Description
Amlodipine (generic name Amlodipine Besylate) is a class of calcium channel blockers. One of the amlodipine product on the market is Norvasc®.
Amlodipine functionalizes by the dilation of blood vessels and the improvement of blood flow, which lead to lowered blood pressure. Thereby, it is used to treat high bold pressure (hypertension). Lowering high blood pressure also reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions, and kidney problems. Amlodipine is also used to prevent certain types of chest pains (angina), which may help to increase the ability to exercise and decrease the frequency of angina attacks. Amlodipine can be used to treat coronary artery disease (CAD) including chronic stable angina, vasospastic angina, and angiographically documented CAD.
Mechanism of action
Amlodipine Besylate is a dihydropyridine calcium antagonist that prevents the transmembrane influx of calcium ions into the vascularsmooth and cardiacmuscle.It attaches to both dihydropyridine and non-dihydropyridine binding sites. The contractile manners of cardiac and vascular smooth muscle are dependent on the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine Besylate inhibits calcium ion influx across cell membranes selectively, with a superior effect on vascular smooth muscle cells than on cardiac muscle cells.
Clinical Use
Amlodipine besylate (ADB) is an important secondgeneration calcium channel blocker that belongs to the dihydropyridine family. It is used for the treatment of hypertension and angina. It is more selective for arterial vascular smooth muscle than for the cardiac tissue. It is approved for the treatment of hypertension and for variant and stable angina and may also be used for dilated cardiomyopathy. ADB has ameliorating effects on the plasma and myocardial catecholamine levels and significantly reduces calcium deposition. It has a negative inotropic effect on the heart that results in a decrease in heart work load.
https://baqai.edu.pk/baqaiassets/bjhs//admin/articlefiles/1525325965upl0.pdf
side effects
1. Heart Failure
Calcium-channel blockers are normally avoided in patients with heart failure but ADB has not been found to have any adverse effects on morbidity or mortality in patients with severe heart failure. Therefore, it may be a suitable treatment option for angina pectoris or hypertension in such patients. However, a study on hypertensive patients found that ADB was less effective than the diuretic chlorthalidone in the prevention of heart failure.
2. Porphyria
Although there have been reports of the successful use of ADB in patients with porphyria, some studies have reported the occurrence of acute exacerbation in such patients.
3. Miscellaneous Adverse Effects
A number of other adverse events occurring in response to the regular use of ADB in 1091 patients with hypertension have been reported. Around 12% (128) patients stopped the intake of the drug due to the appearance of adverse effects. The most common reported adverse effects include ankle edema, flushing, headache, skin rash, and fatigue.
Interaction with Combination Drugs
The evaluation of pharmacokinetic interactions between Amlodipine Besylate(ADB), valsartan and hydrochlorothiazide revealed no clinically relevant interactions. Similarly, combination of ADB and olmesartan medoxomil is also known to have no impact on the pharmacokinetic profiles of individual drugs. Concomitant use of ADB and atorvastatin in patients with hypertension and dyslipidemia has shown to be well tolerated without any adverse pharmacodynamic interaction. The use of triple combination i.e. ADB + Olmesartan Medoxomil + hydrochlorothiazide has also demonstrated to be safe .
References
[1] http://www.webmd.com/drugs/2/drug-5891/amlodipine-oral/details
[2] https://www.drugs.com/amlodipine.html
[3] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b4b30c56-7403-4f69-9a8e-3d82a37e8bc5#section-1
Description
Anilodipine besylate is a new, once-daily, dihydropyridine calcium antagonist useful in
the treatment of hypertension and angina.
Chemical Properties
White Crystalline Solid
Uses
Angiotensin II inhibitor prodrug, antihypertensive
Uses
A dihydropyridine calcium channel blocker. Used as an antianginal and antihypertensive
Uses
Amlodipine besylate is a L-type calcium channel blocker which may be used for the treatment of angina pectoris and hypertension. Amlodipine also inhibits growth of human epidermoid carcinoma A431 cells and has antireproductive effects in male rats.
Definition
ChEBI: The benzenesulfonate salt of amlodipine.
