cost-effectiveness ratios. Probability sensitivity analyses (PSA) and one-way sensitivity analyses were conducted for the main parameters to test the robustness of the model. Compared to olmesartan and amlodipine free combination, amlodipine, and valsartan/amlodipine fixed-dose combination, treatment with olmesartan/amlodipine fixed-dose combination led to fewer CVD events and deaths; resulted in an incremental cost of ¥-5,439 ($-791.36), ¥6,530 ($950.09), and ¥-1,019 ($-148.26) and gained additional QALYs of 0.052, 0.094, and 0.037 per patient, respectively. Compared with olmesartan and amlodipine free combination and valsartan/amlodipine fixed-dose combination, olmesartan/amlodipine fixed-dose combination was dominant. Compared with amlodipine alone, the incremental cost-effectiveness ratios were below the WHO recommended cost-effectiveness threshold, indicating the olmesartan/amlodipine fixed-dose combination was a cost-effective option for hypertensive patients in China. The 10-years' time horizon scenario analysis showed similar results to the 20-years' time horizon. Probabilistic sensitivity analysis and one-way sensitivity analyses showed the robustness of the model results. Olmesartan/amlodipine fixed-dose combination confers better health outcomes and costs less compared with olmesartan and amlodipine free combination and valsartan/amlodipine fixed-dose combination, and is cost-effective compared to amlodipine for hypertension treatment in China.
Topics: Adult; Aged; Aged, 80 and over; Amlodipine; China; Cost-Benefit Analysis; Databases, Factual; Drug Therapy, Combination; Female; Humans; Hypertension; Imidazoles; Male; Medical Records; Middle Aged; Tetrazoles
PubMed: 31782677
DOI: 10.1080/13696998.2019.1699799