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Fixocard Tablet 5mg+50mg
Indications
Amtinol-plus is indicated for the following conditions:
- Patients with essential hypertension
- Patients with co-existing angina pectoris and hypertension
- Patients who have recently experienced a myocardial infarction (MI)
- Patients with refractory angina pectoris who have not responded to nitrate therapy
Pharmacology
Amtinol-plus is a fixed-dose combination of two active ingredients: Amlodipine and Atenolol.
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Amlodipine is a dihydropyridine calcium channel blocker. It inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, with a greater effect on the vascular smooth muscle. By acting as a peripheral vasodilator, Amlodipine reduces peripheral vascular resistance and consequently lowers blood pressure. It decreases vascular tone, reduces coronary vasoreactivity, and decreases cardiac demand by lowering afterload.
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Atenolol is a cardioselective beta-blocker. Its cardioselectivity is dose-dependent. Atenolol lowers blood pressure by reducing cardiac output, decreasing plasma renin activity, and diminishing sympathetic outflow from the central nervous system (CNS). Additionally, it lowers myocardial oxygen demand through its negative inotropic (force of contraction) and negative chronotropic (heart rate) effects.
Dosage & Administration
The recommended dosage of Amtinol-plus is one tablet containing Amlodipine 5 mg and Atenolol 25 mg taken once daily. If necessary, the dosage may be increased to two tablets (5 mg Amlodipine and 25 mg Atenolol each) daily, based on physician guidance. Dosage should be tailored to the individual patient’s needs.
Note: Always follow the physician's advice regarding medication use.
Interaction
- Disopyramide: Atenolol reduces the clearance of disopyramide by 20%, which may lead to additive negative inotropic effects on the heart.
- Ampicillin: At doses of 1 gram and above, it may decrease Atenolol levels.
- Oral Antidiabetics and Insulin: Beta-blockers like Atenolol may reduce tissue sensitivity to insulin and inhibit its secretion, although Atenolol has a lower potential for these effects.
Contraindications
Amtinol-plus should not be used in patients with:
- Known hypersensitivity to either Amlodipine or Atenolol
- Sinus bradycardia
- Second-degree or higher heart block
- Cardiogenic shock
- Hypotension
- Congestive heart failure
- Poor left ventricular function
Side Effects
The combination of Amlodipine and Atenolol is generally well tolerated. Common side effects may include:
- Fatigue
- Headache
- Edema (swelling)
- Nausea
- Drowsiness
- Anxiety
- Depression
Pregnancy & Lactation
Use of Amtinol-plus during pregnancy should only occur if the expected benefits justify potential risks to the fetus. It is contraindicated for nursing mothers; if deemed necessary for treatment, breastfeeding should be discontinued.
Precautions & Warnings
- Bronchospasm: Caution is advised in patients with a history of airway obstruction.
- Renal Impairment: Use with caution in patients with renal impairment, particularly those with a creatinine clearance of less than 30 ml/min, due to potential decreased excretion of Atenolol.
- Hepatic Impairment: Caution is also warranted in patients with severe liver damage due to a prolonged elimination half-life of Amlodipine.
- Drug Withdrawal: Patients should not abruptly discontinue use, as coronary heart disease may be present without symptoms. Any discontinuation should be gradual and under medical supervision.
Overdose Effects
Although not extensively documented, overdose may lead to hypotension and, less frequently, congestive cardiac failure. In cases of suspected overdose, unabsorbed medication may be removed via gastric lavage or activated charcoal. Symptomatic treatment is recommended.
Therapeutic Class
Combined antihypertensive preparations.
Storage Conditions
Store below 30°C in a cool, dry place, away from light and moisture. Keep out of reach of children.
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