Alotendin

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Instructions for use:

1. Release form and composition
2. Indications for use
3. Contraindications
4. Method of application and dosage
5. Side effects
6. Special instructions
7. Drug interactions
8. Analogs
9. Terms and conditions of storage
10. Terms of dispensing from pharmacies

Alotendin is a combined antihypertensive drug containing a selective beta-blocker and a slow calcium channel blocker.

Release form and composition

Dosage form - tablets: oblong, slightly convex on both sides, almost white or white, with a line on one side and engraving (E 571, E 572, E 573 or E 574) on the other, odorless (7 pcs. In blister, in a cardboard box 4 or 8 blisters; 10 pcs. in a blister, in a cardboard box 3 or 9 blisters).

Active substances of the drug: amlodipine and bisoprolol (in the form of fumarate), their content, respectively, in tablets with engraving:

E 571 - 5 mg and 5 mg;
E 572 - 5 mg and 10 mg;
E 573 - 10 mg and 5 mg;
E 574 - 10 mg and 10 mg.

Excipients: microcrystalline cellulose, sodium carboxymethyl starch (type A), magnesium stearate, colloidal anhydrous silicon dioxide.

Indications for use

Arterial hypertension (as a monopreparation or in combination with other antihypertensive drugs);
Chronic stable angina pectoris (as a monotherapy or in combination with other antianginal drugs);
Replacement therapy for patients in whom blood pressure and / or chronic stable angina pectoris can be adequately controlled by the use of amlodipine with bisoprolol at the same doses.

Contraindications

Absolute:

Bradycardia (heart rate less than 60 beats / minute) before starting treatment;
Sick sinus syndrome;
Cardiogenic shock;
Severe aortic stenosis;
Atrioventricular block II or III degree (without pacemaker);
Arterial hypotension (systolic blood pressure <100 mm Hg);
Unstable angina;
Acute heart failure or episodes of heart failure requiring intravenous inotropic drugs;
Sinoatrial blockade;
Metabolic acidosis;
Late stages of peripheral arterial occlusive disease;
Severe Raynaud's syndrome;
Severe chronic obstructive pulmonary disease or severe bronchial asthma;
Untreated pheochromocytoma;
Psoriasis, including a history;
Lactation;
Age up to 18 years (due to insufficient data on the safety and effectiveness of the use of Alotendin);
Hypersensitivity to any component of the drug or dihydropyridine derivatives.

Carefully:

Arterial hypertension and angina pectoris associated with heart failure;
Diabetes mellitus with large fluctuations in blood glucose levels;
Hyperthyroidism;
Fasting or strict diet;
Prinzmetal's angina;
1st degree atrioventricular block;
Occlusive peripheral arterial disease;
Pheochromocytoma (Alotendin can be used only after blockade of alpha-adrenergic receptors);
Bronchial asthma and other chronic obstructive pulmonary diseases (it is necessary to carry out simultaneous bronchodilatory therapy);
Liver failure;
Simultaneous desensitizing therapy;
Surgical intervention under general anesthesia (the drug should be discontinued no later than 48 hours before anesthesia).

Method of administration and dosage

Alotendin should be taken orally 1 tablet once a day, in the morning, swallowing whole and drinking plenty of liquid. Food intake does not affect its effectiveness.

The doctor determines the specific dose individually.

Side effects

Classification of side effects: often (? 1/100 - <1/10), infrequently (? 1/1000 - <1/100), rarely (? 1/10 000 - <1/1000), very rarely (< 1/10 000), the frequency is unknown (based on the available data, an estimate cannot be made).

Possible adverse reactions:

From the side of the cardiovascular system: often - bradycardia, heart palpitations; infrequently - arterial hypotension, worsening of existing heart failure, AV-conduction disturbances;
From the nervous system: often - fatigue, drowsiness, vertigo, headache; infrequently - sleep disorders, visual disturbances, paresthesia, hypesthesia, syncope, taste perversion, mood changes, peripheral neuropathy, tremor, depression; rarely - nightmares, hearing impairment, hallucinations;
From the hematopoietic system: infrequently - thrombocytopenia, leukopenia, purpura;
From the digestive system: often - abdominal pain, diarrhea or constipation, nausea, vomiting; infrequently - dyspepsia, gingival hyperplasia, dry mouth, pancreatitis; rarely - an increase in the activity of hepatic enzymes, hepatitis; the frequency is unknown - gastritis, jaundice, cholestasis, hepatitis (these side effects are more often manifested at the beginning of treatment, are usually mild and disappear within 1-2 weeks);
On the part of the respiratory system: infrequently - rhinitis, shortness of breath, cough, bronchospasm or bronchial asthma in patients with a history of obstructive pulmonary disease;
From the musculoskeletal system: infrequently - arthralgia, muscle cramps, myalgia, muscle weakness, back pain;
From the endocrine system: often - hot flashes; infrequently - hyperglycemia, gynecomastia, impaired potency;
From the urinary system: infrequently - urination disorder, pollakiuria, nocturia;
From the side of the organ of vision: rarely - a decrease in the secretion of lacrimal fluid; very rarely - conjunctivitis;
Dermatological reactions: infrequently - increased sweating, skin discoloration, alopecia; very rarely - psoriasis-like changes on the skin, development or worsening of the course of psoriasis;
Allergic reactions: rarely - skin reactions, rash, itching, angioedema, allergic rhinitis, hypersensitivity reactions (hot flashes, itching, rash), exudative erythema multiforme; frequency unknown - urticaria;
On the part of the body as a whole: often - a feeling of coldness and numbness of the extremities, edema (including peripheral); infrequently - change in body weight (increase or decrease), asthenia, exhaustion, vasculitis; rarely - an increase in triglyceride levels.

