Escordi Cor tabs 5mg #30

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Escordi Cor user manual

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EsCordi Cor is a drug with antianginal and hypotensive action; calcium channel blocker.

Release form and composition

The drug is produced in the form of tablets: flat, heart-shaped with beveled edges, yellow (5 mg) or light yellow (2.5 mg) interspersed, on one side the inscription "A", on the other (depending on the dosage) - " 2.5 "or" 5 "(10 pcs. In a blister; in a cardboard box 3 or 5 blisters and instructions for the use of EsCordi Cor).
1 tablet contains:
    active substance: S (-) amlodipine besylate in terms of S (-) amlodipine - 2.5 or 5 mg;
    additional components: lactose, microcrystalline cellulose, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, yellow iron oxide.

Pharmacodynamics

S (-) amlodipine is a dihydropyridine derivative, the pharmacologically active isomer of amlodipine. The drug belongs to the blockers of slow calcium channels (BMCC), has an antianginal and hypotensive effect. As a result of binding to S (-) dihydropyridine receptors, amlodipine acquires a stronger effect than the R (+) isomer. The substance blocks calcium channels, reduces the transport of calcium ions into the cell through its membrane - to a greater extent into vascular smooth muscle cells than into cardiac muscle cells (cardiomyocytes).
EsCordi Cor has a long-term dose-dependent hypotensive effect, which is caused by a direct vasodilating effect on the smooth muscles of the vascular walls. Taking a single dose of the drug in patients with arterial hypertension leads to a clinically significant decrease in blood pressure (BP) within 24 hours (in the supine and standing position). The onset of the effect is noted 2–4 hours after ingestion, the duration of the action is 24 hours.

Pharmacokinetics

After oral administration of a single dose of 2.5 mg S (-) amlodipine is absorbed from the gastrointestinal tract (GIT). The maximum concentration (Cmax) of the substance in the blood serum (8.30 ± 1.071 ng / ml) is observed after 2.73 ± 0.88 hours, the average absolute bioavailability is 65%. The steady-state concentration of the substance in the blood (Css) is achieved on the eighth day of therapy. Food intake does not affect the absorption of S (-) amlodipine, the agent binds to blood plasma proteins by 93%. The average volume of distribution (Vd) of the active substance is 21 l / kg of body weight, which indicates that it penetrates into the tissues in a larger amount, and in a relatively smaller amount is in the blood. S (-) amlodipine crosses the blood-brain barrier (BBB).
The drug undergoes a slow but active metabolic transformation (90%) in the liver with the formation of metabolites that do not exhibit significant pharmacological activity. The drug is characterized by the effect of the first passage through the liver. After a single oral administration, the half-life (T1 / 2) can vary from 14.62 to 68.88 hours. With repeated administration, T1 / 2 is approximately 45 hours. On average, 60% of an oral dose is excreted by the kidneys, mainly in the form of metabolites; 20-25% - through the intestines and with breast milk, 10% - unchanged. The total clearance of S (-) amlodipine is 0.116 ml / s / kg (7 ml / min / kg or 0.42 l / h / kg).

Indications for use

EsCordi Cor is recommended for the treatment of arterial hypertension of I (mild) severity, as a monotherapy drug or in combination with other antihypertensive drugs.

Contraindications

Absolute:
    severe arterial hypotension;
    Prinzmetal's angina;
    cardiogenic shock, collapse;
    age under 18;
    pregnancy and the period of breastfeeding;
    hypersensitivity to S (-) amlodipine and any other component of the drug, as well as other dihydropyridine derivatives.
Relative (EsCordi Cor should be used with extreme caution):
    sick sinus syndrome (tachycardia, severe bradycardia);
    decompensated course of chronic heart failure (CHF); non-ischemic etiology;
    arterial hypotension of moderate severity;
    hypertrophic obstructive cardiomyopathy;
    aortic / mitral stenosis;
    acute myocardial infarction (including the period 1 month after it);
    violation of the lipid profile;
    diabetes;
    violation of the liver;
    elderly age.


EsCordi Cor, instructions for use: method and dosage

EsCordi Cor is taken orally.
The initial dose of the drug is 2.5 mg once a day. If necessary, to achieve adequate blood pressure control, it is possible to increase the dose to a maximum of 5 mg once a day.

Side effects

    nervous system: headache, dizziness, mood changes, drowsiness, fatigue; rarely - malaise, nervousness, tremor, insomnia, asthenia, hyperesthesia, convulsions, paresthesia, vertigo, unusual dreams, depression, loss of consciousness; extremely rare - agitation, apathy, amnesia, ataxia;
    cardiovascular system: flushing of the face, shortness of breath, palpitations, swelling of the feet and ankles, vasculitis, fainting, marked decrease in blood pressure; rarely - orthostatic hypotension, chest pain, rhythm disturbance (bradycardia, atrial fibrillation, ventricular tachycardia); extremely rare - migraine, development / worsening of heart failure;
    musculoskeletal system: rarely - arthrosis, arthralgia, myalgia (against the background of a long course); extremely rare - myasthenia gravis;
    genitourinary system: rarely - painful urge to urinate, nocturia, pollakiuria, decreased potency; extremely rare - polyuria, dysuria;
    digestive system: epigastric pain, vomiting, nausea; rarely - jaundice and increased activity of liver enzymes (caused by cholestasis), dry mouth, gingival hyperplasia, flatulence, constipation / diarrhea, pancreatitis; extremely rarely - a violation of taste, increased appetite, gastritis;
    allergic reactions: rash (including erythematous, maculopapular rash, urticaria), pruritus, angioedema;
    skin: extremely rare - purpura, xeroderma, dermatitis, alopecia, discoloration of the skin;
    other reactions: rarely - thirst, increase / decrease in body weight, gynecomastia, ringing in the ears, diplopia, blurred vision, eye pain, conjunctivitis, increased sweating, back pain, nosebleeds, dyspnoea, hyperglycemia, polyuricemia, thrombocytopenia, leukopenia; extremely rarely - parosmia, rhinitis, cough, cold clammy sweat, xerophthalmia, violation of accommodation.

