February 1, 2023

Amlodipine or Norvasc treats high blood pressure. This inexpensive, generically available calcium blocker relaxes smooth muscle cells lining arteries and reduces the force against which the heart must pump. Additionally the drug helps protect against chest pain or angina. It ranks among the World Health Organization List of Essential Medicines.

Hello dr. kenda thanks for watching let’s talk about norvasc also known as amlodipine this is a drug that’s known as a calcium blocker principally used for high blood pressure control came on the market 1992 is norvasc them when generic as amlodipine in 2007 it’s on the world health organization list of essential medicines it’s used for high blood pressure control

It’s used for people who have chronic stable angina from narrowing of the coronary arteries it’s used for people who have vasospasm angina phase of engine there’s an janee you get while you’re sitting down the chronic stable engine an engine oh when you’re out moving about and it also might protect the heart if you have coronary artery disease without any kind

Of symptoms it’s very widely used about 14 million people take it every day it’s one of the most popular medicines for high blood pressure control and as a matter of fact it was the sixth most frequent prescription in 2016 and it’s now combined with other medicine so the pill low trel combines the unloader pain and an ace inhibitor also for high blood pressure

The pill cadu it combines atorvastatin also known as lipitor with the n load opinion so that it helps your cholesterol and your blood pressure seems to work better to prevent stroke than it does to prevent heart disease and the more your risk the better the medicine works so if you have really high blood pressure the medicine works better than if you have just

A little bit of high blood pressure and that brings up the issue of the american heart association american college cardiology guideline change in november of 2017 they said oh if your blood pressure is more than 130 you got to do something most people say that’s absolute nonsense if you go and do something with level over 130 between 130 hundred 40 as they

Suggest you’re going to get relatively little benefit so if you have greater risk the higher the pressure the more benefit you’re going to get and as a matter the more risk you have irrespective of just your blood pressure so if you happen to be overweight if you happen to be a cigarette smokers you happen to be diabetic if you happen to have high cholesterol

You’ll get more benefit from taking the pill than if you’re an otherwise thin individual with only a tiny risk and only a minimal elevation of the blood pressure so overall we look at conditional ii stage one hypertension is when the top number is between 140 and 160 typically you can take one pill and that will bring your blood pressure back down to relatively

Normal if you have states to hypertension where the top number is more than 160 typically you’re going to need two pills to start but you have to remember the treatment of high blood pressure with the pill is merely that it is a treatment it is not a cure a cure requires lifestyle changes so if you’re overweight you got to go on a diet lose some weight you have

To decrease the amount of salt we all get too much salt people say they don’t add and he thought that’s not where you get the salt the salts in the food that you eat it’s in the processed food it’s in the can of soup that you consume it’s in the piece of bread that you eat it’s in the pastry it’s all over look to see how much calcium limit the amount of calcium

To somewhere between hopefully 1,500 milligrams a day can go up to 2,400 milligrams a day but if you’re hypertensive cut it down to 1,500 milligrams a day eat more fruit eat more vegetables consume more nuts get more exercise if you’re a cigarette smoker you’re nuts but but stop the habit it’s awful it’s going to increase your risk of vascular disease in here

You’re taking the pill because you want to reduce your risk if you drink too much alcohol too much alcohol is more than two drinks a day for a man more than one drink a day for a woman then cut back remembers the whole purpose of taking the pill the amlodipine or any other kind of a pill is to benefit your health you can’t benefit your health on one hand and

Try to harm it on the other the harm is always going to win now if you have high blood pressure what should you do to start most guidelines suggest the best medicine is probably going to be a diuretic diuretic like chlorothalonil most people are taking hydrochlorothiazide probably doesn’t work as well as chlorothalonil corydon was the original medicine that

Was studied we studied in something known as the all hat study and the benefit of that medicine is that lasts all day the hydrochlorothiazide is going to last about 16 hours so when you go to bed at night your blood pressure can go up but if you take the chlorophyll down hopefully it keeps it in control but that’s the first choice what’s the second choice well

It could be a calcium blocker calcium blockers like amlodipine there are several on the market well it helps but it might increase the risk of heart failure compared to taking the chlorothalonil so it might not be the first point how did the calcium blockers work first of all they don’t do anything to the calcium that’s in your bloodstream so if you measure the

Calcium before you start taking the pill measure it after it’s going to be exactly the same what it does is it changes the ability of the calcium to go from the tissue into the cells into specifically the vascular smooth muscle cells the vascular smooth muscle cells are the cells that line your arteries and arterials so they can’t constrict as much if they can’t

Constrict as much they can’t push the pressure is high the heart doesn’t have to pump with as much pressure because the room that it’s pumping into is more dilated that’s what happens when you take one of these calcium blockers and that’s why they seem to work so well if you happen to have chronic stable engine that you walk for three minutes and have to stop for

A few moments because you get the chest pain then you can walk for another 3 minutes and you got to stop again well they can increase the amount of time that you can walk without getting the chest pain so that’s very good and if you have the variant angina when you’re sitting in bed watching the television and you get the chest pain well you have fewer episodes

In the course of a week than you would if you were taking say a placebo so if we look at people who have documented coronary artery disease people already have narrowing of the vessels inside the heart we’re gonna find that taking this kind of medicine in low dipping is going to decrease the frequency of hospitalization for chest pain is going to decrease the

