Duplekor

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

Duplekor: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Drug interactions
14. Analogs
15. Terms and conditions of storage
16. Terms of dispensing from pharmacies
17. Reviews
18. Price in pharmacies

Latin name: Duplecor

ATX code: C10BX03

Active ingredient: Amlodipine + Atorvastatin (Amlodipine + Atorvastatin)

Producer: Gedeon Richter Romania (Romania)

Description and photo update: 2018-27-07

Duplekor is an antihypertensive and hypolipidemic drug.

Release form and composition

Duplekor is produced in the form of film-coated tablets, biconvex, having a white color:

5 mg + 10 mg: round, with “CE3” written on one side;
5 mg + 20 mg: oblong, with “CE4” written on one side;
10 mg + 10 mg: round, with “CE5” written on one side;
10 mg + 20 mg: oblong, with “CE6” written on one side.

10 tablets in a blister of PA / Al / PVC film and aluminum foil, 3 blisters in a carton box.

Composition of 1 tablet Duplekor 5 mg + 10 mg:

active ingredients: atorvastatin lysinate - 12.628 mg (equivalent to atorvastatin content - 10 mg), amlodipine besylate - 6.944 mg (equivalent to amlodipine content - 5 mg);
auxiliary substances: polysorbate, microcrystalline cellulose (type 102), calcium carbonate, pregelatinized starch, sodium carboxymethyl starch (type A), croscarmellose sodium, colloidal silicon dioxide, magnesium stearate, hyprolose, calcium oxide;
shell: white opadry II 85F18422, [partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), talc, macrogol 4000].

Composition of 1 tablet Duplekor 10 mg + 10 mg:

active ingredients: atorvastatin lysinate - 12.628 mg (equivalent to atorvastatin content - 10 mg), amlodipine besylate - 13.888 mg (equivalent to amlodipine content - 10 mg);
auxiliary substances: polysorbate, calcium carbonate, pregelatinized starch, sodium croscarmellose, sodium carboxymethyl starch (type A), colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose (type 102), hyprolose, calcium oxide;
shell: white opadry II 85F18422 [partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), talc, macrogol 4000].

Composition of 1 tablet Duplekor 5 mg + 20 mg:

active ingredients: atorvastatin lysinate - 25.256 mg (corresponds to the content of atorvastatin - 20 mg), amlodipine besylate - 6.944 mg (corresponds to the content of amlodipine - 5 mg);
excipients: polysorbate, microcrystalline cellulose (type 102), calcium carbonate, pregelatinized starch, croscarmellose sodium, sodium carboxymethyl starch (type A), colloidal silicon dioxide, magnesium stearate, hyprolose, calcium oxide;
shell: white opadry II 85F18422 [partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), macrogol 4000, talc].

Composition of 1 tablet Duplekor 10 mg + 20 mg:

active ingredients: atorvastatin lysinate - 25.256 mg (corresponds to the content of atorvastatin - 20 mg), amlodipine besylate - 13.888 mg (corresponds to the content of amlodipine - 10 mg);
excipients: polysorbate, microcrystalline cellulose (type 102), calcium carbonate, pregelatinized starch, croscarmellose sodium, sodium carboxymethyl starch (type A), colloidal silicon dioxide, magnesium stearate, hyprolose, calcium oxide;
shell: white opadry II 85F18422 [partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), macrogol 4000, talc].

Pharmacological properties

Pharmacodynamics

Duplekor is a combined action drug. It contains two medicinal substances: atorvastatin, an inhibitor of HMG-CoA reductase (3-hydroxy-3-methylglutaryl-coenzyme A), a hypolipidemic agent, and amlodipine, a slow calcium channel blocker, a dihydropyridine derivative.

Atorvastatin

Competitively and selectively, the drug inhibits HMG-CoA reductase, which catalyzes the conversion of 3-hydroxy-3-methylglutaryl-coenzyme A into the steroid precursor mevalonic acid, including cholesterol. Cholesterol and triglycerides in the liver enter the composition of very low density lipoprotein cholesterol (VLDL cholesterol), are transferred to peripheral tissues, which is explained by their ability to penetrate into the blood plasma.

Due to a decrease in the concentration of lipoproteins and cholesterol in the blood plasma under the influence of atorvastatin, the capture and catabolism of LDL cholesterol (low density lipoprotein cholesterol) increases. Atorvastatin reduces the formation of LDL cholesterol, increasing the activity of LDL cholesterol receptors, while simultaneously beneficially affecting the LDL particles.

