Amlodipine insignificantly improved survival relative to placebo but reduced by 47% the composite secondary end point of all-cause death, nonfatal stroke, MI
The effects of amlodipine on mortality and cardiovascular events in hypertensive patients with chronic kidney disease stage 5 on haemodialysis
Common Dialyzable Drugs Mnemonics BLISTMED and ISTUMBLED: B - Barbiturates L - Lithium I - Isoniazid S - Salicylates T - Theophyline / Caffeine (both are methylxanthines)
Background: Left ventricular hypertrophy and asymmetric dimethylarginine (ADMA) are surrogate markers of cardiovascular disease (CVD) in the dialysis
Interactions FAQ What is amlodipine? Amlodipine besylate belongs to a class of medications called calcium channel blockers
Most adults and children aged 6 and over can take amlodipine
0 % Dialyzed (Type of Dialyzer) IHD Dosing; Administration Timing Around HD Session
1 (as besilate) %Protein binding : >95 %Excreted unchanged in urine : 10 : Usual Adult Dose for Hypertension
Atenolol can be dialyzed off
ACE-I or ARB (3rd choice) – see below for some concerns about ACE-I/ARBs
7 AMLODIPINE IN SPECIFIC POPULATIONS 7
Renal Dialysis / adverse effects* Treatment Outcome Substances Descriptions
Hepatic impairment: Dosage recommendations have not been established in patients with mild to moderate hepatic impairment; therefore dose selection should be cautions and should start at the lower end of the dosing range
In addition, the HDPAL trial
Concurrently, studies are needed to shed more light Austell-Amlodipine is not dialysable
DISCUSSION
In clinical trials the incidence of adverse events in elderly patients was approximately 6% higher than that of younger population (< 65 years)
Paediatric population
Amlodipine and valsartan may cause serious side effects
Hepatic impairment: Dosage recommendations have not been established in patients with mild to moderate hepatic impairment; therefore dose selection should be cautions and should start at the lower end of the dosing range