Overdose

Symptoms of an overdose of EsCordi Cor can be: tachycardia, a significant decrease in blood pressure, excessive peripheral vasodilation.
In this condition, gastric lavage is prescribed, activated carbon is given, the lower extremities are elevated, the indicators of lung and heart function, circulating blood volume and urine output are monitored, and measures are taken to maintain the activity of the cardiovascular system. In order to restore vascular tone, vasoconstrictor agents are used (in the absence of contraindications). To eliminate the consequences of calcium channel blockade, intravenous administration of calcium gluconate is prescribed. Hemodialysis is not effective.


Special instructions

During treatment with EsCordi Cor, it is necessary to control body weight and sodium intake, as well as adhere to an appropriate diet.
Maintaining dental hygiene and regular visits to the dentist is required to prevent bleeding, soreness and overgrowth of the gums.
Despite the fact that BMCC does not have a withdrawal syndrome, it is recommended to gradually reduce the dose before completing the course.

Influence on the ability to drive vehicles and complex mechanisms

Patients driving a car or working with other complex mechanisms should be careful, especially at the beginning of therapy, because of the risk of drowsiness and dizziness.

Application during pregnancy and lactation

During pregnancy and lactation, the use of EsCordi Cor is contraindicated.

Childhood use

For patients under 18 years of age, the use of the drug is contraindicated because there is no data confirming the efficacy and safety of using EsCordi Cor in children and adolescents.

With impaired renal function

In the presence of renal failure, the pharmacokinetic parameters of S (-) amlodipine do not undergo significant changes. EsCordi Cor is not removed by hemodialysis.

For violations of liver function

In the presence of functional disorders of the liver, EsCordi Cor must be used with caution. In patients with hepatic insufficiency, the lengthening of T1 / 2, which can reach 60 hours, suggests that the accumulation of the drug in the body will be higher during a long course.

Use in the elderly

In patients over 65 years of age, the excretion of S (-) amlodipine is slower than in young patients (T1 / 2 is approximately 65 hours), but this difference has no clinical significance.
Elderly patients should be especially careful when prescribing EsCordi Cor. The dosage regimen for patients in this group is the same as for people of other age categories, however, with an increase in the dose, patients over 65 years of age need careful monitoring.

Drug interactions

    alpha-adrenostimulants, sympathomimetics, estrogens (sodium retention): the hypotensive effect is weakened;
    quinidine, procainamide and other drugs leading to prolongation of the QT interval: the negative inotropic effect increases and the threat of a significant prolongation of the QT interval may increase;
    inhibitors of microsomal oxidation: increases the level of amlodipine in plasma and aggravates the risk of side effects;
    beta-blockers, thiazide and loop diuretics, verapamil, angiotensin converting enzyme (ACE) inhibitors, nitrates: hypotensive and antianginal effects are enhanced;
    inducers of microsomal liver enzymes: the risk of developing undesirable reactions decreases due to a decrease in the plasma concentration of amlodipine in the blood;
    lithium preparations: the threat of neurotoxicity of these drugs increases (ataxia, nausea, diarrhea, vomiting, tinnitus, tremor);
    digoxin, warfarin: there is no effect on their pharmacokinetic parameters;
    calcium preparations: the effect of BMCC is weakened;
    alpha1-blockers, quinidine, amiodarone, antipsychotics, BMCC: hypotensive effect increases;
    cimetidine: there is no change in the pharmacokinetics of amlodipine;
    grapefruit juice: the concentration of amlodipine in plasma will decrease, but significant changes in its effectiveness are not recorded.

Terms and conditions of storage

Store in a place protected from moisture, out of the reach of children, at a temperature not exceeding 25 ° C.
Shelf life is 3 years.

Reviews about EsCordi Cor

According to a few reviews, EsCordi Cor effectively lowers blood pressure in patients with grade I primary hypertension. For therapy, as a rule, they begin with taking the drug in a dose of 2.5 mg once a day, and in many patients, with regular use, even this initial dose can reduce and stabilize the pressure. In case of insufficient therapeutic effect, the daily dose is increased to 5 mg. EsCordi Cor, according to reviews, improves well-being, eliminates dizziness, and helps to reduce weather dependence.
At the same time, quite a few patients indicate the development of such undesirable effects as drowsiness, fatigue, swelling of the feet and ankles, shortness of breath, palpitations, dizziness, nausea during the period of taking EsCordi Cor. In some cases, it is noted that due to the occurrence of adverse reactions, it was necessary to abandon treatment with this antihypertensive agent.

Terms of sell

You can buy EsCordi Cor without a prescription.