Number revascularisation procedures people are taking this medicine need fewer stents fewer balloon angioplasty fewer coronary bypass surgeries and it might also improve kidney function by increasing the glomerular filtration rate and that’s what goes down as we get older because of the narrowing of some of the vessels going to the heart are going to the kidney

Well how much of the medicine should you take typically we begin at a dose of 5 milligrams a day for high blood pressure but if you have coronary artery disease typically about 10 milligrams so if you have high blood pressure and you start off at 5 milligrams a day after a week or 2 weeks if the blood pressure isn’t controlled then you can increase it to 10

Milligrams 10 milligrams will be the max but if you happen to have liver problems you might have to start at a reduced amount so instead it’s starting at five milligrams you start at two and a half milligrams and if you’re a child then two and a half milligrams is the beginning those five milligrams would be the max and a kid if we look at the different kind

Of amlodipine there are it gets a little confusing because there’s a load of pain wrestle a them load of pain mesylate and load of pain maleate for your purposes it’s all the same now how much effect do you get when you take this pill it’s gonna make the top number go down by somewhere between ten and fifteen points so if your blood pressure is a hundred and

Fifty and you take the drug hundred thirty five well that would be pretty good that by the way is the about the same amount of reduction that you would get if you followed those healthy lifestyle changes except if you follow the healthy lifestyle changes not only is it going to reduce your risk for a heart attack into stroke and cancer and dementia and a whole

Bunch of other chronic degenerative diseases but it’s not gonna cost you anything so that’s the good news about the diet and exercise that works exactly as good or as well as the pill the good news about the pill is that this is a long lactic long-lasting pill and it works as well in the daytime as it does in the nighttime and it works on standing blood pressure

And it works on lying down blood pressure and if you happen to have coronary artery disease and you don’t have high blood pressure you can still take the pill it’s sort of is like analogous to aspirin if you don’t have a fever the aspirin isn’t going to take your temperature from 98 6 down to 97 well if you don’t have high blood pressure this one isn’t going to

Significantly change your blood pressure well remember the higher your pressure is the more benefit you’re going to get so people who have moderate high blood pressure do better than people have mild high blood pressure and if you have mild high blood pressure you may well end up having to take multiple drugs well once you take the drug it’s going to peak inside

The system within about 6 to 12 hours and it’s going to last inside with a half-life of 30 to 50 hours so you’re going to get coverage all day and all night 90% of the drug is going to be metabolized to inactive substances it’s gonna happen in the liver and most of it’s going to get passed out in the urine as far as breastfeeding is concerned no harm pregnancy

No data if you have liver disease as i mentioned you have to be a little careful if you happen to have significant and severe aortic stenosis that’s narrowing of the valve that goes between the heart and the aorta if that’s the issue that you have this pill probably isn’t going to be for you because it has a tendency to worsen the amount of angina and also we

Know that if you’re taking simvastatin also called zocor the maximum dose of the zocor simvastatin you should take is 20 milligrams because the m lodha peen is going to increase the concentration of that drug inside your system does the drug have some side effects sure it does but not significant side effects so most people take the drug they don’t have any

Kind of problem fewer than 2% of the people going to discontinue because of a side effect the side effect there some people get some nausea or indigestion some people get some fatigue some people get tired or belly pain or palpitations men can get some edema because remember they’re dilating the arteries but not violating the vein so the blood gets out to the

Leg but can’t get back as readily so sometimes the fluid fills up inside the leg and flushing occurs more commonly in women than it does in men have to be a little careful if you’re an elderly individual and it’s hot the summertime you’re not getting enough fluid you get a little dehydrated well your blood pressure can go down significantly in the day but up

Significantly when you’re lying down so that’s an issue because of the volume loss there’s some withdrawal syndrome that may occur especially in older women who’ve been taking the medicine for 6 to 12 months should slowly discontinue the drug not a lot of side effects or interactions so you can take this one with grapefruit juice you can take this one with the

Blood thinner warfarin you don’t have to worry about taking it with an antacid and as a matter of fact the only times you seem to have to worry if you’re taking biaxin or clarithromycin or if you’re taking valium well that might boost the amount of amlodipine in the system and then make your blood pressure go down too much how much does the drug cost not very

Much at all actually if you go to blink health you can get the first month free and subsequent months or less than seven dollars if you go to good rx and you pay cash it’s only about 15 dollars or with a coupon as low as three dollars but if you happen to want to go and take the norvasc because you don’t want to take a generic drug that’s gonna cost you almost

$200 so $200 or get it free i think that’s a no-brainer but remember we all have a tendency to think have high blood pressure going to go treat it with a pill you know if you have high blood pressure treat it with diet and exercise cut down the amount of salt that you’re consuming more fruit more vegetable more nuts more whole grains we the labels find out how

Much sodium you’re consuming and if you do that you might not even need the high blood pressure pill or if you need the high blood pressure pill it’ll work better and you get a significantly number of greater benefits significant number of greater benefits if you happen to follow an appropriate lifestyle and remember high blood pressure is extraordinarily common

In our society in primitive societies without our kind of diet where they get some exercise almost unknown thanks for watching i’m dr. ken land you

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Amlodipine By wellnowdoctor