Manufacturing Process
2-[(2-Aminoethoxy)methyl]-4-(2-chlorophenyl)-3-ethoxycarbonyl-5-
methoxycarbonyl-6-methyl-1,4-dihydropyridine (amlodipine) was prepared
from 2-(phthalimidoaminoethoxy)acetoacetate, 2-chlorobenzaldehyde and
methyl-3-aminocrotonate under refluxing in ethanol for 24 hours. The
ketoester was prepared by the method of Troostwijk and Kellog (JCS Chem.
Comm., 1977, p.932). Methyl-3-aminocrotonate can be prepared by known
method. Phthalimido-amino-protecting group was removed using hydrazine
hydrate in ethanol at the reflux temperature.
Although amlodipine is effective as the free base, in practice it is best
administered form of a salt of a pharmaceutically acceptable acid.
Benzensulphonic salt of amlodipine was prepared as follows: Amlodipine base
(65.6 g, 0.161 mols) was slurried in industrial methylated spirit (denatured
alcohol, 326.4 ml) and cooled to 5°C. Benzensulphonic acid (26.2 g, 0.168
mols) was dissolved in industrial methylated spirit (65.6 ml) at 5°C and added
to base. The resulting slurry was then granulated, filtered and washed with 2
volumes the same solvent (65.6 ml). The damp solid was slurred at 5°C for 1
hr in 327.6 ml industrial methylated spirit, filtered, washed with 2 volumes of
the same solvent (65.6 ml) and dried under vacuum at 55°C for 24 hr. A yield
of besylate salt of amlodipine 65 g.
brand name
Norvasc (Pfizer);Istin.
Therapeutic Function
Antianginal, Antihypertensive
General Description
Pharmaceutical secondary standards for application in quality control, provide pharma laboratories and manufacturers with a convenient and cost-effective alternative to the preparation of in-house working standards. Amlodipine besylate is a calcium channel blocker, which inhibits the trans membrane influx of calcium ions into vascular smooth muscles and cardiac muscle. It belongs to the dihydropyridine family. It is used in combination with atorvastatin calcium to treat vasospastic angina, chronic stable angina, hypertension, in elevated serum triglyceride levels, primary dysbetalipoproteinemia.
Biological Activity
L-type calcium channel blocker that displays antihypertensive properties. Inhibits Ca 2+ -induced contractions in depolarized rat aorta (IC 50 = 1.9 nM) and displays vasoprotective effects in cardiovascular disease. Inhibits proliferation of human vascular smooth muscle cells and epidermoid carcinoma A431 cells (IC 50 = 25 μ M).
Biochem/physiol Actions
Amlodipine is an L-type calcium channel blocker. Amlodipine belongs to a class of cardiovascular drugs, which act at the voltage gated calcium channel of the CaV1, or L-type, class. Amlodipine also has antihypertensive and antianginal effects. Its activity resides mainly in the (-)-isomer. Amlodipine inhibits growth of human epidermoid carcinoma A431 cells and has antireproductive effects in male rats.
Veterinary Drugs and Treatments
Oral amlodipine appears to be a useful agent in the treatment of
hypertension in cats and many consider it the drug of choice for this
indication. In pharmacokinetic studies, amlodipine has decreased
blood pressure in dogs with chronic renal disease, but its efficacy in
treating
hypertensive dogs has been disappointing.
Hypertension in cats is usually secondary to other diseases (often
renal failure or cardiac causes such as thyrotoxic cardiomyopathy or
primary hypertrophic cardiomyopathy, etc.) and is most often seen
in middle-aged or geriatric cats. These animals often present with
acute clinical signs such as blindness, seizures, collapse or paresis. A
cat is generally considered hypertensive if systolic blood pressure is
>160 mmHg. Early reports indicate that if antihypertensive therapy
is begun acutely, some vision may be restored in about 50% of cases
of blindness secondary to hypertension.
References
[1] lee yj, park hh, koh sh, choi ny, lee ky. amlodipine besylate and amlodipine camsylate prevent cortical neuronal cell death induced by oxidative stress. j neurochem. 2011 dec;119(6):1262-70. doi: 10.1111/j.1471-4159.2011.07529.x.
[2] yoshida j, ishibashi t, nishio m. antiproliferative effect of ca2+ channel blockers on human epidermoid carcinoma a431 cells. eur j pharmacol. 2003 jul 4;472(1-2):23-31.
[3] henik ra, snyder ps, volk lm. treatment of systemic hypertension in cats with amlodipine besylate. j am anim hosp assoc. 1997 may-jun;33(3):226-34.
