Амлодипин Вертекс Таблетки, коробка, 30 шт, 10 мг, для приема внутрь

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Блокирует кальциевые каналы снижает трансмембранный переход ионов кальция в клетку (в большей степени в гладкомышечные клетки сосудов чем в кардиомиоциты)."}},{"type":"paragraph","data":{"text":"Антиангинальное действие обусловлено расширением коронарных и периферических артерий и артериол: при стенокардии уменьшает выраженность ишемии миокарда; расширяя периферические артериолы снижает общее периферическое сосудистое сопротивление (ОИСС) уменьшает постнагрузку на сердце снижает потребность миокарда в кислороде. Расширяя коронарные артерии и артериолы в неизмененных и в ишемизированных зонах миокарда увеличивает поступление кислорода в миокард (особенно при вазоспастической стенокардии); предотвращает спазм коронарных артерий (в т.ч. вызванной курением). У пациентов со стабильной стенокардией разовая суточная доза увеличивает толерантность к физической нагрузке увеличивает время до наступления приступа стенокардии и \"ишемической\" депрессии сегмента ST снижает частоту приступов стенокардии и потребления нитроглицерина в других нитратов. Оказывает длительный дозозависимый гипотензивный эффект. Гипотензивное действие обусловлено прямым вазодилатирующим влиянием на гладкие мышцы сосудов. При артериальной гипертензии разовая доза обеспечивает клинически значимое снижение артериального давления (АД) на протяжении 24 ч. (в положении пациента \"лежа\" и \"стоя\"). Ортостатическая гипотензия при назначении амлодипина встречается достаточно редко. Не вызывает снижения фракции выброса левого желудочка. Уменьшает степень гипертрофии миокарда левого желудочка. Не оказывает влияния на сократимость и проводимость миокарда не вызывает рефлекторного увеличения частоты сердечных"}},{"type":"paragraph","data":{"text":"сокращений (ЧСС) тормозит агрегацию тромбоцитов увеличивает скорость клубочковой фильтрации обладает слабым натрийуретическим действием."}},{"type":"paragraph","data":{"text":"При диабетической нефропатии не увеличивает выраженность микроальбуминурии. Не оказывает какого-либо неблагоприятного влияния на обмен веществ и концентрацию липидов плазмы крови и может применяться при терапии пациентов с бронхиальной астмой сахарным диабетом и подагрой. Значимое снижение АД наблюдается через 6-10 часов длительность эффекта-24 часа."}},{"type":"paragraph","data":{"text":"У пациентов с заболеваниями сердечно-сосудистой системы включая коронарный атеросклероз с поражением одного сосуда и до стеноза 3-х и более артерий атеросклероз сонных артерий перенесших инфаркт миокарда чрезкожную транслюминальную ангиопластику (ТЛАП) коронарных артерий или пациентов со стенокардией применение амлодипина предупреждает развитие утолщения интимы-медии сонных артерий снижает смертность от инфаркта миокарда инсульта ТЛАП аорто-коронарного шунтирования; приводит к снижению частоты развития нестабильной стенокардии и прогрессирования хронической сердечной недостаточности (ХСН); снижает частоту вмешательств направленных на восстановление коронарного кровотока."}},{"type":"paragraph","data":{"text":"Не повышает риск смерти или развития осложнений и летальных исходов у пациентов с ХСН (III-IV функциональный класс по классификации NYHA) на фоне терапии дигоксином диуретиками и ингибиторами антотензинпревращающего фермента (АПФ). У пациентов с ХСН (III-IV функциональный класс по классификации NYHA) неишемической этиологии при применении амлодипина существует вероятность возникновения отека легких."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"После приема внутрь амлодипин медленно абсорбируется из желудочно-кишечного тракта (ЖКТ). Средняя абсолютная биодоступность составляет 64% максимальная концентрация (Cmax) в сыворотке крови наблюдается через 6-9 часов. Равновесные концентрации (С\u003csub\u003eSS\u003c/sub\u003e) достигаются после 7-8 дней терапии."}},{"type":"paragraph","data":{"text":"Прием пищи не влияет на абсорбцию амлодипина. Средний объем распределения составляет 21 л/кг массы тела что указывает на то что большая часть препарата находятся в тканях а меньшая - в крови. Большая часть препарата находящегося в крови (95%) связывается с белками плазмы крови. Амлодипин подвергается медленному но активному метаболизму в печени при отсутствии значимого эффекта \"первого прохождения\". Метаболиты не обладают существенной фармакологической активностью. После однократного приема период полувыведения (Т1/2) варьирует от 35 до 50 часов при повторном применения Т1/2 составляет приблизительно 45 часов. Около 60% от принятой внутрь дозы выводится почками преимущественно в виде метаболитов 10% - в неизмененном виде а 20-25% - через кишечник с желчью. Общий клиренс амлодипина составляет 0116 мл/с/кг (7 мл/мин./кг 042 л/ч/кг)."