Select to order medicines [Delhi/NCR /Bangalore /Chennai /Bhubaneswar /Hyderabad/Pune & Mumbai region.]
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.
Typical usage: Mild to moderate hypertension. Angina pectoris. Prinzmetals angina.
Side Effects: Headache, peripheral oedema, fatigue, somnolence, nausea, abdominal pain, flushing, dyspepsia, palpitations, dizziness. Rarely pruritus, rash, dyspnoea, asthenia, muscle cramps. Potentially Fatal: Hypotension, bradycardia, conductive system delay and CCF.
Drug Interaction: Increased metabolism with rifampin. Reduced hypotensive effect with calcium. Potentiates effects of thiazide diuretics and ACE inhibitors. Avoid combination with ?-blockers in patients with markedly impaired left ventricular function. May increase serum levels of CYP1A2 substrates e.g. aminophylline, fluvoxamine, ropinirole. CYP3A4 inhibitors (e.g. clarithromycin, doxycycline, isoniazid, nicardipine) may increase the effects of amlodipine. Additive BP-lowering effects when used with sildenafil, tadalafil or vardenafil.
Mechanism Of Action: Amlodipine relaxes peripheral and coronary vascular smooth muscle. It produces coronary vasodilation by inhibiting the entry of Ca ions into the voltage-sensitive channels of the vascular smooth muscle and myocardium during depolarisation. It also increases myocardial O2 delivery in patients with vasospastic angina.
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
There is positive evidence of risk to a breastfed infant or to breastmilk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant (e.g. if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Typical usage: Essential hypertension.
Side Effects: Dizziness, headache, abdominal pain, dyspepsia, diarrhoea, gastroenteritis, nausea, hypotension, peripheral oedema, haematuria, UTI, hyperkalaemia, hypertriglyceridemia, hyperuricaemia, elevated liver enzymes, facial edema, angioedema, and rhabdomyolysis.
Drug Interaction: Concurrent use with ACE inhibitors, potassium-sparing diuretics, potassium salts, and drugs that may increase serum potassium (e.g. ciclosporin, eplerenone) may increase the risk of hyperkalaemia. Concomitant use with NSAIDs may decrease glomerular filtration synergistically; acute renal failure may occur. Increased serum concentrations of lithium and toxicity when used with angiotensin receptor antagonist have been reported; avoid concomitant use of lithium and Olmesartan medoxomil.
Mechanism Of Action: Olmesartan medoxomil is an ester prodrug for olmesartan. It is hydrolysed to olmesartan during absorption from the GI tract. Olmesartan is a selective and competitive angiotensin II Type 1 (AT1) receptor antagonist and hence it blocks the vasocontrictor and aldosterone-secreting effects of angiotensin II.
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