Indapamide, Amlodipine (as besilate)

Indications

Indapamide, Amlodipine (as besilate) is used for: INDAPAMIDE
For the treatment of hypertension, alone or in combination with other antihypertensive drugs, as well as for the treatment of salt and fluid retention associated with congestive heart failure or edema from pregnancy (appropriate only in the management of edema of pathologic origin during pregnancy when clearly needed). Also used for the management of edema as a result of various causes.
AMLODIPINE
For the treatment of hypertension and chronic stable angina.

Adult Dose

Child Dose

Renal Dose

Administration

Contra Indications

Precautions

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Indapamide, Amlodipine (as besilate) :

Mechanism of Action

INDAPAMIDE
Indapamide blocks the slow component of delayed rectifier potassium current (iks) without altering the rapid component (ikr) or the inward rectifier current. Specifically it blocks or antagonizes the action the proteins kcnq1 and kcne1. Indapamide is also thought to stimulate the synthesis of the vasodilatory hypotensive prostaglandin pge2.
AMLODIPINE
Amlodipine decreases arterial smooth muscle contractility and subsequent vasoconstriction by inhibiting the influx of calcium ions through l-type calcium channels. Calcium ions entering the cell through these channels bind to calmodulin. Calcium-bound calmodulin then binds to and activates myosin light chain kinase (mlck). Activated mlck catalyzes the phosphorylation of the regulatory light chain subunit of myosin, a key step in muscle contraction. Signal amplification is achieved by calcium-induced calcium release from the sarcoplasmic reticulum through ryanodine receptors. Inhibition of the initial influx of calcium decreases the contractile activity of arterial smooth muscle cells and results in vasodilation. The vasodilatory effects of amlodipine result in an overall decrease in blood pressure. Amlodipine is a long-acting ccb that may be used to treat mild to moderate essential hypertension and exertion-related angina (chronic stable angina). Another possible mechanism is that amlodipine inhibits vascular smooth muscle carbonic anhydrase i activity causing cellular ph increases which may be involved in regulating intracelluar calcium influx through calcium channels.