Description
Release form
Tablets.
Packing
30 pcs.
Pharmacological action
EsCordi Cor is a slow calcium channel blocker, a derivative of dihydropyridine. It has antianginal and hypotensive effects. Binding to the dihydropyridine receptors S (-), amlodipine is more potent than the R (+) isomer, it blocks calcium channels, reduces the transmembrane transition of calcium ions into the cell (to a greater extent in vascular smooth muscle cells than in cardiomyocytes).
EsCordi Cor has a long dose-dependent hypotensive effect. The antihypertensive effect is due to a direct vasodilating effect on the smooth muscles of blood vessels. With arterial hypertension, a single dose provides a clinically significant reduction in blood pressure over 24 hours (in the patient s position, lying and standing). The onset of the effect is 2-4 hours, the duration of the effect is 24 hours.
Contraindications
– Prinzmetal angina
– severe arterial hypotension
– collapse
– cardiogenic shock
– pregnancy
– lactation period (breastfeeding)
unresponsiveness up to 18 years of age and up to 18 years of age unresponsiveness up to 18 years old and up to 18 years old to S (-) amlodipine and other derivatives of dihydropyridine.
Special instructions
During treatment with EsCordi Kor, monitoring 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 proliferation of gums).
In elderly patients, T1 / 2 and drug clearance may be prolonged. The dosage regimen for the elderly is the same as for patients of other age groups. With increasing doses, careful monitoring of elderly patients is necessary.
Despite the fact that blockers do not have a slow calcium channel withdrawal syndrome, a gradual dose reduction is recommended before discontinuation of treatment.
Effect on driving ability and driving mechanisms
In some patients, mainly at the beginning of treatment, drowsiness and dizziness may occur. When they occur, special precautions should be observed when driving and working with machinery.
Composition
1 tab. contains amlodipine (in the form of besylate) 2.5 mg.
Dosage and administration of
Recommended starting dose of EsCordi Bark – 2.5 mg 1 time / day. With insufficient therapeutic effect, the dose can be increased to 5 mg 1 time / day.
Side effects
From the cardiovascular system: palpitations, shortness of breath, marked decrease in blood pressure, fainting, vasculitis, edema (swelling of the ankles and feet), flushing of the face, rarely – rhythm disturbance (bradycardia, ventricular tachycardia, atrium), chest pain, orthostatic hypotension, very rarely – development or worsening of heart failure, migraine.
From the central nervous system: dizziness, headache, fatigue, drowsiness, mood change rarely – cramps, loss of consciousness, hypersthesia, nervousness, parasthesia, tremor, vertigo, asthenia, malaise, insomnia, depression, unusual dreams, very rarely – ataxia , apathy, agitation, amnesia.
From the digestive system: nausea, vomiting, epigastric pain is rare – an increase in the level of liver enzymes and jaundice (due to cholestasis), pancreatitis, dry mouth, flatulence, gum hyperplasia, constipation or diarrhea, very rarely gastritis, increased appetite, impaired taste sensations.
From the genitourinary system: rarely – pollakiuria, painful urination, nocturia, decreased potency very rarely – dysuria, polyuria.
From the skin: very rarely – xeroderma, alopecia, dermatitis, purpura, discoloration of the skin.
Allergic reactions: pruritus, rash (including erythematous, maculopapular rash, urticaria), angioedema.
From the musculoskeletal system: rarely – arthralgia, arthrosis, myalgia (with prolonged use) very rarely – myasthenia gravis.
Other: rarely – gynecomastia, polyuricemia, increase / decrease in body weight, thrombocytopenia, leukopenia, hyperglycemia, visual impairment, conjunctivitis, diplopia, eye pain, tinnitus, back pain, dyspnea, nosebleeds, increased sweating, thirst very rarely – cold clammy sweat, cough, rhinitis , parosmia, disturbance of accommodation, xerophthalmia.
Drug interactions
Inhibitors of microsomal oxidation increase the concentration of amlodipine in blood plasma, increasing the risk of side effects, and inducers of microsomal enzymes of the liver decrease. Alpha-adrenostimulants, estrogens (sodium retention), sympathomimetics weaken the hypotensive effect. Thiazide and loop 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 can enhance the hypotensive effect. It does not affect the pharmacokinetic parameters of digoxin and warfarin. Cimetidine does not affect the pharmacokinetics of amlodipine. When combined with lithium preparations, it is possible to 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 cause a prolongation of the QT interval increase the negative inotropic effect and may increase the risk of a significant prolongation of the QT interval. Grapefruit juice can reduce the concentration of amlodipine in blood plasma, however, this decrease is so small that it does not significantly change the effect of amlodipine.
Overdose
Symptoms: marked decrease in blood pressure, tachycardia, excessive peripheral vasodilation.
Treatment: gastric lavage, administration of activated charcoal, maintenance of the cardiovascular system, monitoring of heart and lung function, elevated limbs, controlling for bcc and diuresis. To restore vascular tone – the use of vasoconstrictors (in the absence of contraindications to their use). To eliminate the effects of blockade of calcium channels – in / in the introduction of calcium gluconate. Hemodialysis is not effective.
Storage conditions
At a temperature not exceeding 25 ° C.
Deystvuyuschee substances
Levamlodypyn
Conditions of supply of pharmacies
Prescription
Form of Treatment
tablets
Emkyur Pharmaceuticals Ltd., India
