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Amlodipne + atenolol

CARDIOVASCULAR SYSTEM

ANTIANGINAL - [ CARDIOVASCULAR SYSTEM ]

Atenolol is a cardioselective beta blocker. Amlodipine is a dihydropyridine calcium-channel blocker that blocks the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Combination of the two drugs results in additive antihypertensive action. (1,2)

It is indicated in chronic stable angina and hypertension (1,2)

Hypotension, sinus bradycardia, 2nd & 3rd degrees of heart block, cardiogenic shock, overt congestive failure, poor LV function, hypersensitivity to either component, pregnancy. (1,2,3,4)

Headache, hypotension, dizziness, breathlessness, fatigue, muscle cramps, bradycardia, palpitations, flushing, oedema, dyspnoea, dyspepsia, cold extremities. Drowsiness, chestpain & impotence rarely. Hypersensitivity reactions. (1,2,3,4)

Additive effect when used with catecholamine depleting drugs; monitor for hypotension and/or marked bradycardia. If used with clonidine, clonidine withdrawal should occur a few days after withdrawal of the beta-blocker to prevent rebound hypertension; if replacing clonidine by beta-blocker, beta-blocker should be introduced only after clonidine administration has stopped for several days. Concurrent use with prostaglandin synthase inhibiting drugs (e.g. indomethacin) may reduce the hypotensive effects of beta-blockers. (1,2,3,4)

Excessive fall of BP may occur in elderly patients. Caution in patients with COPD, thyrotoxicosis, congestive failure, vasospastic angina, hepatic & renal impairment. Caution in diabetic patients as beta-blockers may mask tachycardia occurring with hypoglycaemia. Withdrawal should be gradual. Avoid in pregnant and lactating women. Safety and efficacy have not been established in children. Not to be used in untreated phaeochromocytoma. (1,2,3,4)

Adult: Per tablet contains atenolol 25 or 50 mg and amlodipine (as besylate) 5 mg: 1 tab once daily, may increase to 2 tablets daily if needed.  Elderly: Per tablet contains atenolol 25 mg and amlodipine (besylate) 5 mg: Initiate with 1 tablet daily.  (1,2,3,4)

1. Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 12th ed. China: McGraw Hill; 2011. 2. National Formulary of India. 4 th ed. Government of India, Ministry of Health and Family Welfare. India: Indian Pharmacopoeia Commission; 2011. 3. Amlodipine. [cited on 2nd september]. Available online from website http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/019787s054lbl.pdf 4. Atenolol. [cited on 2nd september]. Available online from website http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/018240s032lbl.pdf