Swelling of the feet when taking Norvask
tablets 5 mg, tablets 10 mg
Pfizer (United States of America),Pfizer (Indonesia), Pfizer (Belgium), Pfizer GmbH, manufactured by Heinrich Mack Nasle. GmbH (Germany), Pfizer GmbH, manufactured by Heinrich Mack Nasle. GmbH, packaged by Biotec IFPAC (Germany)
Calcium channel blockers of the dihydropyridines group
International Nonproprietary Name
Agen, Acridipine, Amlovas, Amlodipine, Amlotop, Aronar, Vero-Amlodipine, Calchek, Cardilopin, Corvadil, Norvadine, Normodipin, Omelar cardio. Stamlo, Tenox
Pharmacological action - antianginal,hypotensive, vasodilating, spasmolytic. It binds to dihydropyridine receptors, blocks calcium channels, inhibits the transmembrane transition of calcium ions into the cell. The hypotensive effect is due to a direct relaxing effect on the smooth muscles of the vessels, a decrease in the total peripheral vascular resistance (OPSS). As a result of weakening the load on the heart, the need for myocardium in oxygen decreases; the expansion of large coronary arteries and coronary arterioles both in unchanged and ischemic zones of the heart muscle increases the flow of oxygen into the myocardium. It inhibits the aggregation of platelets; increases the rate of glomerular filtration, elimination of sodium and diuresis. The effect develops 1-2 hours after taking and lasts about 24 hours. Due to the gradual manifestation of the action and the prolonged effect, causes a smooth decrease in blood pressure and minimal reflex stimulation of the sympathetic nervous system. Absorbed (regardless of food intake) slowly, but almost completely. The maximum concentration is achieved in 6-12 hours. With constant intake, the equilibrium concentration is created after 7-8 days. Penetrates through the BBB. Half-life is 35-48 hours. Excreted in urine, with bile in breast milk.
Indications for use
Arterial hypertension. Stenocardia stable and vasospastic (Princmetal), including in patients resistant to nitrate therapy or beta-blockers.
Hypersensitivity. arterial hypotension (less than 90 mm Hg), shock, acute myocardial infarction. Restrictions on use: severe aortic stenosis. heart failure. violation of liver function, children's age (safety and efficacy of the application are not determined).
From the cardiovascular system and blood: hyperemia of the skin of the face, palpitations; rarely - rhythm disturbances, pain in the chest, hypotension (including orthostatic). From the nervous system and sensory organs: fatigue. headache. dizziness. drowsiness; rarely fatigue, asthenia. a change in mood, a disorder of vision. From the genitourinary system: peripheral edema (swelling of the ankles and feet); rarely - increased frequency of urination, impotence. On the part of the intestine: nausea. abdominal pain; rarely - dyspepsia. change in the defecation regime, jaundice. On the part of the respiratory system: rarely - shortness of breath. From the side of the musculoskeletal system: rarely - arthralgia. myalgia. paresthesia and pain in the extremities (with prolonged use). From the skin: rashes, itching, rarely - erythema multiforme. Other: rarely - gingival hyperplasia, gynecomastia. increased levels of hepatic enzymes.
Compatible with the main groups of antihypertensiveagents (diuretics, ACE inhibitors, beta-adrenoblockers), nitrates and hypoglycemic drugs. May intensify the action: funds for inhalation anesthesia (derivatives of hydrocarbons), amiodarone. quinidine and other calcium antagonists (may enhance action). NSAIDs reduce the antihypertensive effect.
Symptoms: excessive peripheral vasodilation. pronounced and prolonged decrease in blood pressure, tachycardia. Treatment: gastric lavage, the appointment of activated charcoal, giving the patient a horizontal position with raised legs, monitoring the performance of the heart and lungs, monitoring the volume of circulating blood and diuresis; symptomatic and supportive therapy. iv administration of fluids, calcium gluconate, dopamine, mezaton. Hemodialysis is not effective.
Application in pregnancy and lactation is possible if the expected effect of therapy exceeds the potential risk to the fetus. For the duration of treatment, breastfeeding should be discontinued.
Encyclopedia of medicines. Encyclopedia of medicines 2003г.
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