The efficacy of amlodipine in the management of ischaemic heart disease.
Amlodipine is a dihydropyridine calcium antagonist that has unique pharmacokinetic properties. The drug is absorbed gradually after oral administration and so produces a gradual vasodilatation, reducing the incidence of side effects such as reflex tachycardia and headache, which can be troublesome with other calcium antagonists. Amlodipine also has a long elimination half-life, which makes it suitable for use on a once-daily basis. Controlled clinical studies have confirmed that a suitable dose regimen of amlodipine for use in angina is to start with 5 mg daily and increase this to 10 mg daily if required to control symptoms. Exercise testing carried out 24 hours post dose has confirmed that once-daily doses of amlodipine provide good anti-anginal and anti-ischaemic efficacy for a full 24 hours, a vital aspect of any therapy for ischaemic heart disease. Amlodipine has been shown to have comparable anti-anginal efficacy to the beta-blocker nadolol taken once daily and the calcium antagonist diltiazem taken 3 times daily. When added to the treatment regimen of patients with uncontrolled chronic stable angina despite treatment with nitrates, beta-blockers or both, amlodipine produces improved anti-anginal efficacy. Amlodipine has also been shown to be consistently effective in patients with vasospastic angina. There has been no evidence of tolerance to the anti-anginal effects of amlodipine in formal clinical trials involving treatment for up to 26 weeks.
McGibney
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Pfizer Central Research, Sandwich, Kent, UK.
D017311:Amlodipine; D000787:Angina Pectoris / Q000517:prevention & control; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003327:Coronary Disease / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006801:Humans; D009543:Nifedipine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
D002121:Calcium Channel Blockers; D017311:Amlodipine; D009543:Nifedipine