Atorvastatin reduces the concentration of apolipoprotein B, total cholesterol, LDL cholesterol and triglycerides, while simultaneously leading to an increase in the concentration of apolipoprotein A1 and HDL cholesterol (high density lipoprotein cholesterol).

Due to the inhibition of HMG-CoA reductase, the synthesis of cholesterol in the liver and an increase in the number of hepatic LDL cholesterol receptors on the cell surface, atorvastatin is effective for lowering in patients with hereditary homozygous hypercholesterolemia (i.e., in a group of patients usually resistant to treatment with other lipid-lowering drugs) concentration LDL cholesterol. The risk of ischemic complications (including myocardial infarction with a fatal outcome) when taking atorvastatin decreases by 16%, the risk of re-hospitalization for angina pectoris accompanied by signs of myocardial ischemia decreases by 26%. With atorvastatin therapy, the risk of developing the following complications is significantly reduced:

36% - coronary complications (IHD with a fatal outcome and non-fatal MI);
29% - general coronary complications;
26% - stroke (fatal and non-fatal);
20% - revascularization procedures and general complications of the cardiovascular system.

Amlodipine

Amlodipine prevents calcium ions from entering the smooth muscle cells of the myocardium and blood vessels through the membranes. The hypotensive effect of amlodipine is a consequence of a direct relaxing effect on vascular smooth muscle. The exact mechanism of action of amlodipine in angina pectoris has not been finally described, but it is known that it reduces ischemia in the following ways:

reduces the total peripheral vascular resistance (i.e., afterload on the heart) due to the expansion of peripheral arterioles. In this case, the heart rate does not change, there is a decrease in the load on the heart, which leads to a decrease in the need for oxygen and less energy consumption;
promotes the expansion of the main coronary arteries, coronary arterioles in unchanged and ischemic zones of the myocardium. Due to this, with vasospastic angina (variant angina, or Prinzmetal's angina), oxygen supply to the myocardium increases.

With angina pectoris, a single dose of amlodipine increases the time of the ability to perform physical activity, prevents depression of the ST segment and the development of an angina attack, reduces the frequency of angina attacks and the number of short-acting nitroglycerin tablets (sublingual) taken. Application is possible with diabetes mellitus, gout, bronchial asthma.

Reception of amlodipine does not worsen the clinical condition (ejection fraction of the left ventricle, heart, exercise tolerance and clinical symptoms) in patients with heart failure III – IV functional class (according to NYHA classification).

Pharmacokinetics

Atorvastatin

When taken orally, atorvastatin is rapidly absorbed, within 1–2 hours its maximum plasma concentration is reached. With an increase in the dose of atorvastatin, the degree of its absorption also increases. Bioavailability is approximately 12%.

The average volume of distribution of the substance is 381 liters. The connection of atorvastatin with blood plasma proteins is more than 98%.

Metabolism of atorvastatin occurs with the help of isoenzymes of the cytochrome P4503A4 system to orthohydroxylated and parahydroxylated derivatives and various beta-oxidation products.

Approximately 70% of the decrease in the activity of HMG-CoA reductase occurs due to the action of active circulating metabolites.

Atorvastatin is excreted in the bile after extrahepatic and / or hepatic metabolism. The drug does not undergo significant intestinal-hepatic recirculation. The half-life of atorvastatin from blood plasma is approximately 14 hours. Due to the effect of active metabolites, the period of half the decrease in the inhibitory activity of HMG-CoA reductase is 20-30 hours.

In patients with liver disease caused by alcohol abuse (class B according to the Child-Pugh classification), the concentrations of atorvastatin and its metabolites in the blood are significantly increased.

Amlodipine

Amlodipine is well absorbed when taken orally. After 6–12 hours, the maximum concentration of the substance in the plasma is reached. With food intake, the bioavailability of amlodipine does not change and is 64–80%.

The connection with blood proteins of circulating amlodipine is almost 97%. The volume of distribution is 21 liters. With regular intake of amlodipine, its equilibrium plasma concentrations are reached within a week.

Amlodipine is metabolized in the liver to form inactive metabolites, 10% of unchanged amlodipine and 60% in the form of metabolites are excreted by the kidneys. The approximate half-life from blood plasma is 30-50 hours.

The degree of renal failure does not affect the concentration of amlodipine in plasma. In patients with impaired renal function, it is possible to take the usual initial doses of the drug. During dialysis, amlodipine is not excreted.