}},{"type":"paragraph","data":{"text":"У пожилых пациентов (старше 65 лет) выведение амлодипина замедлено (Т1/2равен 65 ч.) по сравнению с молодыми пациентами однако эта разница не имеет клинического значения. Удлинение Т1/2у пациентов с печеночной недостаточностью предполагает что при длительном применении кумуляция препарата в организме будет выше (Т1/2- до 60 ч.). Почечная недостаточность не оказывает существенного влияния та кинетику амлодипина. У пациентов с нарушением функции почек изменения концентрации амлодипина в плазме крови не коррелируют со степенью почечной недостаточности. Возможно незначительное увеличение Т1/2."}},{"type":"paragraph","data":{"text":"Амлодипин проникает через гематоэнцефалический барьер. При гемодиализе не удаляется."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"- артериальная гипертензия."}},{"type":"paragraph","data":{"text":"- стабильная стенокардия напряжения и вазоспастическая стенокардия."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"- повышенная чувствительность к амлодипину другим производным дигидропиридина и другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"- выраженная артериальная гипотензия (систолическое АД менее 90 мм рт.ст.);"}},{"type":"paragraph","data":{"text":"- кардиогенный шок;"}},{"type":"paragraph","data":{"text":"- острый инфаркт миокарда (в течение первых 28 дней);"}},{"type":"paragraph","data":{"text":"- нестабильная стенокардия (за исключением стенокардии Принцметала);"}},{"type":"paragraph","data":{"text":"- обструкция выносящего тракта левого желудочка;"}},{"type":"paragraph","data":{"text":"- клинически значимый стеноз аорты;"}},{"type":"paragraph","data":{"text":"- возраст до 18 лет (эффективность и безопасность не установлены)."}}]},{"id":14,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"нарушения функции печени синдром слабости синусового узла (выраженная брадикардия тахикардия) ХСН неишемической этиологии Ш-IV функционального класса по классификации NYHA артериальная гипотензия аортальный стеноз митральный стеноз острый инфаркт миокарда (после первых 28 дней) пожилой возраст нарушение функции почек."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В экспериментальных исследованиях фетотоксическое и эмбриотоксическое действие препарата не установлены но применение при беременности возможно только в том случае когда польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Отсутствуют данные свидетельствующие об экскреции амлодипина с грудным молоком. Однако известно что другие БМКК - производные дигидропиридина экскретируются с грудным молоком. В связи с чем при необходимости назначения препарата Амлодипин-Тева в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь один раз в сутки запивая необходимым количеством воды (100 мл)."}},{"type":"paragraph","data":{"text":"При артериальной гипертензии и стенокардии начальная доза составляет 5 мг 1 раз в сутки. При отсутствии терапевтического эффекта в течение 2-4 недель доза препарата может быть увеличена до 10 мг/сут. однократно."}},{"type":"paragraph","data":{"text":"У пожилых пациентов"}},{"type":"paragraph","data":{"text":"Коррекции дозы не требуется."}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции печени"}},{"type":"paragraph","data":{"text":"Несмотря на то что Т1/2 амлодипина как и всех БМКК увеличивается у пациентов с нарушением функции печени коррекции дозы обычно не требуется (см. раздел \"Особые указания\")."}},{"type":"paragraph","data":{"text":"У пациентов с почечной недостаточностью"}},{"type":"paragraph","data":{"text":"Рекомендуется применять Амлодипин-Тева в обычных дозах (см. раздел \"Особые указания\")."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Частота побочных реакций приведенных ниже определялась соответственно следующему (классификация Всемирной организации здравоохранения): очень часто - не менее 10%; часто - не менее 1% но менее 10%; нечасто - не менее 01% но менее 1%; редко - не менее 001% но менее 01%; очень редко - менее 001% включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы - часто - головная боль (особенно в начале лечения) головокружение повышенная утомляемость сонливость; нечасто - общее недомогание гипестезия астения парестезии периферическая нейропатия тремор бессонница эмоциональная лабильность необычные сновидения нервозность повышенная возбудимость депрессия тревога повышенное потоотделение; редко - судороги апатия ажитация; очень редко - атаксия амнезия мигрень."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: часто - тошнота боли в животе; нечасто - рвота анорексия сухость слизистой оболочки полости рта жажда; редко - гиперплазия десен повышение аппетита; очень редко - панкреатит гастрит желтуха (обычно холестатическая) гипербилирубинемия повышение активности \"печеночных\" трансаминаз гепатит."