Hypertension with 3 or more risk factors for cardiovascular events (fatal and non-fatal coronary heart disease, the need for revascularization, fatal and non-fatal myocardial infarction, stroke, transient ischemic attack) with normal or moderately elevated cholesterol without clinically evident coronary heart disease. Used with inefficiency and other lipid-lowering diet nonpharmacologic treatment of dyslipidemia.
Contraindications:
Hypersensitivity, active liver disease or persistent increase in activity enzymes (more than 3-fold) of unknown etiology, marked hypotension (SBP less than 90 mm Hg), the use of women of reproductive age who are not using adequate methods of contraception, pregnancy , lactation, age 18 years.
Side effects:
Amlodipine Besylate. From the CCC: often - peripheral edema (ankles and feet), palpitations, rarely - excessive lowering of blood pressure, orthostatic hypotension, vasculitis, rarely - the development or worsening of heart failure is very rare - arrhythmias (bradycardia, ventricular tachycardia, atrial fibrillation), myocardial infarction, chest pain, migraine. Nervous system disorders: common - headache, dizziness, fatigue, drowsiness, rarely - malaise, fainting, fatigue, hypesthesia, paresthesia, peripheral neuropathy, tremor, insomnia, emotional lability, abnormal dreams, anxiety, depression, anxiety, rarely - convulsions, lethargy, agitation, and very rarely - ataxia, amnesia. From the digestive system: common - nausea, abdominal pain, rarely - vomiting, changes in bowel movements (including constipation, flatulence), indigestion, diarrhea, anorexia, dry mouth, thirst, rarely - gingival hyperplasia, increased appetite; very rare - gastritis, pancreatitis, hyperbilirubinemia, jaundice (usually cholestatic), increased activity of "liver" enzymes, hepatitis.
Atorvastatin Calcium. The nervous system: often - insomnia, headache, asthenia syndrome, rarely - malaise, dizziness, amnesia, paresthesia, peripheral neuropathy, hypoesthesia. From the digestive system: common - nausea, diarrhea, abdominal pain, dyspepsia, constipation, flatulence, rarely - vomiting, anorexia, hepatitis, pancreatitis, jaundice holestatitcheskaya. On the part of the musculoskeletal system: often - myalgia, rarely and seldom - back pain, muscle cramps, myositis, myopathy, arthralgia, rhabdomyolysis. Allergic reactions: rarely - rash, itching, rash, anaphylaxis, bullous eruption, polymorphic erythema, toxic epidermal necrolysis (Lyell's syndrome), malignant exudative erythema multiforme (Stevens-Johnson syndrome).
Dosage and administration:
Inside, with or without food at any time of the day: 1 tablet 1 time. One tablet contains 5 mg/10 mg and 10 mg/10 mg (Amlodipine Besylate, Atorvastatin Calcium, respectively). Initial and maintenance dose is selected individually based on effectiveness and tolerability of the two components. The initial dose of 5/10 mg (hypertension blood pressure should be monitored every 2-4 weeks, with the need to move to a dose of 10/10 mg). In CHD Amlodipine Besylate recommended dose is 5-10 mg 1 time per day. With primary hypercholesterolemia and combined (mixed) hyperlipidemia recommended dose of Atorvastatin Calcium - 10 mg 1 time per day, the therapeutic effect occurs within 2 weeks and reaches a maximum for 4 weeks, with prolonged treatment effect remains. The drug can be given to patients who are already taking one of the components of the drug in monotherapy. Used in combination with non-drug treatments for (diet, exercise, weight loss in obesity, smoking cessation).
Cautions:
Atorvastatin Calcium may increase serum CK activity, which should be taken into account in the differential diagnosis of chest pain. It should be borne in mind that the increase in the activity of CK in 10, compared with the norm, accompanied by myalgia and muscle weakness may be associated with myopathy, in which case treatment should be discontinued. Should regularly monitor liver function before treatment and after 6 and 12 weeks after starting the drug or after dose increases, and periodically (every 6 months) during the entire period of application (to the complete normalization of the patients in whom the activity of transaminases above normal value). Increased activity of "liver" enzymes is observed mainly in the first 3 months of treatment. Recommended to cancel or reduce the dose of the drug at higher performance of AST and ALT more than 3 times. Should temporarily stop using Atorvastatin Calcium in the development of clinical symptoms, implying the presence of acute myopathy, or the presence of factors predisposing to the development of acute renal failure on the background of rhabdomyolysis (severe infection, decreased blood pressure, major surgery, trauma, metabolic, endocrine, or severe electrolyte disturbances ).
