Amlodipine + Atenolol
Indications
Amlodipine + Atenolol is used for:
Patients with essential hypertension; Patients with angina pectoris & hypertension as co-existing diseases; In post MI patients; In patients with refractory angina pectoris where nitrate therapy has failed.
Adult Dose
Oral
Chronic stable angina; Hypertension
Adult: Per tablet contains atenolol 25 or 50 mg and amlodipine 5 mg: 1 tab once daily, may increase to 2 tablets daily if needed.
Elderly: Per tablet contains atenolol 25 mg and amlodipine 5 mg: Initiate with 1 tablet daily.
Child Dose
Safety and efficacy have not been established in children.
Renal Dose
Renal impairment: Per tablet contains atenolol 25 mg and amlodipine (besylate) 5 mg: Initiate with 1 tablet daily.
Administration
Contra Indications
Hypotension, sinus bradycardia, 2nd & 3rd degrees of heart block, cardiogenic shock, overt congestive failure, poor LV function, hypersensitivity to either component, pregnancy.
Precautions
Excessive fall of BP may occur in elderly patients. Caution in patients with COPD, thyrotoxicosis, congestive failure, vasospastic angina, hepatic & renal impairment. Caution in diabetic patients as beta-blockers may mask tachycardia occurring with hypoglycaemia. Withdrawal should be gradual. Lactation. Safety and efficacy have not been established in children. Not to be used in untreated phaeochromocytoma.
Pregnancy-Lactation
Interactions
Additive effect when used with catecholamine depleting drugs; monitor for hypotension and/or marked bradycardia. If used with clonidine, clonidine withdrawal should occur a few days after withdrawal of the beta-blocker to prevent rebound hypertension; if replacing clonidine by beta-blocker, beta-blocker should be introduced only after clonidine administration has stopped for several days. Concurrent use with prostaglandin synthase inhibiting drugs (e.g. indomethacin) may reduce the hypotensive effects of beta-blockers.
Adverse Effects
Side effects of Amlodipine + Atenolol :
Headache, hypotension, dizziness, breathlessness, fatigue, muscle cramps, bradycardia, palpitations, flushing, oedema, dyspnoea, dyspepsia, cold extremities. Drowsiness, chestpain & impotence rarely. Hypersensitivity reactions.
Mechanism of Action
Atenolol is a cardioselective beta blocker. Amlodipine is a dihydropyridine calcium-channel blocker that blocks the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Combination of the two drugs results in additive antihypertensive action.