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: часто - периферические отеки (лодыжек и стоп) сердцебиение \"приливы\" крови к коже лица; нечасто - чрезмерное снижение АД ортостатическая гипотензия васкулит; редко - развитие или усугубление течения ХСН; очень редко - обморок одышка нарушения ритма сердца (включая брадикардию желудочковую тахикардию и мерцание предсердий) инфаркт миокарда боль в трудной клетке отек легких."}},{"type":"paragraph","data":{"text":"Со стороны кроветворной и лимфатической систем: очень редко - тромбоцитопеническая пурпура лейкопения тромбоцитопения."}},{"type":"paragraph","data":{"text":"Со стромы мочевыделительной системы: нечасто - поллакиурия болезненные позывы на мочеиспускание никтурия; очень редко - дизурия полиурия."}},{"type":"paragraph","data":{"text":"Со страны репродуктивной системы и молочных желез: нечасто - гинекомастия импотенция."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: нечасто - одышка ринит; очень редко - кашель."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата: нечасто - мышечные судороги миалгия артралгия боль в спине артроз; редко - миастения."}},{"type":"paragraph","data":{"text":"Со стороны кожных покровов: нечасто - алопеция; редко - дерматит; очень редко - алопеция ксеродермия холодный липкий пот нарушение пигментации кожи."}},{"type":"paragraph","data":{"text":"Аллергические реакции: редко - кожный зуд сыпь (в т.ч. эритематозная макулопапулезная сыпь); очень редко - крапивница ангионевротический отек мулыиформная эритема."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств: нечасто - звон в ушах нарушение зрения диплопия нарушение аккомодации ксерофтальмия конъюнктивит боль в глазах; очень редко - паросмия."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ: очень редко - гипергликемия."}},{"type":"paragraph","data":{"text":"Прочие: нечасто - снижение массы тела увеличение массы тела извращение вкуса носовое кровотечение озноб."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: выраженное снижение АД с возможным развитием рефлекторной тахикардии и чрезмерной периферической вазодилатации (риск развития выраженной и стойкой артериальной гипотензии в т.ч. с развитием шока и летального исхода)."}},{"type":"paragraph","data":{"text":"Лечение: промывание желудка применение активированного угля (особенно в первые 2 часа после передозировки) поддержание функции сердечно-сосудистой системы возвышенное положение нижних конечностей мониторинг показателей работы сердца и легких контроль объема циркулирующей крови (ОЦК) и диуреза. Для восстановления тонуса сосудов - применение сосудосуживающих средств (при отсутствии противопоказаний к их применению); для устранения последствий блокады кальциевых каналов - внутривенное введение кальция глюконата. Гемодиализ неэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Амлодипин может безопасно применяться для терапии артериальной гипертензии вместе с тиазидными диуретиками альфа-адреноблокаторами или ингибиторами АПФ. У пациентов со стабильной стенокардией амлодипин можно комбинировать с другими антиангинальными средствами например с нитратами пролонгированного или короткого действия."}},{"type":"paragraph","data":{"text":"В отличие от других БМКК клинически значимого взаимодействия амлодипина (II поколение БМКК) не был обнаружено при совместном применении с противовоспалительными препаратами (НПВП) в том числе и с индометацином. Возможно усиление антиангинального и гипотензивного действия БМКК при совместном применении с тиазидными и \"петлевыми\" диуретиками ингибиторами АПФ и нитратами а так же усиление их гипотензивного действия при совместном применении с альфа1-адреноблокаторами."}},{"type":"paragraph","data":{"text":"Эритромицин при совместном применении повышает Сmах амлодипина у молодых пациентов на 22% а у пожилых - на 50%."}},{"type":"paragraph","data":{"text":"Бета-адреноблокаторы при одновременном применении с амлодипином могут вызвать обострение течения сердечной недостаточности."}},{"type":"paragraph","data":{"text":"Хотя при изучении амлодипина отрицательного инотропного действия обычно не наблюдали тем не менее некоторые БМКК могут усиливать выраженность отрицательного инотропного действия антиаритмических средств вызывающих удлинение интервала QT (например амиодарон и хинидин)."}},{"type":"paragraph","data":{"text":"Однократный прием 100 мг силденафила у пациентов артериальной гипертензией не оказывает влияния на параметры фармакокинетики амлодипина."}},{"type":"paragraph","data":{"text":"Повторное применение амлодипина в дозе 10 мг и аторвастатина в дозе 80 мг не сопровождается значительными изменениями показателей фармакокинетики аторвастатина."}},{"type":"paragraph","data":{"text":"Этанол (напитки содержащие алкоголь): амлодипин при однократном и повторном применении в дозе 10 мг не влияет на фармакокинетику этанола."}},{"type":"paragraph","data":{"text":"Антиретровирусные средства (ритонавир) увеличивает плазменные концентрации БМКК в том числе и амлодипина."}},{"type":"paragraph","data":{"text":"Нейролептики и изофлуран - усиление гипотензивного действия производных дигидропиридина."