Introduction

Amtinol Plus 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 Amtinol Plus 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.

Uses of Amtinol Plus

• Hypertension (high blood pressure)

Side effects of Amtinol Plus

• 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

How to use Amtinol Plus

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. Amtinol Plus is to be taken empty stomach.

How Amtinol Plus works

Amtinol Plus is a combination of two medicines: Amlodipine and Atenolol, which lowers blood pressure effectively. Amlodipine is a calcium channel blocker which works by relaxing blood vessels while atenolol is a beta blocker which works specifically on the heart to slow down the heart rate. Together, they make the heart more efficient at pumping blood throughout the body.

Indication

Oral Chronic stable angina; Hypertension Adult: Per tablet contains atenolol 25 or 50 mg and amlodipine 5 mg: 1 tab once daily, may increase to 2 tablets daily if needed. Elderly: Per tablet contains atenolol 25 mg and amlodipine 5 mg: Initiate with 1 tablet daily.

Administration

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.

Adult Dose

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. Lactation. Safety and efficacy have not been established in children. Not to be used in untreated phaeochromocytoma.

Renal Dose

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.

Contraindication

Safety and efficacy have not been established in children.

Precaution

Essential hypertension, Patients with angina pectoris & hypertension as co-existing diseases, Post MI patients; In patients with refractory angina pectoris where nitrate therapy has failed.

Side Effect

Renal impairment: Per tablet contains atenolol 25 mg and amlodipine (besylate) 5 mg: Initiate with 1 tablet daily.

Pregnancy Category Note

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

Interaction

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