Amlodipine5mg + Lisinopril 5 mg
BRAND NAME:- MOLD-L TABLET(Amlodipine 5 mg + Lisinopril 5 mg)
COMPOSITION:-Each Tablet contains 5mg Amlodipine and 5mg lisinopril
PACKING:-Each Tablet contains 5mg Amlodipine and 5mg lisinopril
1. Pharmacodynamics: –
a.) Amlodipine: – Amlodipine is a second generation dihydropyridine Ca channel blocker. It exerts it`s antihypertensive, antianginal actions through blocking the influx of Ca ions through voltage gated L-type Ca channels to the peripheral vascular smooth muscle cells, Coronary smooth muscle cells and to the myocardial cells. Thus causes dilatation of vascular endothelium, decrease peripheral resistance, & reduce myocardial oxygen demand .It markedly relax arterioles and milder effects on veins. They do not compromise haemodynamics and cerebral and renal perfusion.
b.) Lisinopril: – It is an angiotensin converting enzyme inhibitor prevents the conversion of angiotensin-1 to angiotensin-2 and abolishes the pressor actions of angiotensin. It decreases aldosterone secretion, sodium and water retention, and total peripheral resistance, leads to fall in BP. The arterioles dilate and the compliance of larger arteries is increased. Both systolic and diastolic BP is lowered. It has no effect on cardiac output and cardiovascular reflexes. There is little dilatation of capacitance vessels; so postural hypotension is not a problem. The drug does not compromise renal, cerebral, and coronary blood flow. BP lowering depending up on sodium status and renin angiotensin activity. So greater fall in BP occurs in Reno vascular accelerated and malignant hypertension. The drug also increases plasma kinin levels and potentiate the hypotensive action of exogenously administered bradykinin. It is used for treatment of systolic heart failure, because it improves symptoms, decrease mortality and reduce ventricular hypertrophy. It reduces both preload and after load and thus increasing cardiac out put in patients with heart failure.
2. Pharmacokinetics: –
a.) Amlodipine: –
- Absorption: Well absorbed orally,
- Distribution: Widely distributed in a protein bound form,
- Metabolism: Metabolized in liver, but there is no active metabolite.
b.) Lisinopril: –
- Absorption: Slowly absorbed orally about 25%.
- Distribution: Widely distributed, but poor brain penetration.
- Metabolism: Not metabolized in the body.
- Excretion: Excreted unchanged in urine.
2. Prinzmetal`s angina
3. Stable angina
4. Antacids : Decrease efficacy of Lisinopril.
5. Indomethacin : Reduces hypotensive effect.
6. Digoxin : Increases plasma digoxin levels.
7. Potassium preparations & Postassium sparing diuretics : Hyperkalaemia and increased risk of renal failure.
8. Lithium : Toxicity due to increased serum concentration of Lithium. Immunosuppressive Drugs : Increased risk of bone marrow depression.
9. Antidepressants , Diuretics, Beta-Blockers, Phenothiazines : Enhance hypotensive effect.
10. Morphine : Enhanced analgesic effect and respiratory depression.