Efficacy and tolerability of fixed dose combination of metoprolol and amlodipine in Indian patients with essential hypertension

Abstract

Background:This open-labeled, post-marketing study was conducted to assess the efficacy and tolerability of fixed dose combination of amlodipine and metoprolol extended release capsules in mild to moderate hypertension in adult Indian patients.Materials and Methods:Of 101 enrolled patients, 64 drug naïve patients were treated with regimen A (amlodipine 5 mg + metoprolol 25 mg) and those with prior history of hypertension (n = 37) were treated with regimen B (amlodipine 5 mg + metoprolol 50 mg) for 8 weeks. Treatment response was assessed at week 4 and 8. Dose up titration to regimen B was carried out for those who failed to achieve the target blood pressure (BP) at week 4 in regimen A and additional antihypertensives were added to those in regimen B. Safety laboratory tests were performed at baseline and end of study.Results:Mean age (±SD) of patients was 53.36 (±11.26) years and body weight (±SD) 63.40 (10.03) kg. Ninety five patients (94.06%) were only hypertensive and 6 (5.94%) had hypertension with history of coronary artery disease; mean duration (±SD) of hypertension was 42.50 (48.07) months. At baseline, patients had a mean (±SD) systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 154.98 (±7.76) mmHg and 95.55 (±5.70) mmHg respectively. There was a statistically significant (P < 0.001) reduction of 12.16% and 14.69% in SBP, 11.49% and 14.65% in DBP at week 4 and week 8 respectively, compared to baseline. Normalization of overall BP was achieved in 49.49% and 70.71% patients at week 4 and 8, respectively. Peripheral edema was reported in 2.97% (3/101) patients.Conclusion:This combination was safe, efficacious, and well-tolerated in study population.

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

“…[ 285 ] Furthermore, some patients require a combination of two drugs in order to achieve a recommended BP target. Several Indian studies evaluated the efficacy of some FDCs: losartan 50 mg plus ramipril 2.5 mg vs each alone,[ 587 ] metoprolol extended release (XL) plus amlodipine vs losartan plus amlodipine,[ 588 ] metoprolol and amlodipine,[ 589 ] and reported that the FDCs were effective, safe and well-tolerated in patients with hypertension. …”