The drug is used to treat hypertension, secondary hypertension and angina pectoris. Analogues of Amlodipine with an identical active substance in the composition are used for the same indications. The most interesting are the substitutes used to treat cardiovascular diseases that do not cause swelling of the legs.
Material Content:
Composition (active substance) Amlodipine
The tablets contain amlodipine in the form of benzenesulfonate or besylate. For the first time, this active substance appeared on the pharmaceutical market in 1992. The American company Pfizer released a tablet form of amlodipine besilate under the trade name Norwask. The name of the same drug in France is Amlor. Dosage varies: 10, 5 and 2.5 mg.
Amlodipine tablets of Russian production - generic of the original Norvask. The dosage of the active substance is 10 and 5 mg. The cost of packing 10 mg tablets (60 pcs.) - 140 rubles., 5 mg (60 pcs.) - 37 rubles.
Under the same trade name, tablets are produced in India, Poland, Serbia, Macedonia. The cost of packing Amlodipine tablets imported (5 mg, 20 or 30 pcs.) - from 75 to 120 rubles.
Amlodipine as part of generic drugs can be used in the form of maleate. It is believed that the besylate and maleic salts of the drug are biologically equivalent, interchangeable. However, a number of studies have revealed the ability of maleate to break down with the formation of physiologically active impurities.
Indications for use of the drug
Amlodipine is an antagonist or blocker of calcium channels, a hypotensive, antianginal agent.The drug reduces the flow of calcium ions into the smooth muscle cells of the choroid. A decrease in the concentration of the mineral element causes the expansion of peripheral and coronary vessels.
The medicine is a blocker of "slow" calcium channels (BMCC), used to reduce high blood pressure (BP). Amlodipine treatment is indicated for grade 1 and 2 arterial hypertension, for the relief of angina attacks, for coronary heart disease.
The drug slows the progression of chronic heart failure.
Tablets should be taken once a day. Over the course of 2–4 hours, blood pressure gradually decreases, while there is no violation of the heart rhythm. The instructions for use also say that Amlodipine can be used in monotherapy and combined with other antianginal agents.
The drug has a number of advantages, which include a mild effect on the body as a whole, a long-term antianginal effect (up to 32 hours), and the ability to reduce the risk of stroke and heart attack. Patients in the reviews also note the negative side of treatment.
Amlodipine causes leg swelling in the feet and ankles, which creates many problems in everyday life. Other side effects of this drug are unpleasant: heart palpitations, shortness of breath, headache, drowsiness, rapid urination.
Russian counterparts with the least side effects
If there is a need to replace Amlodipine, the doctor selects an alternative agent from the same or close pharmacological groups. Generics are not suitable, as they contain the same active substance that causes similar negative effects, for example, swelling of the legs.
The doctor prescribes another drug to the patient only after examination, blood pressure measurement, taking into account age, stage of hypertension, concomitant diseases.
Lercanidipine-SZ is a Russian drug containing the same active substance, which is BMKK. Lercanidipine relaxes smooth muscle cells in the walls of blood vessels, practically does not affect the heart muscle. The drug reduces blood pressure gradually, while protecting the kidneys from the effects of hypertension.
Lercanidipine-SZ and analogues of domestic production - Lerkanorm, Lernikor - drugs "from pressure" with the least side effects. They are prescribed for the treatment of hypertension 1 and 2 degrees.
It is well tolerated by most patients Nifedipine - selective BMCC. The medicine is used for arterial hypertension, coronary heart disease. The Russian drug is one of many generics containing nifedipine. More expensive imported analogues: Cordaflex, Nifecard.
Foreign substitutes of Amlodipine
With hypertension, you can take other drugs from the BMCC group, as well as beta-blockers, ACE inhibitors. Many of these drugs are used as substitutes for amlodipine.
Imported drug Lerkamen (Germany) contains lercanidipine. The active substance, like amlodipine, belongs to the BMCC group. Lerkamen is well tolerated, causes relatively few side effects.
Trade names of other import substitutes for Amlodipine:
- Diltiazem (Romania, Austria);
- Cordipine Retard (Slovenia);
- Valsacor (Slovenia);
- Cordaflex (Hungary).
It is not difficult to replace Amlodipine, however, you should pay attention to INN, which is indicated in small print under the trade name of the drug. It happens that the patient is looking for an alternative to the drug, and buys an analogue with an identical composition, but under a different commercial name.
Amlodipine has a lot of synonyms. Here are just a few of them: Norvask; Amlothop, Kulchek, Cordicore Stamlo. If Amlodipine is not suitable, then its active substance in other means will provoke identical side effects.
Similar remedies that do not cause swelling of the lower extremities
Antagonists of calcium ions cause relaxation of muscle fibers in the walls of blood vessels.The filtration of the fluid in nearby tissues increases, swelling occurs. Side effects are worse when taking the pill with the highest dose of the active substance.
Amlodipine causes leg swelling, but when using the drug with the lowest drug content, this violation is almost not manifested.
Sometimes it is more beneficial to take combination drugs. The combination of the two components enhances the therapeutic effect, but low doses of each ingredient reduce the risk of side effects.
Niperten Combi contains 5 or 10 mg of bisoprolol and amlodipine. Bisoprolol as part of the drug is a beta-blocker that slows the heart rate. The combined drug is prescribed for the treatment of hypertension and heart failure. The combination of bisoprolol with amlodipine quickly causes relaxation of the muscles of the vessels, their expansion, and a decrease in blood pressure.
Lercanidipine-SZ and drugs with the same active substance are much less likely to cause leg swelling compared to Amlodipine. Imported analogues of the Russian drug: Zanidip (Italy), Lerkamen (Germany).
Often in therapy and cardiology, ACE inhibitors are used to reduce blood pressure. Enalapril and lisinopril are drugs from this group that do not cause swelling of the lower extremities. Russian-made tablets with a dosage of 5 and 10 mg are one of the cheapest drugs for high blood pressure. The cost of packaging (20 pcs.) - from 10 to 18 rubles. The more expensive structural analogues of Enalapril are Enap (Slovenia), Lisinoprila - Iromed (Croatia).
Imported combined drugs Enap-N, Enam-N contain enalapril and hydrochlorothiazide. It is a diuretic often used in cardiology to treat hypertension. Hydrochlorothiazide enhances the excretion of fluid through the kidneys.
Combination therapy with drugs with two active substances is more effective with very high blood pressure, the presence of severe concomitant diseases. A triple combination may be used, including a calcium antagonist, an ACE inhibitor, and a diuretic.