Liver dysfunction leads to an increase in the half-life.

Indications for use

Duplekor is used for combination therapy with low doses of atorvastatin and amlodipine.

The drug is intended for the treatment of arterial hypertension in patients with dyslipidemia, regardless of the presence or absence of clinically expressed coronary heart disease, in the presence of the following conditions / diseases:

familial homozygous hypercholesterolemia;
primary hypercholesterolemia (including familial hypercholesterolemia), joint hyperlipidemia (consistent with type IIa and IIb according to Fredrickson's classification);
lipid-lowering diet and other non-pharmacological treatments for dyslipidemia (proved ineffective).

Contraindications

Absolute:

pregnancy and lactation;
severe arterial hypotension (with systolic blood pressure less than 90 mm Hg);
hemodynamically unstable heart failure after acute myocardial infarction;
liver disease in the active stage or a persistent increase in the activity of liver enzymes (more than 3 times higher than normal);
shock (including cardiogenic);
use in women of reproductive age who do not use adequate methods of contraception;
combined use with ketoconazole, itraconazole and telithromycin;
high sensitivity to Duplexor components and dihydropyridine derivatives;
age up to 18 years.

Relative:

acute myocardial infarction (also 1 month after it);
sick sinus syndrome;
extensive surgical interventions (trauma);
non-ischemic etiology of III – IV functional class according to NYHA classification;
hypertrophic obstructive cardiomyopathy;
personal or family history of muscle disease;
hypothyroidism;
myotoxicity while taking other inhibitors of HMG-CoA reductase or fibrates;
arterial hypotension;
metabolic and endocrine disorders;
severe violations of water and electrolyte balance;
acute infections (sepsis);
uncontrolled epilepsy;
age from 65 years.

Instructions for the use of Duplekor: method and dosage

Duplekor should be taken orally, regardless of food intake and time of day.

The recommended dose is 1 tablet once a day.

The maximum dose of the drug Duplekor is 1 tablet with a dosage of 10 mg + 20 mg (amlodipine + atorvastatin, respectively) per day.

Taking the drug should be accompanied by other, non-drug methods of treatment, such as exercise, diet, smoking cessation, in obese patients - weight loss.

The recommended dose (for amlodipine) for ischemic heart disease (ischemic heart disease) is 5-10 mg / day.

In case of arterial hypertension, at the beginning of therapy, Duplekor is used at a dose of 5 mg + 10 mg with mandatory control of blood pressure (blood pressure) every 2-4 weeks, subsequently, if necessary, an increase in the dose is allowed and Duplekor is prescribed 10 mg + 10 mg once a day …

According to the instructions, Duplekor is contraindicated for use in patients with active liver diseases or with a persistent increase in the activity of liver enzymes in the blood serum, exceeding the upper limit of the norm by 3 times.

Side effects

Atorvastatin:

blood and lymphatic system: infrequently - thrombocytopenia;
allergic reactions: often - hypersensitivity; very rarely - anaphylactic reactions, bullous rash, including erythema multiforme, Steven-Johnson syndrome and toxic epidermal necrolysis, angioedema;
metabolism and nutrition: often - hyperglycemia; very rarely - hypoglycemia;
psyche: infrequently - insomnia, nightmares;
nervous system: often - headache; infrequently - dizziness, hypesthesia, dysgeusia, paresthesia, amnesia; rarely, peripheral neuropathy;
organ of hearing and labyrinth: infrequently - tinnitus;
respiratory system, chest and mediastinal organs: often - chest pain; pain in the nasopharynx, nosebleeds;
digestive tract: often - abdominal pain, diarrhea, constipation, flatulence, nausea, dyspepsia; very rarely - vomiting;
hepatobiliary system: rarely - cholestatic jaundice, hepatitis, pancreatitis; very rarely - liver failure;
skin and subcutaneous fat: often - skin rash, itching; infrequently - alopecia;
musculoskeletal system and connective tissue: often - back pain, myalgia, arthralgia; infrequently - myopathy; rarely - rhabdomyolysis, myositis, muscle spasms;
reproductive system and mammary gland: infrequently - erectile dysfunction; very rarely - gynecomastia;
general disorders and local reactions: often - chest pain, increased fatigue, asthenia; rarely - peripheral edema;
laboratory tests: often - an increase in the activity of liver enzymes, as well as creatine phosphokinase in the blood serum; very rarely - an increase in body weight.

