Amdocal 5

Indications

Amdocal is used for managing essential hypertension effectively, either as a monotherapy or in combination with other antihypertensive agents. It is also indicated for treating chronic stable angina pectoris, working well both alone or with other antianginal drugs. For vasospastic angina, Amdocal is suitable for both confirmed and suspected cases and can be used as a standalone treatment or combined with other antianginal medications.

Pharmacology

Amdocal contains Amlodipine, a dihydropyridine calcium-channel blocker with a long duration of action. It influences myocardial cells, the heart’s specialized conduction system, and vascular smooth muscle. Amlodipine induces vasodilation, which reduces peripheral resistance and blood pressure while increasing coronary blood flow. This leads to enhanced myocardial oxygen supply and cardiac output.

Dosage & Administration

For hypertension, the usual starting dose is 5 mg once daily, with a maximum of 10 mg daily. Elderly patients or those with hepatic insufficiency may begin with 2.5 mg daily. For treating chronic stable or vasospastic angina, the dosage ranges from 5 to 10 mg daily, starting with the lower dose for elderly patients or those with hepatic issues. The medication can be taken with or without food.

Interaction

Amdocal may interact with beta-blockers, particularly in patients with severe cardiac impairment. There is no significant interaction with Digoxin, Cimetidine, or Warfarin, and food does not affect its absorption.

Contraindications

Amdocal is contraindicated in patients with hypersensitivity to dihydropyridine derivatives and pregnant women.

Side Effects

Common side effects include dizziness, flushing, headache, hypotension, and peripheral edema. Gastrointestinal disturbances, increased urination, and mental depression may also occur. Severe side effects can include lung toxicity, liver dysfunction, and paradoxical worsening of angina. In rare cases, excessive blood pressure reduction may lead to ischemia or transient blindness.

Pregnancy & Lactation

Amdocal is classified as Pregnancy Category C and should be used only if the benefits outweigh the risks to the fetus. The safety of Amlodipine during breastfeeding is not established, so discontinuation of nursing is recommended while on this medication.

Precautions & Warnings

Caution is advised for patients with hepatic impairment and during pregnancy and breastfeeding.

Use in Special Populations

For children aged 6 to 17 years with hypertension, the starting dose is 2.5 mg daily, which may be increased to 5 mg if necessary. The effects on children under 6 years are not known. Elderly patients can generally tolerate normal dosages, but adjustments should be made carefully. In cases of renal impairment, the standard dosage is recommended as Amdocal is not dialysable. For patients with hepatic impairment, start with 2.5 mg daily and adjust cautiously in severe cases.

Overdose Effects

Overdosage may result in severe hypotension and reflex tachycardia, with potential for shock and fatal outcomes. Management includes cardiovascular support, monitoring, and possibly using vasoconstrictors or intravenous calcium gluconate. Charcoal may be used to reduce absorption if administered within 2 hours.

Therapeutic Class

Calcium-Channel Blockers

Storage Conditions

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