Original Article

Comparison of efficacy and tolerability of different brands of amlodipine in patients with mild to moderate hypertension

Abstract

Background: The efficacy of amlodipine, a calcium channel blocker, in treating systemic hypertension is well established but the most efficacious brand of this drug is still uncertain. The cost of different brands of amlodipine is tremendously different which may affect decision-making in hypertension treatment. The purpose of this study was to compare the efficacy and safety of different brands of amlodipine (Amlodipine, Amlopress, and Norvasc) in the treatment of hypertension in adult patients.
Methods: This was a double-blind, randomized, three-sequence crossover study. Ambulatory patients with hypertension who had the inclusion criteria were enrolled. Patients were randomized and entered into three groups to receive either brand of amlodipine in a crossover method. After every four weeks of treatment completed, the other brand of drug was prescribed. The total period of the study was 12 weeks for all three drugs including four weeks for each brand.
Results: A total of 20 patients entered to the study, 15 completed the 12-week treatment schedule. The absolute reductions in seated and supine systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar with all three brands during the 4 weeks of treatment. Headache, malaise and weakness were the most common reported adverse effects (AE) with all three drugs. Generic amlodipine had the most AE as compared with other brands. These AE were mild and did not require withdrawal of the drug.
Conclusion: There is no statistical difference in lowering blood pressure by three different brands of amlodipine thus everyone which has the lowest price can be the first choice.

Lever AF, Ramsay LE. Treatment of hypertension in the elderly. J Hypertens 1995; 13: 571-79.

Abernethy DR, Schwartz JB. Calcium-antagonist drugs. N Engl J Med 1999; 341: 1447-57

Opie LH. Pharmacological differences between calcium antagonists. Eur Heart J 1997; 18(Suppl A): A71-9.

Singh BN, Josephson MA. Clinical pharmacology, pharmacokinetics and hemodynamic effects of nicardipine. Am Heart J 1990; 119: 427-34.

Black HR. Calcium channel blockers in the treatment of hypertension and prevention of cardiovascular disease: results from major clinical trials. Clin Cornerstone 2004; 6 (4): 53-66.

Liebson PR. Clinical studies of drug reversal of hypertensive left ventricular hypertrophy. Am J Hypertens 1990; 3: 512-7.

Bittar N. Maintaining long-term control of blood pressure: The role of improved compliance. Clin Cardiol 1995; 18 (3):12-16.

Reid JL, Meredith PA, Donnelly R, Elliott HL. Pharmacokinetics of calcium antagonists. J Cardiovasc Pharmacol 1988; 12 (7): 22-26.

Scholz H. Pharmacological aspects of calcium channel blockers. Cardiovasc Drugs Ther 1997; 10 (suppl 3): 869-72.

Hernandez R, Carvajal AR, Armas-de Hernandez MJ, et al . The effects of the calcium antagonist amlodipine on blood pressure and platelet aggregation in hypertensive patients. Postgrad Med J 1991; 67 (suppl 5): S38-40.

Horwitz LD, Weinberger HD, Clegg L. Comparison of amlodipme and longacting diltiazem in the treatment of mild or moderate hypertension. Am J Hypertens 1997; 10 (11): 1263-9.

Huraib S, Askar A, Abu-Aisha H, Al-Wakeel J, Mitwalli A, Al-Majed S. Efficacy of once-daily amlodipine in the control of 24-hour blood pressure using ambulatory blood pressure monitoring. Curr Ther Res Clin and Exp 1995; 56 (11): 1125-31.

Cross BW, Kirby MG, Miller S, Shah SH, Sheldon DM, Sweeney MT. A multicentre study of the safety and efficacy of amlodipine in mild to moderate hypertension. Br J Clin Prac 1993; 47 (5): 237-40.

Guidelines Committee: 2003 European Society of Hypertension European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011–53.

Thatcher SJ. Medication compliance. Pediater Clin North Am 1981; 28: 5-21.

Langdon C. Treatment of hypertension in patients >65 years of age: experience with amlodipine. Clinical Therapeutics 2000; 22: 1473-82.

Pfammatter JP. Amlodipine once-daily in systemic hypertension. Cardiology 1998; 157: 618- 21.

Doggrell SA. Is amlodipine the best initial monotherapy for hypertension? Expert Opin Pharmacother 2006; 7 (6): 829- 32.

Kloner RA, Sowers JR, DiBona GF, Gaffney M, Wein M. Sex- and agerelated antihypertensive effects of amlodipine. Am J Cardiol 1996; 77: 713- 22.

Mroczek WJ, Burris JF, Allenby KS. A double-blind evaluation of the effect of amlodipine on ambulatory blood pressure in hypertensive patients. J Cardiovasc Pharmacol 1988; 12(7):S79-84.

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IssueVol 1, No 2 (Spring 2013) QRcode
SectionOriginal Article(s)
Keywords
Amlodipine Amlopress Norvasc Hypertension

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How to Cite
1.
Hadjibabaie M, Khoee SH, Nematipoor E, Gholami K, Fatahian A, Jahangard Z. Comparison of efficacy and tolerability of different brands of amlodipine in patients with mild to moderate hypertension. J Pharm Care. 2015;1(2):41-44.