Amlodipine:

blood and lymphatic system: very rarely - leukopenia, thrombocytopenia;
allergic reactions: very rarely - hypersensitivity, urticaria, Stevens-Johnson syndrome, erythema multiforme, exfoliative dermatitis, angioedema, photosensitivity;
metabolism and nutrition: very rarely - hyperglycemia;
psyche: infrequently - insomnia, mood lability (including anxiety), depression; rarely - confusion of consciousness;
nervous system: often - dizziness, drowsiness, headache (especially at the beginning of treatment); infrequently - tremor, fainting, hypesthesia, dysgeusia, paresthesia; very rarely - muscle hypertonicity, peripheral neuropathy;
organ of vision: infrequently - visual impairment (including diplopia);
organ of hearing and labyrinth: infrequently - tinnitus;
cardiovascular system: often - rush of blood to the skin of the face, peripheral edema of the ankles and feet; infrequently - a feeling of palpitations, a marked decrease in blood pressure; very rarely - myocardial infarction (including bradycardia, ventricular tachycardia and atrial fibrillation), vasculitis;
respiratory system, organs of the chest and mediastinum: infrequently - shortness of breath, rhinitis; very rarely - cough;
digestive tract: often - abdominal pain, nausea; infrequently - vomiting, dyspepsia, intestinal dysfunction (constipation or diarrhea), dryness of the oral mucosa; very rarely - pancreatitis, gastritis, hypertrophic gingivitis;
hepatobiliary system: very rarely - hepatitis, cholestatic jaundice;
skin and subcutaneous fat: infrequently - alopecia, purpura, skin pigmentation disorders, hyperhidrosis, skin rash, itching, exanthema;
musculoskeletal system and connective tissue: often - ankle swelling; infrequently - arthralgia, myalgia, muscle spasms, back pain;
kidneys and urinary tract: infrequently - urinary disorders, nocturia, pollakiuria;
reproductive system and mammary gland: infrequently - erectile dysfunction, gynecomastia;
local reactions: often - edema, increased fatigue; infrequently - asthenia, chest pain, pain, general malaise;
laboratory tests: infrequently - an increase or decrease in body weight; rarely - an increase in the activity of hepatic transaminases.

Overdose

Overdose cases of Duplekor are not described.

A significant increase in the clearance of the drug during hemodialysis is unlikely, due to the fact that both of its active substances actively bind to blood plasma proteins.

In case of an overdose of amlodipine, the following symptoms can be observed: excessive peripheral vasodilation, leading to reflex tachycardia, a pronounced and persistent decrease in blood pressure, which can lead to the development of shock and death.

Treatment of an overdose of amlodipine: activated charcoal - 10 mg immediately or within 2 hours after taking amlodipine. In some cases, gastric lavage. A pronounced decrease in blood pressure requires active measures aimed at maintaining the function of the cardiovascular system and monitoring the performance of the heart and lungs, controlling the volume of circulating blood and urine output, as well as the position of the limbs on the dais. To restore blood pressure and vascular tone, it is recommended to take a vasoconstrictor drug, if there are no contraindications to taking it. To eliminate the consequences of calcium channel blockade - intravenous administration of calcium gluconate.

Symptoms of an atorvastatin overdose have not been described.

Treatment of atorvastatin overdose: symptomatic and supportive therapy as needed.

special instructions

There is a risk of pulmonary edema in patients with CHF (NYHA functional class III – IV) of non-ischemic etiology while taking amlodipine, this group of patients should be prescribed the drug with extreme caution.

Myalgia is sometimes observed in patients taking atorvastatin. In such cases, it is necessary to control the activity of CPK (creatine phosphokinase). If the CPK activity is more than 5 times higher than the upper limit of the norm, the CPK activity should be monitored regularly for 5-7 days to confirm the results.

Situations in which the activity of CPK should be determined before starting therapy with atorvastatin:

a history of alcohol abuse and / or liver disease;
own and family history of muscle diseases;
hypothyroidism;
a history of myotoxicity while taking other HMG-CoA reductase inhibitors or fibrates;
a history of liver disease and / or alcohol abuse;
age over 65 years in the presence of risk factors for the development of rhabdomyolysis.

It is necessary to carefully weigh the expected benefits and risks of therapy and regularly monitor patients. If the CPK activity is increased by more than 5 times compared to the upper limit of the norm, treatment should not be started.

Control of CPK activity should be carried out if muscle pain, cramps or weakness occur during treatment. If it becomes known that the activity of CPK more than 5 times exceeded the upper limit of the norm, therapy should be stopped.

