Dosage regimen
Inside, the initial dose for the treatment of arterial hypertension and angina pectoris is 5 mg of the drug 1 time / day. The maximum daily dose is 10 mg once. With arterial hypertension, the maintenance dose can be 2.5-5 mg (1/2 tablet of 5 mg - 1 tablet of 5 mg) / day.
With angina pectoris and vasospastic angina pectoris - 5-10 mg / day, once. In order to prevent angina attacks - 10 mg / day.
Amlodipine is prescribed with caution in patients with impaired liver function as a hypotensive agent, at an initial dose of 2.5 mg (1/2 tablet of 5 mg), and 5 mg as an antianginal drug.
In elderly patients, T1 / 2 of amlodipine may increase and CC may decrease. Dose changes are not required, but closer monitoring of patients is necessary.
Dose changes are not required with simultaneous administration with thiazide diuretics, beta-blockers and ACE inhibitors.
No dose changes are required in patients with renal failure.
Side effect
Classification of the incidence of side effects of the World Health Organization (WHO): very often> 1/10, often from> 1/100 to <1/10, sometimes from> 1/1000 to <1/100, rarely from> 1/10000 to <1/1000, very rarely from <1/10000, including individual messages.
From the cardiovascular system: often - palpitations, peripheral edema (swelling of the ankles and feet), “tides” of blood to the skin of the face; sometimes - an excessive decrease in blood pressure; very rarely - syncope, shortness of breath, vasculitis, orthostatic hypotension, the development or worsening of heart failure, cardiac arrhythmias (including bradycardia, ventricular tachycardia and atrial fibrillation), myocardial infarction, chest pain.
From the central and peripheral nervous system: often - headache, dizziness, increased fatigue, drowsiness; sometimes - asthenia, general malaise, hypesthesia, paresthesia, peripheral neuropathy, tremor, insomnia, mood lability, unusual dreams, nervousness, depression, anxiety; very rarely - migraine, increased sweating, apathy.
From the digestive system: often - nausea, abdominal pain; sometimes - vomiting, constipation or diarrhea, flatulence, dyspepsia, anorexia, dry mouth, thirst; rarely - gingival hyperplasia, increased appetite; very rarely - pancreatitis, gastritis, jaundice (due to cholestasis), hyperbilirubinemia, increased activity of hepatic transaminases, hepatitis.
From the hemopoietic organs: very rarely - thrombocytopenic purpura, leukopenia, thrombocytopenia.
From the genitourinary system: sometimes - frequent urination, painful urination, nocturia, impotence, very rarely - dysuria, polyuria, gynecomastia.
From the respiratory system: sometimes - shortness of breath, rhinitis, very rarely - cough.
From the skin: rarely - dermatitis, very rarely - alopecia, xeroderma, "cold" sweat, a violation of skin pigmentation.
Allergic reactions: pruritus, rash (including erythematous, maculopapular rash, urticaria), angioedema, erythema multiforme.
From the musculoskeletal system: sometimes - muscle cramps, myalgia, arthralgia, back pain, arthrosis, rarely - myasthenia gravis.
Other: sometimes - tinnitus, diplopia, disturbance of accommodation, xerophthalmia, conjunctivitis, eye pain, chills, nosebleeds, very rarely - parosmia, hyperglycemia.
Contraindications
severe arterial hypotension (systolic blood pressure less than 90 mm Hg);
collapse, cardiogenic shock;
unstable angina (with the exception of Prinzmetal angina);
clinically significant aortic stenosis;
pregnancy and lactation;
age up to 18 years (effectiveness and safety have not been studied);
lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
hypersensitivity to amlodipine, dihydropyridine derivatives and other components of the drug.
With caution in case of impaired liver function, sinus node weakness syndrome (SSS) (severe bradycardia, tachycardia), chronic heart failure of nonischemic etiology of functional class III-IV etiology according to NYHA classification, arterial hypotension, aortic stenosis, mitral stenosis, hypertrophic obstructive cardiomyopathy, acute infarction myocardium (and within 1 month after myocardial infarction), in old age.
