Amocal-AT
Generic Name
Amlodipine (as Besilate) 5 mg + Atenolol 50 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| amocal at 5 mg tablet | ৳ 6.02 | ৳ 84.28 |
Description
Overview of the medicine
Amocal-AT 5 mg Tablet is a combination medicine containing Amlodipine and Atenolol. It is primarily used to treat high blood pressure (hypertension) and angina pectoris.
Uses & Indications
Dosage
Adults
Typically, one tablet (Amlodipine 5 mg + Atenolol 50 mg) once daily. Dosage may be adjusted based on patient response and tolerability.
Elderly
Initiate with lower doses and monitor closely due to potential for decreased renal and hepatic function.
Renal_impairment
Atenolol is excreted renally; dosage adjustment is necessary for patients with severe renal impairment (creatinine clearance <35 ml/min). Amlodipine dosage typically does not require adjustment.
How to Take
Take orally with a glass of water, with or without food, usually at the same time each day.
Mechanism of Action
Amlodipine, a calcium channel blocker, dilates blood vessels, reducing peripheral vascular resistance. Atenolol, a beta-1 selective adrenergic blocker, reduces heart rate, cardiac output, and myocardial oxygen demand. Together, they effectively lower blood pressure and relieve angina symptoms.
Pharmacokinetics
Onset
Amlodipine: Gradual onset, full effect in 6-12 hours. Atenolol: Within 1 hour.
Excretion
Amlodipine: Primarily excreted in urine as inactive metabolites. Atenolol: Primarily excreted unchanged in urine.
Half life
Amlodipine: 30-50 hours. Atenolol: 6-7 hours.
Absorption
Amlodipine: Well absorbed orally, peak plasma concentration in 6-12 hours. Atenolol: Incompletely absorbed, ~50% bioavailability, peak plasma concentration in 2-4 hours.
Metabolism
Amlodipine: Extensively metabolized in the liver to inactive metabolites. Atenolol: Minimal hepatic metabolism.
Side Effects
Contraindications
- Cardiogenic shock
- Uncontrolled heart failure
- Severe bradycardia
- Hypotension
- Second or third-degree atrioventricular (AV) block
- Sick sinus syndrome
- Severe asthma or chronic obstructive pulmonary disease (COPD)
Drug Interactions
Alpha-1 blockers
Increased risk of first-dose hypotension.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Other antihypertensives
Additive hypotensive effect.
Non-steroidal anti-inflammatory drugs (NSAIDs)
May reduce the antihypertensive effect.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase amlodipine plasma concentrations.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, cardiac insufficiency, and bronchospasm. Management involves supportive measures, including administration of IV fluids, vasopressors, atropine, and glucagon as appropriate.
Pregnancy & Lactation
Pregnancy Category C for Amlodipine and D for Atenolol (especially in 2nd/3rd trimesters). Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Atenolol is excreted in breast milk; Amlodipine is also detected. Consult a doctor before use during lactation.
Side Effects
Contraindications
- Cardiogenic shock
- Uncontrolled heart failure
- Severe bradycardia
- Hypotension
- Second or third-degree atrioventricular (AV) block
- Sick sinus syndrome
- Severe asthma or chronic obstructive pulmonary disease (COPD)
Drug Interactions
Alpha-1 blockers
Increased risk of first-dose hypotension.
Digitalis glycosides
Increased risk of bradycardia and AV block.
Other antihypertensives
Additive hypotensive effect.
Non-steroidal anti-inflammatory drugs (NSAIDs)
May reduce the antihypertensive effect.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase amlodipine plasma concentrations.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, cardiac insufficiency, and bronchospasm. Management involves supportive measures, including administration of IV fluids, vasopressors, atropine, and glucagon as appropriate.
Pregnancy & Lactation
Pregnancy Category C for Amlodipine and D for Atenolol (especially in 2nd/3rd trimesters). Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Atenolol is excreted in breast milk; Amlodipine is also detected. Consult a doctor before use during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Generic drug available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Amlodipine-Atenolol fixed-dose combination in managing hypertension and angina.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Renal function tests (e.g., serum creatinine, BUN)
- Liver function tests (e.g., ALT, AST)
Doctor Notes
- Monitor patient's blood pressure and heart rate regularly.
- Advise patients on the importance of gradual withdrawal to avoid rebound effects, especially in patients with ischemic heart disease.
- Consider dosage adjustment in elderly patients and those with renal impairment.
Patient Guidelines
- Take the medicine regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking this medicine abruptly without consulting your doctor.
- Report any unusual symptoms or side effects to your healthcare provider.
- Maintain a healthy lifestyle, including diet and exercise.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness, fatigue, or drowsiness. Avoid driving or operating heavy machinery until you know how it affects you.
Lifestyle Advice
- Follow a low-sodium, low-fat diet.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress through relaxation techniques.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.