After the return to the norm of CPK activity and after the symptoms disappear, it is allowed to re-prescribe the drug with a lower dose of atorvastatin, but only under the supervision of a doctor.

Influence on the ability to drive vehicles and complex mechanisms

The effect of Duplekor on the ability to drive vehicles and use complex mechanisms has not been studied, but given the possible excessive lowering of blood pressure, the likelihood of developing dizziness and fainting, caution should be exercised when driving vehicles and operating mechanisms.

Application during pregnancy and lactation

Reception of Duplekor is contraindicated in pregnant women. Women of reproductive age can use the drug only if the chance of pregnancy is low and should be informed about the likelihood of the risk to the fetus.

When pregnancy is detected, therapy should be discontinued and alternative treatment initiated, if necessary.

The use of the drug Duplekor during lactation is also contraindicated, since there is no data on whether atorvastatin, amlodipine and their metabolites are excreted in breast milk.

Pediatric use

Duplekor is contraindicated for persons under the age of 18.

With impaired renal function

Patients with impaired renal function can take normal doses of Duplekor.

For violations of liver function

When planning and during treatment with atorvastatin, it is necessary to monitor liver function. In the event that the increase in the activity of hepatic enzymes exceeds the upper limit of the norm by 3 times, it is recommended to reduce the dose of the drug or interrupt therapy.

Due to the fact that with impaired liver function, the half-life of amlodipine increases, such patients should be prescribed the drug with extreme caution.

Drug interactions

Interactions with atorvastatin

The following combinations are contraindicated:

itraconazole, ketoconazole: the metabolism of atorvastatin decreases in the liver, and therefore the risk of dose-dependent adverse events (for example, rhabdomyolysis) increases;
telithromycin: the risk of dose-dependent adverse events (for example, rhabdomyolysis) increases, the metabolism of atorvastatin in the liver decreases.

It is not recommended to combine gemfibrozil and other fibric acid derivatives, as the risk of unwanted dose-related events (rhabdomyolysis) increases.

The following combinations are used with extreme caution:

inhibitors of isoenzymes or the cytochrome P ₄₅₀ ZA4 system: atorvastatin is metabolized by isoenzymes of the cytochrome P _{450 system}, CYPZA4;
the CYP3A4 inhibitor, erythromycin, increases the plasma concentration of atorvastatin by 40%. Co-administration of atorvastatin and CYP3A4 inhibitors, some macrolide antibiotics (eg, clarithromycin, erythromycin), amiodarone, protease inhibitors or antidepressants, immunosuppressants (cyclosporine), antifungal agents related to azoles (eg, itraconazole, ketoconazonazole) will lead to an increase in the plasma concentration of atorvastatin. In this regard, atorvastatin should be used with caution with the above drugs;
inducers of isoenzymes of the cytochrome P ₄₅₀ ZA4 system: the simultaneous use of atorvastatin and inducers of isoenzymes of the cytochrome P ₄₅₀ ZA4 system (for example, rifampicin, phenytoin) can lead to a significant decrease in the concentration of atorvastatin in the blood plasma. In connection with these properties of rifampicin (inhibition of the hepatocyte capture transporter OATP1B1 and induction of enzymes of the cytochrome P ₄₅₀ 3A4 system), simultaneous therapy with atorvastatin and rifampicin led to an average increase in the C _max and AUC parameters of atorvastatin by 90% and 12%, respectively. Conversely, a decrease in the concentration of atorvastatin in blood plasma by approximately 80% was accompanied by the intake of atorvastatin some time after the use of rifampicin;
warfarin: coadministration of atorvastatin with warfarin can provoke an increase in the anticoagulant effect with the risk of bleeding. Patients receiving warfarin therapy should be monitored by the attending physician, as the dose of the anticoagulant may need to be adjusted;
nicotinic acid: lipid-lowering doses of nicotinic acid (more than 1 g / day) when taken together with HMG-CoA reductase inhibitors may increase the risk of myopathy. In rare cases, renal failure may develop as a result of rhabdomyolysis and myoglobinuria. Therefore, it is necessary to weigh the expected benefits and the potential risk of the combined use of atorvastatin and nicotinic acid in lipid-lowering doses.

