Norvasc
Norvasc
Norvasc (Amlodipine)Pharmacological action
Blocker of the "slow" calcium channels. Blocks "slow" calcium channels, inhibits transmembrane transition of calcium in cells of an unstriated muscle of heart and vessels.
Renders antihypertensive and antianginal effect.
The mechanism of antihypertensive Norvasc (Amlodipine) action is caused by direct relaxing influence on unstriated muscles of vessels.
Norvasc (Amlodipine) reduces an ischemia of a myocardium two ways: dilates peripheric arterioles and thus reduces afterload, thus the CARDIAC CONTRACTIONS RATE practically does not change, that leads to depression of consumption of energy and requirement of a myocardium for oxygen; and also dilates coronary and peripheric arteries and arterioles both in normal, prevents development of the coronary spasm caused by smoking.
At patients with an arterial hypertensia single daily Norvasc (Amlodipine) dose provides depression of a BP throughout 24 h as in a prone position, and standing. Thanks to the slow beginning of Norvasc (Amlodipine) action does not cause sharp depression of a BP.
At patients with a stenocardia the single daily Norvasc (Amlodipine) dose enlarges time of performance of an exercise stress, detains development of the next attack of a stenocardia and depression of segment ST (on 1 mm) during its performance, reduces frequency of attacks of a stenocardia and consumption of Tabulettaes Nitroglycerini.
At patients with cardiovascular diseases (including a coronary atherosclerosis with a lesion of one vessel and to a stenosis of 3 and more arteries and an atherosclerosis of carotids), transferred a myocardial infarction, Norvasc (Amlodipine) application warns development of a thickening of an intima-medii of carotids, considerably reduces a lethality from the cardiovascular reasons, a myocardial infarction, a stroke, aorto-coronary shunting, leads to depression of number of hospitalisation concerning an astable stenocardia and advance of a chronic heart failure, reduces frequency of the interventions referred on restoration of a coronary blood flow.
Norvasc (Amlodipine) does not raise risk of mors or development of the complications leading to lethal outcomes at patients with a chronic heart failure (III-IV a functional class on classification NYHA) against therapy by digoxin amd diuretics.
At patients with a chronic heart failure (III-IV the functional class on classification NYHA) not ischemic aetiology at Norvasc (Amlodipine) application exists probability of occurrence of a fluid lungs.
Norvasc does not render any adverse influence on a metabolism and concentration of lipids of a blood plasma.
Indications
- An arterial hypertensia (both as monotherapy, and in a combination to other antihypertensive agents);
- A stable stenocardia and a vasospastic stenocardia (both as monotherapy, and in a combination to other antianginal agents).
Dosage regimen
At an arterial hypertensia and a stenocardia the average initial dose makes 5 mg of 1 times/sut, depending on individual reaction of its patient it is possible to enlarge to the maximum dose making 10 mg.
At elderly patients the preparation is recommended to be applied in average therapeutic doses, change of a dose of a preparation is not required.
In spite of the fact that T1/2 of Norvasc , as well as all blockers of calcium channels, it is enlarged at patients with disturbances of function of the liver, any changes of a dosage of a preparation usually it is not required from the given category of patients.
Side effect
From cardiovascular system: often - peripheric edemas (malleoluses and feet), palpitation; sometimes - excessive depression of a BP, an orthostatic hypotension, a vasculitis; seldom - development or heart failure aggravation; very seldom - disturbances of a rhythm of heart (including a bradycardia, a ventricular tachycardia and an atrial fibrillation), a myocardial infarction, pains in a thorax, a migraine.
From osteomuscular system: sometimes - an arthralgia, cramps of muscles, a dorsodynia, an arthrosis; seldom - a myasthenia.
From party TSNS and peripheric nervous system: often - sensation of fever and blood "inflow" to a face skin, undue fatigability, giddiness, a headache, drowsiness; sometimes - a malaise, a syncope, the raised diaphoresis, an asthenia, hypesthesias, paresthesias, a peripheric neuropathy, a tremor, a sleeplessness, lability of the mood, unusual dreamings, nervousness, depression, alarm; seldom - cramps, apathy, agitation; an amnesia.
From the alimentary system: often - an abdominal pain, a nausea; sometimes - vomiting, a constipation, a meteorism, a dyspepsia, a diarrhoeia, an anorexia, dryness in a mouth, thirst; seldom - a hyperplasia of gums, appetite rising; very seldom - a gastritis, a pancreatitis, a hyperbilirubinemia, an icterus (usually cholestatic), rising of activity of hepatic transaminases, a hepatitis.
From hemopoiesis system: very seldom - a Werlhof's disease, a leukopenia, a thrombocytopenia.
From a metabolism: very seldom - a hyperglycaemia.
From respiratory system: sometimes - a dyspnea, a rhinitis; very seldom - tussis.
Allergic reactions: sometimes - a dermal itch, an eruption; very seldom - a Quincke's disease, an urticaria.
The other: sometimes - an alopecia, a ring in ears, a gynecomastia, augmentation/decrease of mass of a body, sight disturbance, a diplopia, accommodation disturbance, a xeroma, a conjunctivitis, a pain in eyes, a food faddism, a fever, a nasal bleeding; seldom - a dermatitis; a xerodermia, cold sweat, xanthopathy disturbance.
Contraindications
- A serious arterial hypotension;
- A hypersensibility to Amlodipine and also to other components of a preparation.
Pregnancy and lactemia
Safety of Norvasc application at pregnancy and in a lactemia (thoracal feeding) is not established, therefore application at pregnancy is possible only in that case when the advantage for mother exceeds risk for a foetus and the newborn.
Special indicatings
With care it is necessary to apply a preparation to patients with disturbances of function of a liver, a chronic heart failure (III-IV a functional class on classification NYHA) not ischemic aetiology, an aortal stenosis, an acute myocardial infarction (and during 1 month after it).
To patients with small mass of a body, to patients of low growth and patients with the expressed disturbance of function of a liver dose reduction can be demanded.
During treatment at the stomatologist (the control of mass of a body and observation are necessary for prevention of morbidity, a staxis and a hyperplasia of gums).
Use in pediatrics
With care it is necessary to prescribe a preparation to children and teenagers about 18 years since efficiency and safety of its application for the given group of patients precisely are not established are elderly.
Influence on ability to driving of motor transport and to management of mechanisms
Though against Norvasc reception of any negative influence on ability to control by the car or other means it was not observed, however owing to possible excessive depression of a BP, development of giddiness, drowsiness and other by-effects it is necessary to show consideration for individual action of a preparation in the specified situations, especially in the beginning of treatment and at change of a regimen of dosage.
Overdosage
Treatment: appointment of the activated coal (especially in the first 2 h after an overdosage), a gastric lavage (on occasion), giving of raised position to extremities, active maintenance of function of cardiovascular system, monitoring of indicators of work of heart and lungs and a diuresis. For restoration of a tonus of vessels and a BP if there are no contraindications, application of vasoconstrictive preparations is possible. Use i.v. introduction of gluconat of calcium.
Conditions and periods of storage
B.Preparat's list should be stored at temperature not above 30 C, in a place inaccessible to children. A period of validity - 5 years.
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