There are isolated cases of such severe reactions as arrhythmia (atrial fibrillation and ventricular tachycardia), angina pectoris, myocardial infarction. They are connected with the underlying disease or with the use of Alotendin, it has not been reliably established.

special instructions

The drug should not be discontinued abruptly, especially in case of ischemic heart disease. possible deterioration of the clinical condition. It is recommended to gradually reduce the dose.

Alotendin reduces the secretion of lacrimal fluid, this should be taken into account in patients who wear contact lenses.

In some cases, the drug can affect the speed of reactions and the ability to concentrate, especially at the beginning of use, when changing the dose and simultaneously drinking alcohol.

Drug interactions

Alotendin should not be used concomitantly with class I calcium channel blockers (for example, verapamil) and class III (diltiazem), since they adversely affect contractility, blood pressure and atrioventricular conduction. Intravenous administration of verapamil to patients receiving beta-blockers (bisoprolol) can lead to severe arterial hypotension and atrioventricular blockade.

It is not recommended to combine Alotendin with centrally acting antihypertensive drugs (for example, methyldopa, moxonidine, clonidine, rilmenidine), since this combination can lead to vasodilation, decreased heart rate and cardiac output. In the case of abrupt withdrawal of the drug, the risk of developing a withdrawal syndrome, manifested in the form of hypertension, increases.

Alotendin should be used with caution together with the following drugs: long-acting nitrates, beta-blockers, thiazide diuretics, oral hypoglycemic drugs, nonsteroidal anti-inflammatory drugs, antibiotics, glyceryl trinitrate preparations for sublingual use.

In combination with the following drugs, Alotendin should also be used with great caution:

Derivatives of dihydropyridine (nifedipine), class II calcium channel blockers: may increase arterial hypotension; in patients with heart failure - to increase the likelihood of increasing further deterioration of the pumping function of the ventricles;
Parasympathomimetic drugs: can cause an increase in the time of atrioventricular conduction and thereby increase the risk of developing bradycardia;
Non-steroidal anti-inflammatory drugs: may reduce the antihypertensive effect of Alotendin;
Oral hypoglycemic drugs and insulin: can cause an increase in the hypoglycemic effect, due to the blockade of β-adrenergic receptors, it is possible to mask the symptoms of hypoglycemia;
Class I antiarrhythmic drugs (for example, propafenone, lidocaine, quinidine, phenytoin, disopyramide, flecainide): can increase the effect of the drug during atrioventricular conduction, and also potentiate the negative inotropic effect;
Class III antiarrhythmic drugs (eg, amiodarone): may increase the effect on atrioventricular conduction time;
Topical preparations containing a beta-blocker (for example, eye drops for the treatment of glaucoma): may interfere with the systemic effects of Alotendin;
Digitalis glycosides: May slow down heart rate and increase atrioventricular conduction time;
Antihypertensive drugs and other drugs with an antihypertensive effect (for example, phenothiazines, tricyclic antidepressants and barbiturates): may increase the risk of arterial hypotension;
Beta-sympathomimetic agents (for example, dobutamine and isoprenaline): May reduce the effect of both active ingredients of Alotendin.

In patients undergoing general anesthesia, beta-blockers (in this case, bisoprolol) reduce the incidence of arrhythmias and myocardial ischemia during induction of anesthesia, intubation and in the postoperative period. Currently, it is recommended to maintain beta-blockade perioperatively. The anesthesiologist should be mindful of beta blockade as there is a potential for interaction with other drugs, as a result of which a weakening of reflex tachycardia, the development of bradyarrhythmia, inhibition of the reflex ability to compensate for blood loss is possible. If it is necessary to stop taking Alotendin before surgery, this should be done gradually, completely completing the intake of the drug approximately 48 hours before anesthesia.

Mefloquine may increase the risk of bradycardia. Monoamine oxidase inhibitors (with the exception of type B inhibitors) can enhance the hypotensive effect of bisoprolol and increase the risk of developing a hypertensive crisis. The possibility of the simultaneous use of these drugs in each case is decided individually.

Analogs

The analogue of Alotendin is Niperten Combi.

Terms and conditions of storage

Store at temperatures up to 25 ° C in a dry, dark place out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!