Amlodipine + Metoprolol Pharmacology

Amlodipine + Metoprolol

About Amlodipine + Metoprolol
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Mechanism of Action of Amlodipine + Metoprolol
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Pharmacokinets of Amlodipine + Metoprolol
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Onset of Action for Amlodipine + Metoprolol
N/A
Duration of Action for Amlodipine + Metoprolol
N/A
Half Life of Amlodipine + Metoprolol
N/A
Side Effects of Amlodipine + Metoprolol
N/A
Contra-indications of Amlodipine + Metoprolol
N/A
Special Precautions while taking Amlodipine + Metoprolol
N/A
Pregnancy Related Information
Contraindicated; since Amlodipine and Metoprolol are contraindicated in pregnancy.So the combination generic cannot be used in pregnancy.
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; since Amlodipine is contraindicated in lactation.
Children Related Information
N/A
Indications for Amlodipine + Metoprolol
It is a combination of calcium channel blocker Amlodipine and Beta blocker Metoprolol.
1.Hypertension
2.Arrhythmias
3.Angina
Interactions for Amlodipine + Metoprolol
N/A
Typical Dosage for Amlodipine + Metoprolol
Adult: 1 tablet / day
Schedule of Amlodipine + Metoprolol
N/A
Storage Requirements for Amlodipine + Metoprolol
N/A
Effects of Missed Dosage of Amlodipine + Metoprolol
N/A
Effects of Overdose of Amlodipine + Metoprolol
N/A

Amlodipine

About Amlodipine
Calcium Channel Blocker, Anti hypertensive,anti angina.
Mechanism of Action of Amlodipine
Amlodipine is a second generation dihydropyridine Ca channel blocker. It exerts it`s antihypertensive, antianginal actions through blocking the influx of Ca ions through voltage gated L-type Ca channels to the peripheral vascular smooth muscle cells, Coronary smooth muscle cells and to the myocardial cells. Thus causes dilatation of vascular endothelium, decrease peripheral resistance, & reduce myocardial oxygen demand .It markedly relax arterioles and milder effects on veins. They do not compromise haemodynamics and cerebral and renal perfusion.
Pharmacokinets of Amlodipine
Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized in liver, but there is no active metabolite.
Onset of Action for Amlodipine
Slow
Duration of Action for Amlodipine
24 hours
Half Life of Amlodipine
N/A
Side Effects of Amlodipine
1.Palpitation
2.Flushing
3.Nausea
4.Vomiting
5.Abdominal pain
6.Edema
7.Headache
8.Dizziness
9.Paresthesia
10.Light headedness
11.Fatigue
12.Aggravates myocardial ischaemia
13.Rashes
Contra-indications of Amlodipine
1.Heart failure
2.Aortic stenosis
3.Hypersensitivity to the drug
4.Unstable angina
5.Hepatic impairment
6.Along with other anti hypertensive drugs.
Special Precautions while taking Amlodipine
1.Cardiovascular disorders: Use cautiously in cardiovascular disorders because it aggravates myocardial ischaemia.
2.Sick sinus syndrome
3.Renal impairment
4.Use cautiously along with other antihypertensive drugs,
Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution.
Children Related Information
Contraindicated
Indications for Amlodipine
1.Hypertension
2.Prinzmetal`s angina
3.Stable angina
Interactions for Amlodipine
ACE inhibitors, Thiazide diuretics: Potentiates effect of these drugs.
Beta Blockers: Best avoided, especially by those with impaired LV function due to depressant effect on myocardial contractibility or AV conduction.
Fentanyl: Severe hypotension or increased fluid volume requirements.
Typical Dosage for Amlodipine
5 mg once daily.
Maximum dose: 10mg/day
Prinzmetal`s angina and Stable angina:
5 to 10mg once daily.
Hypertension: 2.5 to 5mg once daily. Dose may increase up to 10mg once daily as required by the individual needs.
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Schedule of Amlodipine
H
Storage Requirements for Amlodipine
Store at room temperature below 30 degree C. Protect from moisture and light.

Effects of Missed Dosage of Amlodipine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Amlodipine
Monitor &support cardiac and respiratory functions. Measure the BP. Give cardiovascular support by elevating the limbs and maintaining fluid balance. Administer vasopressers like nor epinephrine and Calcium gluconate if required.

