Tenox

Tenox has an antianginal and antihypertensive effect.

Indications Tenoks

It is used in such cases:

• increased values of blood pressure (as a monotherapeutic drug or in combination with other antihypertensive drugs);
• a stable form of variant angina pectoris  (in the form of a monotherapeutic agent or as an adjuvant in combination with other antihypertensive drugs).

[1]

Release form

The preparation is produced in tablet form. Inside the box contains 3, 9 or 10 blister packs with tablets having a volume of 5 or 10 mg.

[2]

Pharmacodynamics

The drug is part of the Ca 2-channel channel blockers group. Its active element has antihypertensive as well as anti-anginal properties. The therapeutic effect is due to synthesis with dihydropyridine endings, as well as blocking of the Ca channels, thus preventing the passage of calcium ions through the cell membrane (mostly smooth muscle cells of the vessels, and to a lesser extent, cardiomyocytes).

Antianginal influence develops by expanding the arteries (peripheral and coronary). Due to the expansion of arterioles with the main coronary arteries in the area of healthy and ischemic areas of the heart muscle, the amount of incoming oxygen increases, which prevents the appearance of constriction (it can also be caused by smoking).

During angina, the use of a single daily dosage of the drug can increase the period of exercise, inhibits the development of depression in the ST segment of the "ischemic" nature, and also reduces the need for nitroglycerin and the number of seizures occurring.

The antihypertensive effect is long-lasting and depends on the size of the portion. It develops with the help of direct vasodilating action against the cells of the smooth muscles of the vessels. At higher BP indices, a single dose of Tenox leads to a significant decrease in these values, and this effect continues for 24 hours. In addition, the tolerance to physical exertion and the severity of left ventricular hypertrophy are reduced.

With IHD, the drug has cardioprotective and anti-atherosclerotic effects.

Medication can slow down platelet aggregation and accelerate glomerular filtration processes, and with it has a slight natriuretic effect.

The development of medication exposure on average occurs after 2-4 hours after taking drugs, and then persists for 24 hours.

[3], [4], [5], [6]

Pharmacokinetics

The drug at low speed is absorbed from the digestive tract. The average absolute bioavailability is 64%. Peak values within the blood serum are noted after 6-9 hours. To obtain stable equilibrium parameters of the drug, it is required to take it for 7 days.

The metabolism of amlodipine is extensive and occurs in the liver at a slow rate (approximately 90% of the substance is metabolized). As a result, inactive decay products are formed that do not have a significant drug effect.

In case of a single dose of LS, the half-life inside is 32-48 hours, and with repeated application - about 45 hours.

About 60% of the drug is excreted in the form of metabolic products with urine, and another 10% - in unchanged form. The remaining 20-25% of LS are excreted with mother's milk and feces. The medicine can pass through the BBB. When hemodialysis is not allocated.

[7], [8]

Dosing and administration

The medication is used orally. Taking into account the type of pathology, the treatment regimen and the sizes of dosage portions are selected:

• at the increased indices of blood pressure: the size of the initial portion per day is equal to 5 mg (single dose); the size of the maintenance dosage for the day is 2.5-5 mg. For a day allowed to consume a maximum of 10 mg of the drug;
• with angina pectoris: a single application of 5-10 mg of medicine per day.

People with small stature, reduced weight and liver problems, as well as elderly patients, need to take medicines at an initial dosage of 2.5 mg to develop an antihypertensive effect, and 5 mg to develop an antianginal effect.

When used in combination with ACE inhibitors, diuretic drugs of thiazide type and β-adrenoblockers, correction of Tenox dosages is not required.

The medicine does not have withdrawal syndrome, but before the end of its use it is recommended to gradually reduce the portion size.

[12], [13]

Use Tenoks during pregnancy

Tenox is not prescribed to pregnant women.

Contraindications

The main contraindications:

• the presence of intolerance against amlodipine and other dihydropyridine derivatives, and in addition to the composite elements of the drug;
• decreased values of blood pressure in a severe degree;
• cardiogenic shock or collapse (acute vascular insufficiency);
• women during lactation.

