Amlodipine + Atenolol

Amlodipine + Atenolol is used to treat hypertension (high blood pressure). This is a combination of two medicines that controls blood pressure when a single medication is not effective. It helps to lower high blood pressure and thus reduces the chances of future heart attack and stroke.

You can take Amlodipine + Atenolol at any time of day, on empty stomach, but it is best to take it at the same time each day. Keep taking it for as long as advised by your doctor. Even if you feel well, do not stop this medicine on your own because high blood pressure often has no symptoms. If you stop taking it, your condition may get worse.

Keeping active with regular exercise, reducing your weight and eating a healthy diet will also help control your blood pressure. Follow your doctor's advice while taking this medicine. It may cause side effects like headache, ankle swelling, slow heart rate, and nausea. It may also cause dizziness, so do not drive or do anything that requires mental focus until you know how this medicine affects you.

This might raise the level of potassium in the blood, hence avoid potassium rich food or supplements. You may be asked for regular monitoring of blood pressure, kidney function, and electrolytes level while on the treatment. Before taking it, let your doctor know if you have any liver or kidney problems. Pregnant or breastfeeding women should also consult their doctor for advice before taking this medicine. You also need to tell your doctor what other medicines you are taking especially those used to treat high blood pressure or heart conditions.

• Patients with essential hypertension
• Patients with angina pectoris & hypertension as co-existing diseases
• Post MI patients
• Patients with refractory angina pectoris where nitrate therapy has failed

Amlodipine is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle; it has a greater effect on vascular smooth muscle than on cardiac muscle. Amlodipine is a peripheral vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.

Atenolol is a cardioselective beta-blocker. The cardio-selectivity is dose-related. Atenolol causes a reduction in blood pressure by lowering cardiac output, decreasing the plasma renin activity and sympathetic outflow from CNS.

Amlodipine relaxes and widens blood vessels, lowering blood pressure and improving blood flow. Atenolol slows the heart rate and reduces the heart's workload, helping lower blood pressure and reduce chest pain. Together, they make the heart more efficient at pumping blood throughout the body.

Adult Dose:

• Recommended dosage is Amlodipine and Atenolol 5/25 mg tablet once daily
• If necessary, the dosage may be increased to 5/25 mg two tablets daily or as advised by the physicians
• Dosage should be individualized
• 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

Renal Dose: Dose adjustment may be needed for renal impairment if creatinine clearance is less than 30 ml/min because of possible reduction in the excretion of unchanged Atenolol.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Amlodipine + Atenolol is to be taken empty stomach.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

• Sleepiness
• Headache
• Ankle swelling
• Flushing (sense of warmth in the face, ears, neck and trunk)
• Slow heart rate
• Palpitations
• Nausea
• Edema (swelling)
• Constipation
• Tiredness
• Cold extremities
• Fatigue
• Drowsiness
• Anxiety
• Depression

[UNSAFE] May cause side effects which could affect your ability to drive. May cause dizziness, headaches, nausea or tiredness, all of which could affect your ability to concentrate and drive.

Get up slowly when rising from a sitting or lying position. Do not stop taking the medication suddenly without talking to your doctor as it can cause sudden increase in your blood pressure. Let your doctor know if you are pregnant or planning for pregnancy.

Caution in patients with airway obstruction (Bronchospasm). Caution in patients with severe liver damage because of prolongation of the elimination half-life of Amlodipine. Since coronary heart disease may exist without being recognized, patients should be warned against stopping the drug suddenly. Any discontinuation should be gradual and under observation.

• Hypersensitivity to either component
• Sinus bradycardia
• Second and higher degrees of heart block
• Cardiogenic shock
• Hypotension
• Congestive heart failure
• Poor left ventricular function
• Safety and efficacy have not been established in children
• Untreated phaeochromocytoma

• Disopyramide: Atenolol reduces the clearance of disopyramide by 20%. Additive negative inotropic effects on the heart may be produced.
• Ampicillin: at doses of 1 gm and above may reduce Atenolol levels.
• Oral antidiabetics and insulin: Beta-blockers may decrease tissue sensitivity to insulin and inhibit insulin secretion e.g. in response to oral antidiabetics. Atenolol has less potential for these actions.

[UNSAFE] It is unsafe to consume alcohol with Amlodipine + Atenolol.

[CONSULT YOUR DOCTOR] Amlodipine + Atenolol is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby (Pregnancy Category D). However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[CONSULT YOUR DOCTOR] Amlodipine + Atenolol is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby. If its use is considered necessary, breast-feeding should be stopped.

Safety and efficacy have not been established in children.

Excessive fall of BP may occur in elderly patients.

[CAUTION] Amlodipine + Atenolol should be used with caution in patients with kidney disease. Dose adjustment of Amlodipine + Atenolol may be needed. Please consult your doctor. Regular monitoring of blood pressure is recommended and can help in better dose adjustment.

Caution may be necessary if the creatinine clearance is less than 30 ml/min because of possible reduction in the excretion of unchanged Atenolol.

[CAUTION] Amlodipine + Atenolol should be used with caution in patients with liver disease. Dose adjustment of Amlodipine + Atenolol may be needed. Please consult your doctor. Amlodipine + Atenolol is started at a lower dose in patients with liver disease and further increased slowly with careful monitoring.

Though not documented, hypotension and less frequently congestive cardiac failure may occur in cases of overdosage. Unabsorbed drugs may be removed by gastric lavage or administration of activated charcoal. Symptomatic treatment is suggested.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.