After taking amlodipine, the legs swell

A drug Amlodipine - calcium channel blocker of the group of derivativesdihydropyridine. One of the regulatory mechanisms in cells and tissues is a change in the concentration of Ca2 + ions in the cytoplasm and intercellular fluid. In this case, the exchange is carried out through special channels in the cell membranes, they are of 6 types and are localized in various organs and tissues. Amlodipine It is able to selectively block L-type channels,located in the vascular wall, and in the myocardium, in particular in cells of contractile and conduction systems of the heart muscle. Blocking the passage of calcium ions through the membrane, the drug prevents the increase in intracellular calcium concentration. As a result, the contractile activity of vascular wall cells is inhibited, the tone of the vessels is reduced, blood pressure is lowered. When taking the recommended doses of the drug, its effect on the tone of the vessels of the venous bed is not observed, thus, when taking therapeutic doses of the drug, it is impossible to develop orthostatic hypotension.
Due to the gradual introduction of Amlodipine totarget cells and its long-term effect does not develop reflex tachycardia when it is applied, since the decrease in the vascular tone is gradual, due to this there are no fluctuations in the indices of arterial pressure, which is characteristic for other drugs of this group. Under the action of the drug, not only the arteries and arterioles expand, but also peripheral vessels, including coronary vessels, thus, the intensity of manifestations of ischemia of the heart muscle decreases, the course of angina is facilitated. By reducing the tone of the vessels without increasing the heart rate, the heart load decreases, which also contributes to reducing the need for the heart in oxygen.
A drug Amlodipine has a weak diuretic effect (accelerates glomerular filtration and removal of sodium from the body). Promotes the production of nitric oxide, has antioxidant abilities.
The therapeutic effect occurs after 2-4 hours after oral administration of the drug and lasts for a day (the effect persists in a state of rest and in a state of physical activity).
Amlodipine slowly absorbed from the gastrointestinal tracttract, while the degree of adsorption does not depend on the intake of food. Has high (more than 65%) bioavailability. The maximum concentration in the blood plasma reaches after oral intake after 6 hours, binding to plasma proteins is almost 98%. Well penetrates through placental and blood-brain barrier, excreted in breast milk. The metabolism of the drug occurs in the liver, excreted mainly by the kidneys, but some of it is excreted with feces. The half-life is 35 hours, in elderly patients and patients with insufficient liver function, the half-life period almost doubles.

Indications for use:
A drug Amlodipine used to treat arterial hypertensionadults (allowed as monotherapy with amlodipine, or a combination of it with other antihypertensive drugs); angina pectoris, angina Prinzmetal (vasospastic angina), including therapy is shown in cases where nitrates and B-adrenoblockers do not have the expected effect; ischemic heart disease, including chronic. The drug can be used in patients with chronic heart failure and bronchial asthma.

Mode of application:
In the treatment of uncomplicated arterial hypertension take 2.5 mg of the drug Amlodipine 1 time per day.
When hypertension is complicated with coronary heart disease and angina, take 5 mg of the drug once a day.
If necessary, the dose of the drug can be increased to 10 mg.
The maximum daily dose is 10 mg.
In complex therapy with other antihypertensive agents, amlodipine does not require correction of doses.
In patients with renal insufficiency and elderly patients, dose changes are not required.


Side effects:
From the side of the cardiovascular system and systemhemopoiesis: dyspnea, swelling of the extremities, hyperemia of the upper part of the face and body, pain in the chest, hypotension, migraine, extrasystole, cardiac rhythm disturbances. Thrombocytopenia, leukopenia, hyperglycemia.
From the central nervous system: dizziness, fatigue, headache, disturbed sleep and wakefulness. Convulsions, tremor, asthenia, loss of consciousness, paresthesia, nervousness, depression, increased anxiety, apathy, amnesia.
From the gastrointestinal tract: pain in the epigastric region, nausea, vomiting. Changes in liver enzymes, increased bilirubin levels, dry mouth, stools, flatulence, increased appetite, gastritis, pancreatitis.
Others: violation of urination, violations of sexual function, possible development of joint pathologies, myasthenia gravis. Dermatitis, itchy skin, hives, erythematous rash.
Possible impairment of vision (including discomfort, pain in the eyes, diplopia, conjunctivitis), ringing in the ears, changes in body temperature, nosebleeds, increased sweating.

Contraindications :
Contraindications to the use of the drug Amlodipine are: increased individual sensitivity to the components of the drug, arterial hypotension, cardiogenic shock, collapse, pregnancy and lactation.
With caution appoint a drug in patients withchronic heart failure, diabetes mellitus, impaired lipid metabolism, impaired liver function, elderly patients and persons under 18 years old.
Also, with caution, appoint patients who underwent myocardial infarction (especially the first month after acute myocardial infarction).

Pregnancy :
Studies on the safety of the drug Amlodipine during pregnancy were not performed, therefore, the drug can be taken only under the strict supervision of the attending physician, if the expected benefit for the mother is higher than the possible risks to the fetus.
If it is necessary to prescribe the drug during lactation, it is necessary to resolve the issue of stopping breastfeeding for the period of treatment.

Interaction with other drugs:
Preparations of Ca2 + can reduce the effect Amlodipine. Also reduce the effectiveness of amlodipinedrugs sympathomimetic series, estrogens, non-steroidal anti-inflammatory drugs. Drugs that reduce the activity of liver enzymes can enhance the toxic effect of amlodipine and contribute to the manifestation of its side effects. Diuretics, B-adrenoblockers, ACE inhibitors, neuroleptics, nitrates and amiodarone can potentiate the action of amlodipine. Admission of amlodipine does not affect the intake of cardiac glycosides (including digoxin). Simultaneous reception with lithium drugs increases their toxicity and promotes the manifestation and enhancement of side effects.

Overdose :
In case of an overdose Amlodipine patients have hypotension, tachycardia,excessive expansion of peripheral vessels. In case of an overdose, gastric lavage, intake of adsorptive agents, symptomatic therapy, including maintenance of cardiovascular functions, are indicated. It is recommended to constantly monitor blood pressure, change the position of the patient's body so that the limbs are on some elevation. Also shown is the intravenous administration of calcium and dopamine. In case of an overdose Amlodipine the hemodialysis does not have an effect.

Storage conditions:
Amlodipine Store in a dry place away from direct sunlight, at a temperature of no higher than 25 degrees Celsius. Shelf life - 2 years.

Form of issue:
Tablets of 2.5; 5 or 10 mg of active ingredient per 10 pcs. in the blister for 1 or 3 blisters in a cardboard package.
For 5 or 10 mg of active ingredient per 100 pcs. in a can of polymeric materials, in a cardboard box.

Composition :
1 tablet of the drug Amlodipine contains:
Amlodipine besylate (in terms of amlodipine) is 2.5; 5 or 10 mg;
Excipients.

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