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Is Amtas-AT and Losartan effective for hypertension?

Monday, 29 January 2007
Answered by: Dr. Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. I am taking Amtas-AT in the morning and Losartan potassium 25 mg at night for controlling my blood pressure. Now it is at 130/85. What are the best medicines I can take as per recent data?

A.  Amtas-AT is a combination product of two medicines: atenolol and amlodipine. In addition you are taking losartan. Thus you are taking three medicines for controlling blood pressure. It is not clear if an attempt was made to control the BP with lesser number of medicines. There has been lot of changes recently in the treatment of blood pressure, particularly in young sexually active males. The globally accepted guidelines are:
  • In patients younger than 55, first choice initial therapy should be an ACE inhibitor such as enalapril (sold under the trade name of BQL etc.) 5-10 mg 1-2 times daily.
  • In cases where two drugs are required, then add a calcium channel blocker such as amlodipine (sold under the trade name of Amlodac etc.) 5 mg once daily or a diuretic such as indapamide (sold under the trade name of Indicontin Continus) one tablet in the morning daily.
  • If treatment with three drugs is required, enalapril (BQL), amlodipine (Amlodac) and indapamide (Indocontin Continus) should be used.
  • Atenolol and other similar beta-blockers are not recommended because they perform less well than other drugs and the increasing evidence that they carry an unacceptable risk of provoking diabetes apart from causing impotence in males. It is also not a good idea to take combination products since the dose of individual agents cannot be titrated.
  • A.  Amtas-AT is a combination product of two medicines: atenolol and amlodipine. In addition you are taking losartan. Thus you are taking three medicines for controlling blood pressure. It is not clear if an attempt was made to control the BP with lesser number of medicines. There has been lot of changes recently in the treatment of blood pressure, particularly in young sexually active males. The globally accepted guidelines are:
  • In patients younger than 55, first choice initial therapy should be an ACE inhibitor such as enalapril (sold under the trade name of BQL etc.) 5-10 mg 1-2 times daily.
  • In cases where two drugs are required, then add a calcium channel blocker such as amlodipine (sold under the trade name of Amlodac etc.) 5 mg once daily or a diuretic such as indapamide (sold under the trade name of Indicontin Continus) one tablet in the morning daily.
  • If treatment with three drugs is required, enalapril (BQL), amlodipine (Amlodac) and indapamide (Indocontin Continus) should be used.
  • Atenolol and other similar beta-blockers are not recommended because they perform less well than other drugs and the increasing evidence that they carry an unacceptable risk of provoking diabetes apart from causing impotence in males. It is also not a good idea to take combination products since the dose of individual agents cannot be titrated.
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