Indication

Combination drug used to treat high blood pressure not effectively controlled by monotherapy. 

Pharmacodynamics

Amlodipine: Falls under Calcium Channel Blocker. Inhibits the transport of calcium and vascular smooth muscle cells resulting in inhibition of excitation-contraction coupling and subsequent contraction.

Losartan: Falls under Angiotensin Receptor Blocker.  Blocks the vasoconstrictor and aldosterone-secreting effects of Angiotensin II at various receptor sites, including vascular smooth muscle and the adrenal glands.

Pharmakokinetic Properties

Amlodipine

• Absorption: Well absorbed after oral administration (64-90)%
• Distribution: Protein Binding is (95-98) % . Crosses the placenta.
• Metabolism/Excretion: Mostly metabolized by liver
• Half-Life: 30-50 hr

Losartan

• Absorption: Well absorbed but undergoes extensive first-pass hepatic metabolism, resulting in 33 % bioavailability
• Distribution: Protein Binding 99%. Crosses the placenta
• Metabolism/Excretion: Undergoes extensive first-pass liver metabolism ,14% is converted to active metabolite.4%excreted unchanged in urine; 6% excreted in urine as active metabolites.
• Half- Life: 2hrs(6-9 hrs for metabolites).

Warning & Precaution

• History of angioedema
• Heart Failure with or without renal failure
• Excessive vomiting & Diarrhoea leading to extreme loss of fluid
• In patient with kidney transplant recently
• Impaired Liver function

Children and Adolescents

Not recommended

Pregnancy Category :  C

Breast Feeding : Not recommended