LODICARD

Amlodipine plus Atenolol

Composition:

Lodicard: Each tablet contains Amlodipine besilate BP equivalent to Amlodipine 5 mg plus Atenolol BP 50 mg.

Pharmacology:

Lodicard Tablet is a fixed-dose combination of amlodipine and atenolol. Amlodipine is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle; it has a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Thus it dilates the peripheral vessels to cause a reduction in peripheral resistance and decreases myocardial contraction to reduce cardiac output, finally resulting in a reduction of blood pressure. Atenolol is a cardio selective beta-blocker. The cardio selectivity is dose-related. Atenolol causes a reduction in blood pressure by lowering cardiac output, through decreasing plasma renin activity and heart rate.

Indications:

Lodicard is indicated for the following indications: 1) For the treatment of hypertension 2) For chronic stable angina 3) In post MI patients 4) In patients with refractory angina pectoris where nitrate therapy has failed.

Dosage and administration:

The usual daily dose is one tablet of Lodicard. However, the dose may be titrated depending on therapeutic response.

Contraindications:

Hypersensitivity to either component, sinus bradycardia, second and higher degrees of heart block, cardiogenic shock, hypotension, congestive heart failure, poor left ventricular function.

Adverse reactions:

The combination of amlodipine and atenolol is well tolerated. Side effects include headache, flushing, edema, dizziness, dyspepsia, fatigue and cold extremities.

Precautions:

Impaired hepatic function: Caution may be necessary in the use of the combination in patients with severe liver damage because of prolongation of the elimination half- life of amlodipine. Impaired renal function: The combination can be used in patients with renal impairment. However, caution may be necessary if the creatinine clearance is less than 30 ml/min because of possible reduction in the excretion of unchanged atenolol.

High risk groups:

Use in pregnancy: The combination should be used during pregnancy only if the expected benefit outweighs the potential fetal risk.

Use in lactation: The combination should not be used by nursing mothers. If its use is considered necessary, breast feeding should be stopped.

Drug interactions:

Disopyramide: Atenolol reduces the clearance of disopyramide by 20%. Additive negative ionotropic effects on the heart may be produced. Ampicillin: At doses of 1 g and above may reduce atenolol levels. Insulin: Beta-blockers may decrease tissue sensitivity to insulin.

Storage:

Store in a cool and dry place, protected from light. Keep out of the reach of children.

Packing: