{"id":51478,"date":"2023-09-20T09:22:07","date_gmt":"2023-09-20T09:22:07","guid":{"rendered":"https:\/\/medsname.com\/amlopres\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"amlopres","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/amlopres\/","title":{"rendered":"Amlopres"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Amlopres?<\/h3>\n<p style=\"margin:0;\"><strong>Amlopres<\/strong> je <strong>2,5 \/ 5 \/ 10 mg tableta amlodipinu<\/strong> od spole\u010dnosti Cipla \u2014 dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f (CCB) t\u0159et\u00ed generace. Zaveden 1990 (Pfizer jako <strong>Norvasc \/ Istin<\/strong>). Referen\u010dn\u00ed DHP pro hypertenzi celosv\u011btov\u011b. Plazmatick\u00fd polo\u010das 35-50 hodin \u2014 nejdel\u0161\u00ed ze v\u0161ech CCB a jeden z nejdel\u0161\u00edch polo\u010das\u016f v kardiovaskul\u00e1rn\u00ed medic\u00edn\u011b. Extr\u00e9mn\u011b dlouh\u00fd polo\u010das amlodipinu znamen\u00e1: (1) vynechan\u00e1 d\u00e1vka o den m\u00e1 minim\u00e1ln\u00ed \u00fa\u010dinek, (2) postupn\u00fd hladk\u00fd n\u00e1stup \u00fa\u010dinku bez <strong>reflexn\u00ed tachykardie<\/strong> (na rozd\u00edl od kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00edho nifedipinu), (3) nen\u00ed t\u0159eba prodlou\u017een\u011b uvol\u0148ovan\u00fdch forem, (4) lze bezpe\u010dn\u011b kombinovat s jakoukoli jinou t\u0159\u00eddou antihypertenziv v\u010detn\u011b betablok\u00e1tor\u016f. Typick\u00e1 d\u00e1vka pro hypertenzi: <strong>5 mg jednou denn\u011b (2,5 mg u star\u0161\u00edch pacient\u016f, mal\u00e9 postavy nebo p\u0159i jatern\u00edm po\u0161kozen\u00ed)<\/strong>; c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed 5-10 mg jednou denn\u011b. Hlavn\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: otoky kotn\u00edk\u016f (perifern\u00ed ed\u00e9my), n\u00e1valy horka, bolesti hlavy z vasodilatace, reflexn\u00ed tachykardie (tlumen\u00e1 dlouh\u00fdm polo\u010dasem amlodipinu; \u010dast\u00e1 u IR nifedipinu). Bezpe\u010dn\u00e1 kombinace s betablok\u00e1tory, ACE inhibitory, ARB a thiazidy (na rozd\u00edl od ne-DHP CCB). T\u011bhotenstv\u00ed: nifedipin MR je bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed a \u010dasto prvn\u00ed volbou; amlodipin je rozumnou druhou mo\u017enost\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Amlopres?<\/h2>\n<p>Amlopres jsou peror\u00e1ln\u00ed tablety amlodipinu 2,5 \/ 5 \/ 10 mg od spole\u010dnosti Cipla, dod\u00e1van\u00e9 v balen\u00ed po 30-90 tablet\u00e1ch. Uveden na trh 1990 (Pfizer jako <strong>Norvasc \/ Istin<\/strong>). Referen\u010dn\u00ed DHP pro hypertenzi celosv\u011btov\u011b.<\/p>\n<p>Amlodipin pat\u0159\u00ed do podt\u0159\u00eddy <strong>dihydropyridinov\u00fdch blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/strong> , kter\u00e1 se odli\u0161uje od nedihydropyridin\u016f (<a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">verapamil<\/a>) sv\u00fdm <strong>selektivn\u00ed \u00fa\u010dinek na c\u00e9vn\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm srde\u010dn\u00edm \u00fa\u010dinkem<\/strong>. Tento selektivn\u00ed profil je klinicky v\u00fdznamn\u00fd: DHP lze bezpe\u010dn\u011b kombinovat s beta-blok\u00e1tory (kombinace je standardn\u00ed u anginy pectoris), zat\u00edmco ne-DHP nikoli (riziko aditivn\u00ed bradykardie\/blok\u00e1dy srdce).<\/p>\n<h2 class=\"wp-block-heading\">Jak Amlodipin funguje<\/h2>\n<p>Blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se v\u00e1\u017eou na L-typ nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch kalciov\u00fdch kan\u00e1l\u016f a sni\u017euj\u00ed vstup v\u00e1pn\u00edku do bu\u0148ky b\u011bhem depolarizace. V <strong>hladk\u00e9m svalstvu tepen<\/strong>, znamen\u00e1 sn\u00ed\u017een\u00fd vstup v\u00e1pn\u00edku m\u00e9n\u011b interakce aktin-myozin a <strong>p\u0159\u00edmou vazodilataci tepen<\/strong> \u2014 sn\u00ed\u017een\u00ed syst\u00e9mov\u00e9 c\u00e9vn\u00ed rezistence a krevn\u00edho tlaku.<\/p>\n<p>Dihydropyridiny jsou ~10kr\u00e1t \u00fa\u010dinn\u011bj\u0161\u00ed na c\u00e9vn\u00ed hladk\u00e9 svalstvo ne\u017e na srde\u010dn\u00ed sval \u2014 dominantn\u00edm klinick\u00fdm \u00fa\u010dinkem je tedy vazodilatace s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm potla\u010den\u00edm srde\u010dn\u00ed kontraktility nebo veden\u00ed. Baroreflex t\u011bla m\u016f\u017ee vyvolat m\u00edrnou reflexn\u00ed tachykardii po rychl\u00e9m n\u00e1stupu vazodilatace; velmi pomal\u00fd n\u00e1stup amlodipinu tento \u00fa\u010dinek klinicky eliminuje.<\/p>\n<p>N\u00e1stup klinick\u00e9ho \u00fa\u010dinku: postupn\u00fd b\u011bhem 6-12 hodin, pln\u00fd \u00fa\u010dinek za 7-8 dn\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Nekomplikovan\u00e1 hypertenze<\/strong> \u2014 \u010dasto prvn\u00ed volba, zejm\u00e9na pro \u010dernochy a pacienty nad 55 let (NICE, AHA)<\/li>\n<li><strong>Hypertenze + stabiln\u00ed angina pectoris<\/strong> (dvoj\u00ed indikace)<\/li>\n<li><strong>Prinzmetalova\/vasospastick\u00e1 angina<\/strong> \u2014 prvn\u00ed volba<\/li>\n<li><strong>Raynaud\u016fv fenom\u00e9n<\/strong><\/li>\n<li><strong>Hypertenze u srde\u010dn\u00edho selh\u00e1n\u00ed s zachovanou ejek\u010dn\u00ed frakc\u00ed<\/strong> (HF-pEF) \u2014 bezpe\u010dn\u011bj\u0161\u00ed ne\u017e ne-DHP CCB, kter\u00e9 jsou kontraindikov\u00e1ny u HF-REF<\/li>\n<li><strong>Hypertenze v t\u011bhotenstv\u00ed<\/strong> \u2014 nen\u00ed prvn\u00ed volbou, ale rozumn\u00e1 druh\u00e1 mo\u017enost po methyldop\u011b \/ labetalolu \/ nifedipinu MR<\/li>\n<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> <strong>ASCOT-BPLA (2005)<\/strong> \u2014 perindopril + amlodipin p\u0159ekonal atenolol + thiazid u kardiovaskul\u00e1rn\u00edch v\u00fdsledk\u016f u hypertenze, co\u017e stanovilo modern\u00ed preferenci CCB + ACEi\/ARB p\u0159ed beta-blok\u00e1torem + thiazidem. <strong>VALUE (2004)<\/strong> \u2014 l\u00e9\u010dba zalo\u017een\u00e1 na amlodipinu m\u011bla m\u00edrnou v\u00fdhodu oproti l\u00e9\u010db\u011b zalo\u017een\u00e9 na valsartanu u v\u00fdsledk\u016f mrtvice+infarktu, z velk\u00e9 \u010d\u00e1sti zp\u016fsobenou rychlej\u0161\u00edm poklesem TK. <strong>ALLHAT (2002)<\/strong> \u2014 amlodipine je ekvivalentn\u00ed chlorthalidonu u v\u011bt\u0161iny v\u00fdsledk\u016f, lep\u0161\u00ed ne\u017e lisinopril u c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody u \u010dernoch\u016f.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Amlopres<\/h2>\n<p><strong>Hypertenze:<\/strong><\/p>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> 5 mg jednou denn\u011b (2,5 mg u star\u0161\u00edch pacient\u016f, mal\u00e9 postavy nebo p\u0159i jatern\u00edm po\u0161kozen\u00ed)<\/li>\n<li><strong>C\u00edlov\u00e1 d\u00e1vka:<\/strong> 5-10 mg jednou denn\u011b<\/li>\n<li><strong>Maxim\u00e1ln\u00ed d\u00e1vka:<\/strong> 10 mg jednou denn\u011b<\/li>\n<li>Titrujte ka\u017ed\u00fdch 1-2 t\u00fddny na z\u00e1klad\u011b odpov\u011bdi krevn\u00edho tlaku a sn\u00e1\u0161enlivosti (zejm\u00e9na otok\u016f)<\/li>\n<\/ul>\n<p><strong>Angina pectoris:<\/strong> 5-10 mg jednou denn\u011b u chronick\u00e9 stabiln\u00ed a vazospastick\u00e9 anginy pectoris<\/p>\n<p><strong>Pod\u00e1v\u00e1n\u00ed:<\/strong> jednou denn\u011b (nebo dvakr\u00e1t denn\u011b u IR formulac\u00ed nifedipinu). Polykejte cel\u00e9 \u2014 NEROZDRCUJTE ani NED\u011aLTE tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (dod\u00e1v\u00e1 IR d\u00e1vku s rizikem hypotenze). U\u017e\u00edvejte s j\u00eddlem nebo bez j\u00eddla.<\/p>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> \u017e\u00e1dn\u00fd specifick\u00fd abstinen\u010dn\u00ed syndrom; lze vysadit bez postupn\u00e9ho sni\u017eov\u00e1n\u00ed d\u00e1vky. Krevn\u00ed tlak se vr\u00e1t\u00ed na p\u0159edl\u00e9\u010debn\u00e9 hodnoty b\u011bhem 1-2 t\u00fddn\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;5%, v\u011bt\u0161inou m\u00edrn\u00e9 a p\u0159echodn\u00e9):<\/strong><\/p>\n<ul>\n<li><strong>Perifern\u00ed (kotn\u00edkov\u00e9) otoky<\/strong> \u2014 Perifern\u00ed (kotn\u00edkov\u00e9) otoky zp\u016fsoben\u00e9 prekapil\u00e1rn\u00ed vazodilatac\u00ed \u2014 z\u00e1visl\u00e9 na d\u00e1vce (a\u017e 25% p\u0159i 10 mg\/den). Nejsou zp\u016fsobeny p\u0159et\u00ed\u017een\u00edm tekutinami; nereaguj\u00ed na diuretika. \u0158e\u0161en\u00ed: sn\u00ed\u017eit d\u00e1vku, kombinovat s ACE inhibitorem nebo ARB (kter\u00e9 neutralizuj\u00ed otoky vyv\u00e1\u017eenou pre- a postkapil\u00e1rn\u00ed vazodilatac\u00ed), nebo p\u0159ej\u00edt na ne-DHP BKK (diltiazem, verapamil), pokud je \u00fa\u010dinek na srde\u010dn\u00ed frekvenci p\u0159ijateln\u00fd.<\/li>\n<li>N\u00e1valy horka (teplo v obli\u010deji a horn\u00ed \u010d\u00e1sti t\u011bla)<\/li>\n<li>Bolest hlavy (zejm\u00e9na na za\u010d\u00e1tku terapie; obvykle se p\u0159izp\u016fsob\u00ed b\u011bhem 2-4 t\u00fddn\u016f)<\/li>\n<li>M\u00edrn\u00e9 palpitace (m\u00e9n\u011b \u010dast\u00e9 ne\u017e u kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00edho nifedipinu)<\/li>\n<li>Z\u00e1vrat\u011b, ortostatick\u00e1 hypotenze<\/li>\n<li>\u00danava<\/li>\n<li>M\u00edrn\u00e1 z\u00e1cpa (m\u00e9n\u011b ne\u017e u ne-DHP)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong><\/p>\n<ul>\n<li>Vyr\u00e1\u017eka, sv\u011bd\u011bn\u00ed<\/li>\n<li>Nevolnost, b\u0159i\u0161n\u00ed dyskomfort<\/li>\n<li>Erektiln\u00ed dysfunkce (vz\u00e1cn\u011b)<\/li>\n<li>Zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f (obvykle m\u00edrn\u00e9, reverzibiln\u00ed)<\/li>\n<li>Vz\u00e1cn\u00e9 hl\u00e1\u0161en\u00e9 p\u0159\u00edpady fotosenzitivity<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace a upozorn\u011bn\u00ed<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na amlodipin nebo t\u0159\u00eddu dihydropyridin\u016f<\/li>\n<li>Kardiogenn\u00ed \u0161ok<\/li>\n<li>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za (m\u016f\u017ee zp\u016fsobit kritickou hypotenzi)<\/li>\n<li>Nestabiln\u00ed angina pectoris nebo infarkt myokardu do 1 m\u011bs\u00edce (DHP krom\u011b amlodipinu)<\/li>\n<li>Obstruk\u010dn\u00ed hypertrofick\u00e1 kardiomyopatie (dynamicky sni\u017euje v\u00fdtokov\u00fd gradient)<\/li>\n<li>T\u011b\u017ek\u00e9 po\u0161kozen\u00ed jater (v\u0161echny DHP jsou metabolizov\u00e1ny j\u00e1try)<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> amlodipin nen\u00ed prvn\u00ed volbou v t\u011bhotenstv\u00ed, ale m\u00e1 uklid\u0148uj\u00edc\u00ed observa\u010dn\u00ed data; rozumn\u00e1 volba druh\u00e9 linie, pokud labetalol, methyldopa a nifedipin MR jsou ne\u00fa\u010dinn\u00e9 nebo kontraindikovan\u00e9.<\/p>\n<p><strong>Kojen\u00ed:<\/strong> mal\u00e9 mno\u017estv\u00ed v mate\u0159sk\u00e9m ml\u00e9ce; obecn\u011b pova\u017eov\u00e1no za p\u0159ijateln\u00e9 s monitorov\u00e1n\u00edm kojence.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/strong> \u2014 inhibuje metabolismus CYP3A4; m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny amlodipinu a zejm\u00e9na nifedipinu\/nimodipinu 2\u20133\u00d7. Vyvarujte se u\u017e\u00edv\u00e1n\u00ed v l\u00e9\u010debn\u00e9 dny, nebo u\u017e\u00edvejte konzistentn\u011b, pokud v\u016fbec.<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (ketokonazol, itrakonazol, klarithromycin, ritonavir, kobicistat) \u2014 zvy\u0161uj\u00ed plazmatick\u00e9 hladiny BKK; sni\u017ete d\u00e1vku nebo se vyhn\u011bte<\/li>\n<li><strong>Siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1) \u2014 sni\u017euj\u00ed plazmatick\u00e9 hladiny BKK; m\u016f\u017ee b\u00fdt nutn\u00e9 zv\u00fd\u0161it d\u00e1vku<\/li>\n<li><strong>Simvastatin<\/strong> \u2014 amlodipin m\u00edrn\u011b zvy\u0161uje expozici simvastatinu; omezte simvastatin na 20 mg\/den p\u0159i kombinaci<\/li>\n<li><strong>Beta-blok\u00e1tory<\/strong> \u2014 DHP lze kombinovat <strong>bezpe\u010dn\u011b<\/strong> s betablok\u00e1tory (kombinace je standardem u anginy pectoris \u2014 betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii, BKK zaji\u0161\u0165uje vazodilataci). Na rozd\u00edl od ne-DHP BKK (diltiazem, verapamil), kter\u00e9 by se s betablok\u00e1tory NEM\u011aLY kombinovat.<\/li>\n<li><strong>Jin\u00e1 antihypertenziva<\/strong> \u2014 obecn\u011b komplement\u00e1rn\u00ed; monitorujte TK<\/li>\n<li><strong>Sildenafil \/ tadalafil<\/strong> (Inhibitory PDE5 pro erektiln\u00ed dysfunkci) \u2014 aditivn\u00ed hypotenze; opatrnost zejm\u00e9na p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch CCB<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">P\u0159ehled t\u0159\u00eddy blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">CCB<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">T\u0159\u00edda<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Niche<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlodipin (Amlode, Amlip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (3. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Referen\u010dn\u00ed DHP; jednou denn\u011b pro hypertenzi a anginu pectoris; d\u016fkazy ze studie ASCOT<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/depin\/\">Nifedipin (Depin, Nicardia Retard, Cardipin)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (1. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed MR; tokol\u00fdza; pro chronickou hypertenzi nutno pou\u017e\u00edt ER formulace<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/nimodip-nimodipine\/\">Nimodipin (Nimodip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (cerebrovaskul\u00e1rn\u00ed)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevence vazospazmu p\u0159i subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed \u2014 NEPOU\u017d\u00cdVAT pro b\u011b\u017enou hypertenzi<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Diltiazem (Dilzem, Dilzem CD)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (benzothiazepin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HTN + kontrola srde\u010dn\u00ed frekvence + angina; st\u0159edn\u00ed srde\u010dn\u00ed \u00fa\u010dinek<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">Verapamil (Calaptin 40, Calaptin SR)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (fenylalkylamin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Nejsiln\u011bj\u0161\u00ed srde\u010dn\u00ed \u00fa\u010dinek; SVT, kontrola frekvence p\u0159i AF, cluster headache<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>DHP vs non-DHP \u2014 pro\u010d na tom z\u00e1le\u017e\u00ed:<\/strong> DHP (amlodipin, nifedipin) selektivn\u011b p\u016fsob\u00ed na arteri\u00e1ln\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm srde\u010dn\u00edm \u00fa\u010dinkem \u2014 lze bezpe\u010dn\u011b kombinovat s betablok\u00e1tory. Non-DHP (diltiazem, verapamil) zpomaluj\u00ed AV nod\u00e1ln\u00ed veden\u00ed a sni\u017euj\u00ed srde\u010dn\u00ed kontraktilitu \u2014 <strong>NEKOMBINUJTE s betablok\u00e1tory<\/strong> (riziko aditivn\u00ed bradykardie, srde\u010dn\u00edho bloku a akutn\u00edho srde\u010dn\u00edho selh\u00e1n\u00ed). Pokud pacient ji\u017e u\u017e\u00edv\u00e1 betablok\u00e1tor, pou\u017eijte DHP.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Amlopres p\u0159i teplot\u011b do 25\u00b0C. Chra\u0148te p\u0159ed sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d mi po u\u017e\u00edv\u00e1n\u00ed Amlopresu ot\u00e9kaj\u00ed kotn\u00edky?<\/h3>\n<p><strong>Perifern\u00ed ed\u00e9m je t\u0159\u00eddn\u00edm \u00fa\u010dinkem dihydropyridin\u016f<\/strong>, zp\u016fsoben\u00fdm prekapil\u00e1rn\u00ed arteriol\u00e1rn\u00ed dilatac\u00ed, kter\u00e1 zvy\u0161uje hydrostatick\u00fd tlak v venul\u00e1ch doln\u00edch kon\u010detin. NEN\u00cd to <strong>p\u0159et\u00ed\u017een\u00ed tekutinami<\/strong> a NEREAGUJE na diuretika. Mo\u017enosti \u0159e\u0161en\u00ed: (1) sn\u00ed\u017eit d\u00e1vku BKK; (2) <strong>p\u0159idejte ACE inhibitor nebo ARB<\/strong> kter\u00fd vyrovn\u00e1v\u00e1 pre- a postkapil\u00e1rn\u00ed vazodilataci a eliminuje mechanismus vzniku otok\u016f (\u010dasto preferovan\u00e9 \u0159e\u0161en\u00ed); (3) p\u0159ejd\u011bte na ne-DHP BKK (diltiazem, verapamil), pokud jsou p\u0159ijateln\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky souvisej\u00edc\u00ed s frekvenc\u00ed; (4) elevace nohou a kompresn\u00ed pun\u010dochy jako dopl\u0148kov\u00e1 opat\u0159en\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Jak dlouho trv\u00e1, ne\u017e Amlopres sn\u00ed\u017e\u00ed krevn\u00ed tlak?<\/h3>\n<p>Postupn\u00fd n\u00e1stup \u00fa\u010dinku \u2013 m\u011b\u0159iteln\u00e9 sn\u00ed\u017een\u00ed TK do 24\u201348 hodin; pln\u00fd \u00fa\u010dinek za 7\u20138 dn\u00ed. Extr\u00e9mn\u011b dlouh\u00fd polo\u010das amlodipinu (35\u201350 h) poskytuje jeden z nejplynulej\u0161\u00edch profil\u016f TK v kardiovaskul\u00e1rn\u00ed medic\u00edn\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Amlopres s betablok\u00e1torem?<\/h3>\n<p><strong>Ano \u2013 DHP lze bezpe\u010dn\u011b kombinovat s betablok\u00e1tory.<\/strong> Tato kombinace je standardem u anginy pectoris: DHP zp\u016fsobuje vazodilataci a sni\u017euje spot\u0159ebu kysl\u00edku myokardem; betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii. To se li\u0161\u00ed od ne-DHP BKK (,), kter\u00e9 by se s betablok\u00e1tory NEM\u011aLY kombinovat kv\u016fli riziku aditivn\u00ed bradykardie a srde\u010dn\u00edho bloku.<a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">verapamil<\/a>Mohu j\u00edst grapefruit p\u0159i u\u017e\u00edv\u00e1n\u00ed Amlopresu?.<\/p>\n<h3 class=\"wp-block-heading\">Grapefruit (\u0161\u0165\u00e1va i \u010derstv\u00e9 ovoce) inhibuje metabolismus CYP3A4 a m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny amlodipinu 2\u20133\u00d7, \u010d\u00edm\u017e zvy\u0161uje riziko hypotenze, z\u00e1vrat\u00ed a otok\u016f. Doporu\u010den\u00fd postup: vyhn\u011bte se grapefruitu\/\u0161\u0165\u00e1v\u011b p\u0159i u\u017e\u00edv\u00e1n\u00ed BKK, nebo jej konzumujte konzistentn\u011b (va\u0161e d\u00e1vka je titrov\u00e1na podle odpov\u011bdi TK; ob\u010dasn\u00e1 konzumace grapefruitu to naru\u0161uje).<\/h3>\n<p>Grapefruit (juice and fresh fruit) inhibits CYP3A4 metabolism and can raise amlodipine plasma levels by 2-3\u00d7, increasing the risk of hypotension, dizziness, and oedema. Best practice: avoid grapefruit\/juice while on CCBs, or consume consistently (your dose is titrated to BP response; sporadic grapefruit disrupts that).<\/p>\n<h3 class=\"wp-block-heading\">Je Amlopres bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n<p>Amlodipin nen\u00ed v t\u011bhotenstv\u00ed l\u00e9kem prvn\u00ed volby, ale existuj\u00ed uklid\u0148uj\u00edc\u00ed observa\u010dn\u00ed data; je rozumnou druhou volbou, pokud jsou labetalol, methyldopa a nifedipin MR ne\u00fa\u010dinn\u00e9 nebo kontraindikovan\u00e9. Proberte to se sv\u00fdm gynekologem.<\/p>\n<h3 class=\"wp-block-heading\">Mohu kombinovat Amlopres s dal\u0161\u00edmi l\u00e9ky na krevn\u00ed tlak?<\/h3>\n<p>Ano \u2014 DHP blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se dob\u0159e kombinuj\u00ed s <strong>ACE inhibitory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">ramipril<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/lispro\/\">lisinoprilem<\/a>), <strong>sartany<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/olmin\/\">olmesartan<\/a>), <strong>beta-blok\u00e1tory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/betablock-xl\/\">metoprolol<\/a>), a <strong>thiazidov\u00fdmi diuretiky<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">HCTZ<\/a>). Kombinace ACE inhibitoru\/sartanu + blok\u00e1toru kalciov\u00fdch kan\u00e1l\u016f je obzvl\u00e1\u0161t\u011b u\u017eite\u010dn\u00e1, proto\u017ee eliminuje vedlej\u0161\u00ed \u00fa\u010dinek v podob\u011b otoku kotn\u00edk\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Kde si mohu koupit Amlopres online?<\/h3>\n<p>Amlopres (amlodipin 2,5 \/ 5 \/ 10 mg, 30-90 tablet) m\u016f\u017eete zakoupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/amlip\/\">Amlip \u2014 Amlodipin 2,5\/5 mg (DHP blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">Calaptin 40 \u2014 Verapamil IR 40 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calaptin-sr\/\">Calaptin SR \u2014 Verapamil SR 120\/240 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cardipin-retard\/\">Cardipin Retard \u2014 Nifedipin 20 mg ER<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Dilzem \u2014 Diltiazem IR 30\/60 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/losar\/\">Losar \u2014 Losartan (alternativa ARB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Amlopres jsou tablety amlodipinu 2,5\/5\/10 mg od spole\u010dnosti Cipla \u2014 dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f prvn\u00ed volby. Doporu\u010deno v pokynech spolu s t\u0159\u00eddami ACEi, ARB a thiazid\u016f pro hypertenzi. Pou\u017e\u00edv\u00e1 se tak\u00e9 u chronick\u00e9 stabiln\u00ed anginy pectoris a vazospastick\u00e9 anginy pectoris. Polo\u010das 30-50 hodin zaji\u0161\u0165uje plynulou 24hodinovou kontrolu; d\u016fkaz z studie ACCOMPLISH pro kombinaci s ACEi\/ARB. Otoky kotn\u00edk\u016f (10-20 %) jsou hlavn\u00edm vedlej\u0161\u00edm \u00fa\u010dinkem omezuj\u00edc\u00edm d\u00e1vkov\u00e1n\u00ed \u2014 \u010d\u00e1ste\u010dn\u011b kompenzovan\u00fdm p\u0159id\u00e1n\u00edm ARB (vazodilatace ARB vyva\u017euje p\u0159evahu amlodipinu v arteriol\u00e1ch).<\/p>","protected":false},"featured_media":51479,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3362,3363],"class_list":{"0":"post-51478","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-amlodipine","11":"product_tag-amlopres","13":"first","14":"outofstock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51478","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51478"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51479"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51478"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51478"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51478"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}