Caution is required when using in these situations:

• problems in the work of the liver;
• expressed degree of tachycardia or bradycardia, as well as diagnosed Short's syndrome;
• HCM of obstructive nature or CHF, which has a decompensated form;
• stenosis of the aortic or mitral valve mouth;
• time interval after the transferred myocardial infarction (1 month);
• people of advanced age.

[9]

Side effects Tenoks

Taking a medication can trigger the appearance of some side effects:

• violations in the work of the CAS: a decrease in the values of blood pressure, swelling on the legs, dyspnoea, fainting, hot flashes and vasculitis, and in addition there are occasional heart rhythm disorders. There may be ventricular tachycardia, atrial fibrillation, orthostatic collapse, migraine and pain in the sternum, as well as worsening of heart failure;
• lesions affecting the function of the central nervous system: an increased sense of fatigue, dizziness, convulsions, mood lability and a feeling of drowsiness. Occasionally, there were hypsesies, a feeling of nervousness, loss of consciousness, tremor, paresthesia with vertigo, and agitation or apathy, insomnia, amnesia, ataxia, or depression;
• disorders that affect digestive activity: pain symptoms in the epigastric zone, nausea, or vomiting. Occasionally, liver enzymes (transaminases) increase and cholestasis of jaundice develops. There may also be bloating, gastritis, diarrhea or constipation, mouth dryness, pancreatitis and gingival hyperplasia;
• disorders affecting the urogenital system: pollakiuria or nocturia, sexual dysfunction, accompanied by pain of urge to urinate and weakening of potency. There is polyuria or dysuria;
• lesions of the epidermis: alopecia, purpura and xeroderma, and in addition dermatitis and a change in the shade of the epidermis;
• disorders of ODA function: myalgia or arthralgia, as well as myasthenia gravis or arthrosis;
• allergic signs: itching or rashes (hives, maculopapular or erythematous rash). Sometimes Quincke's edema develops;
• other disorders: polyuricemia, pain in the back, hyperglycemia, gynecomastia, increase or decrease in weight. There is also leuko- or thrombocytopenia, ear ringing, visual disturbances (such as diplopia, pain in the eyes, conjunctivitis, xerophthalmia or an accommodation disorder), hyperhidrosis, nosebleeds and thirst.

[10], [11]

Overdose

With intoxication, tachycardia, a sharp decrease in blood pressure and increased peripheral vasodilation are noted.

To eliminate the disorders it is recommended to perform gastric lavage, give the patient an activated charcoal, and in addition to monitor and support the work of the CAS and respiratory system parameters. It is also recommended to lift the affected limbs and perform a diuresis session.

To restore vascular tone, vasoconstrictors are used, and to eliminate complications that arise due to blocking the activity of calcium channels, intravenous calcium gluconate is required. The procedure of hemodialysis is ineffective.

Interactions with other drugs

It is possible to combine Tenox with antibacterial or antidiabetic drugs, as well as with NSAIDs (this includes indomethacin).

When combined with verapamil, nitrates, diuretics of the loop type, ACE inhibitors and adrenoblockers, the antihypertensive and antianginal properties of the drug are increased.

Quinidine with amiodarone, neuroleptics, and other CCBs increase the antihypertensive effect of the drug.

With simultaneous use with lithium medicines, symptoms of their neurotoxicity (such as vomiting, tremors, ear noise, nausea, ataxia and diarrhea) may increase.

[14], [15],

Storage conditions

Tenox should be kept in a place that is closed from access by young children. Temperature indicators - no more than 30 ° C.

[16], [17]

Shelf life

Tenox is allowed to be applied within 48 months after the release of the therapeutic agent.

Application for children

The drug is not used in pediatric practice, because its safety and drug efficacy for this age group are not defined.

Analogues

Analogues of the drug are drugs Normodipine with Amlodipine, Emlodipine and Agen 5/10 with Stamlo.

[18], [19], [20], [21]

Reviews

Tenox gets a lot of different reviews. A large number of patients testifies to its high effectiveness in stopping angina attacks and with a decrease in high blood pressure. As a generic, amlodipine has a small number of negative manifestations, which is its advantage. One of the drawbacks of the drug is a fairly high price.