Combinations allowed for use:

antacids: a decrease in the concentration of atorvastatin in blood plasma by about 35%, however, the degree of decrease in the content of LDL cholesterol does not change;
grapefruit juice: an increase in plasma concentrations of drugs, the metabolism of which occurs with the help of isoenzymes of the cytochrome CYP3A4 system;
oral contraceptives: increased plasma concentrations of norethisterone and ethinyl estradiol;
colestipol: the hypolipidemic effect of co-administration with colestipol is superior to that for each drug separately, despite a decrease in the concentration of atorvastatin by 25% when it is used together with colestipol.

Interactions with amlodipine

Combinations not recommended for use: infusion solution of dantrolene (in animals that were co-administered intravenously with verapamil and dantrolene, ventricular fibrillation often occurred; joint use of amlodipine and dantrolene should be avoided).

The following combinations should be used with extreme caution:

inducers of the CYP3A4 isoenzyme: antiepileptic drugs (for example, carbamazepine, phenobarbital, phenytoin, fophenytoin, primidone), rifampicin: due to the induction of the metabolism of amlodipine, it is possible to decrease the concentration of slow calcium channel blockers, in particular amlodipine, in the blood plasma. When taking the above inducers of the CYP3A4 isoenzyme, clinical observation is recommended and, if necessary, correction of the dose of amlodipine, otherwise the simultaneous administration of the inducer of the CYP3A4 isoenzyme should be discontinued;
baclofen: enhances the hypotensive effect (it may be necessary to monitor blood pressure and reduce the dose of the antihypertensive drug);
CYP3A4 isoenzyme inhibitors: while healthy young volunteers took an inhibitor of the CYP3A4 isoenzyme - erythromycin, and elderly patients took the CYP3A4 isoenzyme - diltiazem, an increase in the concentration of amlodipine in blood plasma by 22% and 50%, respectively, was noted, but the clinical significance of these data remained unknown. It is possible that potent inhibitors of the CYP3A4 isoenzyme (eg, ketoconazole, itraconazole, ritonavir) are more likely to lead to an increase in the concentration of amlodipine in the blood plasma than diltiazem.

Combinations allowed for use:

a1-adrenergic receptor blockers (prazosin, doxazosin, alfuzosin, tamsulosin, terazosin): increased hypotensive effect, risk of severe orthostatic hypotension;
amifostine: increased hypotensive effect due to the manifestation of its undesirable effects;
tricyclic antidepressants and neuroleptics: risk of orthostatic hypotension or arterial hypotension;
beta-blockers (carvedilol, bisoprolol, metoprolol): risk of developing heart failure or arterial hypotension in case of latent or uncontrolled heart failure;
corticosteroids, tetracosactide: weakening of the hypotensive effect;
antihypertensive drugs: strengthening the hypotensive effect of amlodipine;
nitrates, sildenafil: lowering blood pressure (blood pressure);
cimetidine, atorvastatin, aluminum, magnesium-containing antacids, grapefruit juice: do not affect the pharmacokinetics of amlodipine.

Interaction studies have shown that amlodipine does not affect the pharmacokinetics of atorvastatin, digoxin, warfarin, cyclosporine and alcohol.

With the simultaneous administration of blockers of slow calcium channels with lithium preparations, there is a possibility of an increase in the manifestation of their neurotoxicity (tinnitus, ataxia, tremor, nausea, vomiting, diarrhea).

Other interactions

No interaction of atorvastatin with antibiotics, non-steroidal anti-inflammatory drugs, cimetidine, hypoglycemic drugs, antihypertensive drugs was noted.

Amiodarone and verapamil inhibit the activity of cytochrome CYP3A4 enzymes, therefore, their combined use with atorvastatin can lead to an increase in the concentration of atorvastatin.

Antipyrine (phenazone): repeated joint administration of doses of atorvastatin and phenazone showed little or no effect on the clearance of phenazone.

With prolonged combined use of digoxin with 10 mg of atorvastatin, a slight increase in the equilibrium concentrations of the latter was noted.

With the combined use of atorvastatin with fusidic acid, rhabdomyolysis may develop.

Analogs

Duplekor analogues are: Atoris Combi, Kaduet.

Terms and conditions of storage

Shelf life is 2 years.

Store in a dry place at a temperature not exceeding 25 ° С, out of direct sunlight, keep out of the reach of children.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Duplekor

There are few reviews about Duplekor, indicating the effectiveness of the drug and its relatively low cost.

Price for Duplekor in pharmacies

Price for Duplekor (30 tablets in a package):

5 mg + 10 mg - about 480 rubles;
10 mg + 10 mg - about 530 rubles;
5 mg + 20 mg - about 770 rubles;
10 mg + 20 mg - about 550 rubles.

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

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