Tenocab 25

Indications

Amlodipine + Atenolol is prescribed for:

• Management of essential hypertension.
• Treatment of angina pectoris and co-existing hypertension.
• Post myocardial infarction (MI) patients.
• Individuals with refractory angina pectoris, especially where nitrate therapy has failed.

Use only as directed by a registered healthcare provider.

Pharmacology

This product is a fixed-dose combination of Amlodipine and Atenolol:

• Amlodipine is a dihydropyridine calcium channel blocker that inhibits calcium ion influx into vascular smooth muscle and cardiac muscle. It has a stronger effect on vascular smooth muscle, reducing peripheral vascular resistance and lowering blood pressure. It also improves coronary vasoreactivity and reduces afterload, easing the heart’s workload.
• Atenolol is a cardioselective beta-blocker. Its effect on beta-1 receptors helps lower blood pressure by reducing cardiac output, plasma renin activity, and sympathetic nervous system output. Atenolol also decreases myocardial oxygen demand by slowing heart rate and reducing the force of contraction.

Dosage & Administration

• The typical starting dosage is Amlodipine 5 mg / Atenolol 25 mg tablet, taken once daily.
• If necessary, the dosage may be increased to two tablets daily (5/25 mg) or as per the healthcare provider’s recommendation.

Always follow the advice of a registered healthcare professional for dosing.

Drug Interactions

• Disopyramide: Atenolol may reduce disopyramide clearance by 20%, potentially leading to additive negative inotropic effects.
• Ampicillin: Doses of 1 gm or more can lower Atenolol levels.
• Oral Antidiabetics & Insulin: Beta-blockers like Atenolol may reduce insulin sensitivity or inhibit insulin secretion, though Atenolol’s effect is less pronounced.

Contraindications

This combination should not be used in patients with:

• Hypersensitivity to either Amlodipine or Atenolol.
• Sinus bradycardia or second-degree heart block and higher.
• Cardiogenic shock, hypotension, congestive heart failure, or poor left ventricular function.

Side Effects

The combination is generally well tolerated, though some potential side effects include:

• Fatigue
• Headache
• Edema
• Nausea
• Drowsiness
• Anxiety or depression

Pregnancy & Lactation

• Use during pregnancy only if the potential benefits outweigh any risks to the fetus.
• Not recommended during breastfeeding. If its use is necessary, breastfeeding should be discontinued.

Precautions & Warnings

• Bronchospasm: Caution is advised for patients with airway obstruction.
• Renal Impairment: Safe for renal impairment, but extra care is needed if creatinine clearance is below 30 mL/min due to potential Atenolol accumulation.
• Hepatic Impairment: Caution is required for those with severe liver damage, as Amlodipine’s half-life may be prolonged.
• Drug Withdrawal: Discontinuing the medication abruptly may worsen coronary heart disease. Any cessation should be gradual under medical supervision.

Overdose Effects

Overdose may cause hypotension, and in rare cases, congestive heart failure. If overdose occurs, treatment may involve gastric lavage or activated charcoal to remove unabsorbed medication. Symptomatic treatment is recommended.

Therapeutic Class

• Combined Antihypertensive Medications.

Storage Instructions

Store at temperatures below 30°C, away from light and moisture. Keep out of the reach of children.