Tenox

Tenox has antianginal and antihypertensive effects.

Indications Tenoxa

It is used in the following cases:

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

[ 1 ]

Release form

The drug is released in tablet form. The box contains 3, 9 or 10 blister packs with tablets of 5 or 10 mg.

[ 2 ]

Pharmacodynamics

The drug belongs to the group of 2nd generation Ca channel blockers. Its active element has antihypertensive and antianginal properties. The therapeutic effect is due to synthesis with dihydropyridine endings, as well as blocking Ca channels, thereby preventing the passage of calcium ions through the cell membrane (mainly vascular smooth muscle cells, and, to a lesser extent, cardiomyocytes).

The antianginal effect develops by dilating the arteries (peripheral and coronary). Due to the dilatation of arterioles with the main coronary arteries in the area of healthy and ischemic areas of the heart muscle, the volume of incoming oxygen increases, which prevents the occurrence of constriction (it can also be caused by smoking).

During angina, taking a single daily dose of the drug allows for an increase in the period of physical activity, inhibits the development of "ischemic" depression in the ST segment, and also reduces the need for nitroglycerin and the number of attacks that occur.

The antihypertensive effect is long-lasting and dose-dependent. It develops through direct vasodilating action on vascular smooth muscle cells. At elevated blood pressure levels, a single dose of Tenox leads to a significant reduction in these values, and this effect lasts for 24 hours. In addition, tolerance to physical activity and the severity of left ventricular membrane hypertrophy are reduced.

In case of coronary heart disease, the drug has a cardioprotective and anti-atherosclerotic effect.

The drug can slow down platelet aggregation and accelerate glomerular filtration processes, and at the same time has a mild natriuretic effect.

The development of the drug effect occurs on average 2-4 hours after taking the drug, and then lasts for 24 hours.

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

Pharmacokinetics

The drug is absorbed from the gastrointestinal tract at a low rate. The average absolute bioavailability is 64%. Peak values in the blood serum are noted after 6-9 hours. To obtain stable equilibrium values of the drug, it is necessary to take it for 7 days.

Amlodipine metabolism 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 medicinal effect.

With a single oral administration of the drug, the half-life is 32-48 hours, and with repeated use - approximately 45 hours.

About 60% of the drug is excreted in the form of metabolic products in the urine, and another 10% is excreted unchanged. The remaining 20-25% of the drug is excreted with breast milk and feces. The drug can pass through the BBB. It is not excreted during hemodialysis.

[ 7 ], [ 8 ]

Dosing and administration

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

• for elevated blood pressure: the initial daily dose is 5 mg (single dose); the maintenance dose is 2.5-5 mg per day. A maximum of 10 mg of the drug is allowed per day;
• for angina pectoris: a single dose of 5-10 mg of medication per day.

People with short stature, low weight and liver problems, as well as elderly patients, need to take the drug in 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, thiazide-type diuretics and β-blockers, no dosage adjustment of Tenox is required.

The drug does not have a withdrawal syndrome, but before stopping its use, it is recommended to gradually reduce the portion size.

[ 11 ], [ 12 ]

Use Tenoxa during pregnancy

Tenox is not prescribed to pregnant women.

Contraindications

Main contraindications:

• the presence of intolerance to amlodipine and other dihydropyridine derivatives, as well as the constituent elements of the drug;
• severely reduced blood pressure;
• cardiogenic shock or collapse (acute vascular insufficiency);
• women during lactation.

Caution is required when using in the following situations:

• problems with liver function;
• severe tachycardia or bradycardia, as well as diagnosed Short's syndrome;
• HCM of obstructive nature or CHF in a decompensated form;
• stenosis of the aortic or mitral valve;
• time period after myocardial infarction (1 month);
• elderly people.

[ 9 ]

Side effects Tenoxa

Taking the medication may cause some side effects:

• disturbances in the functioning of the cardiovascular system: decreased blood pressure, swelling of the legs, dyspnea, fainting, hot flashes and vasculitis, and in addition, heart rhythm disturbances are occasionally observed. Ventricular tachycardia, atrial fibrillation, orthostatic collapse, migraine and pain in the sternum area may occur, as well as worsening heart failure;
• lesions affecting the function of the central nervous system: increased feeling of fatigue, dizziness, convulsions, mood lability and a feeling of drowsiness. Rarely, hypoesthesia, a feeling of nervousness, loss of consciousness, tremor, paresthesia with vertigo, as well as agitation or apathy, insomnia, amnesia, ataxia or a state of depression were noted;
• disorders affecting the digestive system: pain in the epigastric region, nausea or vomiting. Occasionally, liver enzyme levels (transaminases) increase and cholestasis-induced jaundice develops. Bloating, gastritis, diarrhea or constipation, dry mouth, pancreatitis and gingival hyperplasia may also occur;
• disorders affecting the urogenital system: pollakiuria or nocturia, sexual dysfunction, painful urge to urinate and decreased potency. Polyuria or dysuria may appear sporadically;
• lesions of the epidermis: alopecia, purpura and xeroderma, as well as dermatitis and changes in the shade of the epidermis;
• disorders of the musculoskeletal system: myalgia or arthralgia, as well as myasthenia or arthrosis;
• allergic symptoms: itching or rash (urticaria, maculopapular or erythematous rash). Sometimes angioedema develops;
• Other disorders: polyuricemia, back pain, hyperglycemia, gynecomastia, weight gain or loss. Leukopenia or thrombocytopenia, tinnitus, visual disturbances (such as diplopia, eye pain, conjunctivitis, xerophthalmia or accommodation disorder), hyperhidrosis, nosebleeds and thirst are also observed.

[ 10 ]

Overdose

In case of intoxication, tachycardia, a sharp decrease in blood pressure and increased peripheral vasodilation are observed.

To eliminate disorders, it is recommended to perform gastric lavage, give the patient activated carbon, and also monitor and maintain the work of the cardiovascular system and respiratory system indicators. It is also recommended to raise the victim's limbs and perform a diuresis session.

Vasoconstrictors are used to restore vascular tone, and intravenous calcium gluconate is required to eliminate complications that arise due to blocking calcium channel activity. Hemodialysis is ineffective.

Interactions with other drugs

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

When combined with verapamil, nitrates, loop diuretics, ACE inhibitors and beta blockers, an increase in the antihypertensive and antianginal properties of the drug is noted.

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

When used simultaneously with lithium drugs, symptoms of their neurotoxicity (such as vomiting, tremor, tinnitus, nausea, ataxia and diarrhea) may increase.

[ 13 ], [ 14 ]

Storage conditions

Tenox should be kept in a place out of reach of small children. Temperature indicators – no more than 30°C.

[ 15 ], [ 16 ]

Shelf life

Tenox is approved for use within 48 months from the date of release of the therapeutic agent.

Application for children

The drug is not used in pediatric practice, because its safety and medicinal efficacy for this age group have not been determined.

Analogues

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

[ 17 ], [ 18 ], [ 19 ], [ 20 ]

Reviews

Tenox receives many different reviews. A large number of patients speak of its high effectiveness in stopping angina attacks and reducing high blood pressure. As a generic amlodipine has a small number of negative manifestations, which is its advantage. One of the disadvantages of the drug is its fairly high price.