Metoprolol

About Metoprolol
A selective ?1 blocker, Anti-hypertensive.
Mechanism of Action of Metoprolol
Metoprolol is a cardio selective beta-1 adrenergic antagonist.
It have negative chronotropic and negative inotropic effects on heart. It decreases oxygen consumption; cardiac work and aortic pressure It decreases nor adrenaline and renin releases. It decreases central sympathetic out flow. In sympathetic over activity, it prolongs systole by retarding conduction. It increases oxygen supply and exercise tolerance in angina patients. The drug decreases BP in hypertensive individuals.
Antimigraine action: Metoprolol is useful in migraine due to its beta blockade action. Through beta blockade action it inhibits vasodilation and relieves migraine.
Pharmacokinets of Metoprolol
Absorption: well absorbed orally, bioavailabity is increased by administering along with food. Distribution: Widely distributed. Metabolism: Metabolized in liver by hydroxylation. Excretion: Excreted through urine.
Onset of Action for Metoprolol
15minutes
Duration of Action for Metoprolol
Up to 1 to12 hours
Half Life of Metoprolol
N/A
Side Effects of Metoprolol
1.Heart failure
2.Nightmares
3.Gastrointestinal problems
4.Nausea
5.Tiredness
6.Sinus bradycardia
7.Depression
8.Rash
9.Hypotension
10.Dizziness
11.Fatigue
12.Vomiting
13.Diarrhoea
14.Headache
15.Bronchospasm
Contra-indications of Metoprolol
1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Congestive heart failure
4.Cardiogenic shock
5.Bradycardia
6.Bronchial asthma
7.Diabetes mellitus
Special Precautions while taking Metoprolol
1.Congestive heart failure
2.Hepatic impairment
3.The drug should be gradually withdraw with caution
4.Respiratory disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Contraindicated
Indications for Metoprolol
1.Hypertension
2.Arrhythmias
3.Angina
4.Migraine
5.Prophylaxis of myocardial infarction
6.Thyrotoxicosis
Interactions for Metoprolol
Thioamines: Increased efficacy of metoprolol.
Thyroid hormones: Decreased efficacy of metoprolol.
Benzodiazepines: Increased efficacy of benzodiazepines.
Clonidine: Abrupt withdrawal of clonidine may lead to hypertensive crisis.
Ergot alkaloids: Peripheral ischaemia, possible peripheral gangrene.
Lidocaine: Increased lidocaine level may occur leading to toxicity.
Prazosin: Increased postural hypotension produced by parzosin.
Sulphonylureas: Hypoglycaemic effects may be attenuated.
Typical Dosage for Metoprolol
Oral
Adult: 50 to 450mg/day
Hypertension: Starts with 50mg to 100mg/day once daily or in divided doses and gradually increases up to 450mg/day based on patient`s response
Arrhythmias:
Oral: 100mg to 150mg/day in 2 to 3 divided doses
I.V.: Dose range: 10 to 15mg. Starts with 5mg infused within 5minutes. Then repeat the therapy with the same dose at every 5minutes interval based on patient`s response
Maximum dose: 20mg
Angina: 50mg twice daily, gradually increases based on patient`s response at one week intervals
Maximum dose: 0.4gm/day
Migraine: 0.1 to 0.2gm/day in divided doses in 12th hourly to 6th hourly.
Prophylaxis of myocardial infarction: 0.1 to 0.2gm/day in divided doses
Myocardial infarction: 15mg in 3divided doses at 2minutes interval as I.V.bolus administration. Then 200mg orally in four divided doses for 2days.

Schedule of Metoprolol
H
Storage Requirements for Metoprolol
Store at controlled room temperature between 20 to 25 degree C in a well closed container

Effects of Missed Dosage of Metoprolol
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Metoprolol
Treatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal. Treat Bradycardia with atropine 0.5 to 1mg.If required administer isoproterinol with caution. Treat hypotension with glucagons and vasopressors like epinephrine. Treat cardiac failure with diuretics and cardiac glycosides. Treat bronchospasm with isoproterinol and aminophylline

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