Aloten Forte
Generic Name
Atenolol + Amlodipine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| aloten forte 5 mg tablet | ৳ 4.51 | ৳ 45.10 |
Description
Overview of the medicine
Aloten Forte 5 mg Tablet is a combination medication containing Atenolol and Amlodipine, used to treat high blood pressure (hypertension) and angina. Atenolol is a beta-blocker that reduces heart rate and blood pressure, while Amlodipine is a calcium channel blocker that relaxes blood vessels, further lowering blood pressure and improving blood flow to the heart.
Uses & Indications
Dosage
Adults
Typically, one tablet once daily. Dosage may be adjusted based on individual response and tolerability.
Elderly
Lower initial dose may be considered, with careful titration. Monitor renal function.
Renal_impairment
Atenolol component requires dose adjustment in severe renal impairment (CrCl < 35 mL/min). Amlodipine does not require dose adjustment for renal impairment.
How to Take
Take orally with or without food, preferably at the same time each day. Do not crush or chew the tablet.
Mechanism of Action
Atenolol selectively blocks beta-1 adrenergic receptors, primarily in the heart, reducing heart rate, cardiac output, and renin release from the kidneys, thus lowering blood pressure. Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. This causes peripheral arterial vasodilation, reducing peripheral vascular resistance and blood pressure, and dilates coronary arteries, increasing myocardial oxygen delivery.
Pharmacokinetics
Onset
Atenolol: 1 hour. Amlodipine: 6-12 hours.
Excretion
Atenolol: primarily excreted unchanged by the kidneys. Amlodipine: excreted in urine as inactive metabolites.
Half life
Atenolol: 6-7 hours (prolonged in renal impairment). Amlodipine: 30-50 hours.
Absorption
Atenolol: ~50% absorbed orally, peak plasma levels in 2-4 hours. Amlodipine: well absorbed, ~64-90% bioavailability, peak plasma levels in 6-12 hours.
Metabolism
Atenolol: minimally metabolized by the liver. Amlodipine: extensively metabolized in the liver to inactive metabolites.
Side Effects
Contraindications
- Severe bradycardia
- Cardiogenic shock
- Sick sinus syndrome (unless permanent pacemaker in place)
- Second or third-degree AV block
- Decompensated heart failure
- Severe peripheral arterial disease
- Hypotension
- Known hypersensitivity to Atenolol, Amlodipine, or any excipients
Drug Interactions
NSAIDs
May reduce the anti-hypertensive effect of beta-blockers and calcium channel blockers.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Other anti-hypertensives
Additive hypotensive effect.
CYP3A4 inducers (e.g., rifampicin)
May decrease amlodipine exposure.
Class I antiarrhythmics (e.g., disopyramide)
Increased risk of cardiac depression.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase amlodipine exposure.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, and bronchospasm. Treatment is symptomatic and supportive, including IV fluids, atropine for bradycardia, glucagon, and vasopressors if necessary.
Pregnancy & Lactation
Pregnancy Category D for Atenolol (use only if benefits outweigh risks). Amlodipine is Pregnancy Category C. Not recommended during breastfeeding due to excretion into breast milk.
Side Effects
Contraindications
- Severe bradycardia
- Cardiogenic shock
- Sick sinus syndrome (unless permanent pacemaker in place)
- Second or third-degree AV block
- Decompensated heart failure
- Severe peripheral arterial disease
- Hypotension
- Known hypersensitivity to Atenolol, Amlodipine, or any excipients
Drug Interactions
NSAIDs
May reduce the anti-hypertensive effect of beta-blockers and calcium channel blockers.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Other anti-hypertensives
Additive hypotensive effect.
CYP3A4 inducers (e.g., rifampicin)
May decrease amlodipine exposure.
Class I antiarrhythmics (e.g., disopyramide)
Increased risk of cardiac depression.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase amlodipine exposure.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, and bronchospasm. Treatment is symptomatic and supportive, including IV fluids, atropine for bradycardia, glucagon, and vasopressors if necessary.
Pregnancy & Lactation
Pregnancy Category D for Atenolol (use only if benefits outweigh risks). Amlodipine is Pregnancy Category C. Not recommended during breastfeeding due to excretion into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of both Atenolol and Amlodipine individually and in combination for hypertension and angina management. Studies have shown improved blood pressure control and cardiovascular outcomes with this combination.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function tests (e.g., serum creatinine, eGFR)
- Liver function tests (periodically)
Doctor Notes
- Consider potential drug interactions, especially with other cardiovascular medications.
- Monitor blood pressure and heart rate regularly.
- Educate patients on the importance of gradual discontinuation to avoid rebound effects.
Patient Guidelines
- Take this medication regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking this medicine abruptly without consulting your doctor, especially if you have heart disease.
- Report any unusual symptoms like swelling in ankles, difficulty breathing, or severe dizziness to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine may cause dizziness or fatigue, especially at the start of treatment or after a dose increase. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet low in salt and fat.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively.
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