Comparative Effect of Racemic Amlodipine and its Enantiomer with Atenolol on Hypertensive Patients—A Randomized, Open, Parallel Group Study

Rajanandh, Muhasaparur Ganesan; Parihar, Ashish Singh; Subramaniyan, K.

doi:10.1016/j.jecm.2013.10.007

Cited by 5 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…S-AM was also assessed in combination with other antihypertensives like atenolol [ 26 , 27 ] and telmisartan [ 28 , 29 ] and in patients receiving both angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) and beta blocker (BB) [ 16 ]. In studies of combination with atenolol and ACEI/ARB + BB, S-AM had similar antihypertensive efficacy compared to racemic amlodipine ( Table 1 ).…”

Section: S-amlodipine In Hypertensionmentioning

confidence: 99%

S-Amlodipine: An Isomer with Difference—Time to Shift from Racemic Amlodipine

Dalal

Mohan

Iyengar

et al. 2018

International Journal of Hypertension

View full text Add to dashboard Cite

Calcium channel blockers are among the first-line drugs for treatment of hypertension (HTN). S-amlodipine (S-AM), an S-enantiomer of amlodipine, is available in India and in other countries like China, Korea, Russia, Ukraine, and Nepal. Being clinically researched for nearly two decades, we performed in-depth review of S-AM. This review discusses clinical evidence from total 42 studies (26 randomized controlled trials, 14 observational studies, and 2 meta-analyses) corroborating over 7400 patients treated with S-AM. Efficacy and safety of S-AM in HTN in comparison to racemic amlodipine, used as monotherapy and in combination with other antihypertensives, efficacy in angina, and pleiotropic benefits with S-AM, are discussed in this review.

show abstract

Section: S-amlodipine In Hypertensionmentioning

confidence: 99%

S-Amlodipine: An Isomer with Difference—Time to Shift from Racemic Amlodipine

Dalal

Mohan

Iyengar

et al. 2018

International Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…The mechanism considered to occur in pedal edema is due to increased hydrostatic pressure across capillaries which result in reflex constriction of post capillary vessels. The management involves cessation of the drug and substitution with an alternative antihypertensive agent [4]. In this patient, a combination of angiotensin receptor blocker and thiazide diuretic is prescribed as an alternative therapy.…”

Section: Discussionmentioning

confidence: 99%

Amlodipine Induced Severe Pedal Edema: A Case Report from a Tertiary Care Hospital

Sanghavi¹,

Someshwari²,

Ganesan³

et al. 2017

J Pharmacovigil

View full text Add to dashboard Cite

Amlodipine is a fourth generation dihydropyridine derivative calcium channel blocker, mainly used in the treatment of hypertension, angina and certain other cardiac disorders. It is an L-type Ca2+ channel blocker, which leads to inhibitory action on the sympathetic N-type Ca2+ channels. The oral bioavailability of amlodipine is between 64% and 90%. The longer duration of action of amlodipine is due to a combination of high bioavailability, slow clearance and long half-life where by plasma concentration of the drug is above minimum effective concentration for a long time and show sustained efficacy. The most frequently occurring adverse effect with amlodipine therapy includes palpitation, flushing, ankle edema, hypotension, headache and nausea. PedaPl edema is a common adverse effect of calcium channel blocker (Amlodipine, Nifedipine, Diltiazem, Felodpine, Isradipine). We report a patient who developed pitting type pedal edema after treating with amlodipine for hypertension.Keywords: Amlodipine; Glimepride; Pedal edema Case DescriptionA 43 yrs old male patient was admitted to general medicine ward with complaints of swelling of the legs. On further interviewing, he was a known case of diabetes mellitus, under oral hypoglycemic agent of glimepride 2 mg and metformin 500 mg for past 1 yr. Before 3 months the patient was also diagnosed with hypertension and was under irregular medication.By examining the vital sign, blood pressure was found to be 160/90 mmHg, pulse rate 78 beats per minute and all other laboratory investigations such as complete blood count, liver function test urine analysis, chest X ray, electrocardiograph seems to be normal. The diabetic profile shows Random blood glucose -262 mg/dl, HbA1C-7%. From the subjective, laboratory examination and past history of the patient he was diagnosed with type II diabetes mellitus and hypertension. The patient was treated with glimepride 2 mg, metformin 500 mg and amlodipine 2.5 mg orally once daily. On the 4th day after initiation of amlodipine therapy, the patient was presented with pedal edema (pitting type). The physician interprets that the pedal edema was caused by amlodipine. On cessation of amlodipine the patient was recovered from edema and an alternative anti-hypertensive agent, telmisartan 40 mg and hydrochlorothiazide 12.5 mg once daily was prescribed.

show abstract

“…In fact, the reason for the inactivity of R(+)enantiomer is the inability to stereoselective binding to specific blood plasma proteins 15,[18][19][20] . Based on available literature resources, the antihypertensive activity of (S)-(-)-amlodipine is twice as high as that of racemic R/S-amlodipine [21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

Comparative assessment of the clinical efficacy of various amlodipine isomers in 1st and 2nd degree arterial hypertension patients

Ermakov¹,

Pashanova²

2021

Bangladesh J Med Sci

View full text Add to dashboard Cite

Objective: The paper presents the results of clinical trials of medications based on S-amlodipine and S/R-amlodipine. Materials and methods: A total of 140 patients diagnosed with arterial hypertension of I and II degree were included into study, in particular, 70 patients with 1st degree and another 70 patients with 2nd degree hypertensive disease. A group consisted of 80 male (57%) and 60 female patients (43%) aged from 45 to 73 years. The average age of the examined patients was 62.1±5.8 years. Duration of the disease was established between 1 and 22 years (12.5±1.2 years on average). Results and discussion: The stereoselectivity mechanisms of the studied amlodipine enantiomers were found to initiate the activity of only one S-amlodipine isomer. Applying S-amlodipine in treatment was proved to improve significantly the clinical results, facilitate the course of hypertensive disease, and normalize the structure and functional heart condition. After 8 weeks of amlodipine-based treatment, the diastolic pressure in groups receiving S-amlodipine reduced by 20-25% and systolic pressure reduction was between 20% and 31%. Among patients taking the original amlodipine medication consisting of S and R enantiomers, the diastolic pressure decrease was between 19.4% and 24%, and the systolic pressure reduced from 16.7% to 27.37%. Conclusions: By using S-amlodipine, the prescribed medication dosage can be reduced by 50%, which allows diminishing the drug load on the body and lessen the side effects. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.439-448

show abstract

Comparative Effect of Racemic Amlodipine and its Enantiomer with Atenolol on Hypertensive Patients—A Randomized, Open, Parallel Group Study

Cited by 5 publications

References 13 publications

S-Amlodipine: An Isomer with Difference—Time to Shift from Racemic Amlodipine

S-Amlodipine: An Isomer with Difference—Time to Shift from Racemic Amlodipine

Amlodipine Induced Severe Pedal Edema: A Case Report from a Tertiary Care Hospital

Comparative assessment of the clinical efficacy of various amlodipine isomers in 1st and 2nd degree arterial hypertension patients

Contact Info

Product

Resources

About