}},{"type":"paragraph","data":{"text":"Препараты кальция могут уменьшить эффект БМКК."}},{"type":"paragraph","data":{"text":"При совместном применении амлодипина с препаратами лития возможно усиление проявления нейротоксичности (тошнота рвота диарея атаксия тремор шум в ушах). Амлодипин не изменяет фармакокинетику циклоспорина."}},{"type":"paragraph","data":{"text":"Не оказывает влияние на концентрацию в сыворотке крови дигоксина и его почечный клиренс."}},{"type":"paragraph","data":{"text":"Не оказывает существенного влияния на действие варфарина (протромбиновое время). Циметидин не влияет на фармакокинетику амлодипина."}},{"type":"paragraph","data":{"text":"В исследованиях invitro амлодипин не влияет на связывание с белками плазмы крови дигоксина фенитоина варфарина и индометацина."}},{"type":"paragraph","data":{"text":"Грейпфрутовый сок: одновременный однократный прием 240 мг грейпфрутового сока и 10 мг амлодипина внутрь не сопровождается существенным изменением фармакокинетики амлодипина."}},{"type":"paragraph","data":{"text":"Алюминий- или магнийсодержащие антациды: их однократный прием не оказывает существенного влияния на фармакокинетику амлодипина."}}]},{"id":9,"name":"Особые указания","slug":"","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В период терапии препаратом Амлодипин-Тева необходимо контролировать массу тела и потребление натрия показано назначение соответствующей диеты."}},{"type":"paragraph","data":{"text":"Необходимо поддержание гигиены полости рта и наблюдение у стоматолога (для предотвращения болезненности кровоточивости и гиперплазии десен)."}},{"type":"paragraph","data":{"text":"При использовании Амлодипина-Тева у пациентов с хронической сердечной недостаточностью III и IV функционального класса по классификации NYHA возможно развитие отека легких."}},{"type":"paragraph","data":{"text":"При остром инфаркте миокарда Амлодипин-Тева назначают после стабилизации показателей гемодинамики (см. раздел \"Противопоказания\")."}},{"type":"paragraph","data":{"text":"Пациенты с печеночной недостаточностью при необходимости приема Амлодипина-Тева должны находиться под наблюдением врача."}},{"type":"paragraph","data":{"text":"У пациентов пожилого возраста может увеличиваться Т1/2 и снижаться клиренс препарата. Изменения доз не требуется но необходимо более тщательное наблюдение за пациентами данной категории."}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции почек необходим контроль состояния. Эффективность и безопасность применения препарата Амлодипина-Тева при гипертоническом кризе не установлена."}},{"type":"paragraph","data":{"text":"Несмотря на отсутствие у БМКК синдрома \"отмены\" прекращением лечения препаратом Амлодипин-Тева желательно проводить постепенно уменьшая дозу препарата."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Хотя на фоне приема Амлодипина-Тева какого-либо отрицательного влияния на способность управлять автотранспортом или другими сложными механизмами не наблюдалось однако вследствие возможного чрезмерного снижения АД развития головокружения сонливости и других побочных реакций следует соблюдать осторожность в перечисленных ситуациях особенно в начале лечения и при увеличении дозы."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 5 мг и 10 мг."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте!"}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"5 лет."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Общество с ограниченной ответственностью \"Тева\" (ООО \"Тева\"), 150066, Ярославская обл., г. Ярославль, ул. 1-я Технологическая, д. 20, Россия"}}]},{"id":22,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Тева Фармацевтические Предприятия Лтд"}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Блокатор \"медленных\" кальциевых каналов производное дигидропиридина - блокатор \"медленных\" кальциевых каналов (БМКК) II поколения оказывает антиангинальное и гипотензивное действие. Блокирует кальциевые каналы снижает трансмембранный переход ионов кальция в клетку (в большей степени в гладкомышечные клетки сосудов чем в кардиомиоциты). Антиангинальное действие обусловлено расширением коронарных и периферических артерий и артериол: при стенокардии уменьшает выраженность ишемии миокарда; расширяя периферические артериолы снижает общее периферическое сосудистое сопротивление (ОИСС) уменьшает постнагрузку на сердце снижает потребность миокарда в кислороде. Расширяя коронарные артерии и артериолы в неизмененных и в ишемизированных зонах миокарда увеличивает поступление кислорода в миокард (особенно при вазоспастической стенокардии); предотвращает спазм коронарных артерий (в т.ч. вызванной курением). У пациентов со стабильной стенокардией разовая суточная доза увеличивает толерантность к физической нагрузке увеличивает время до наступления приступа стенокардии и \"ишемической\" депрессии сегмента ST снижает частоту приступов стенокардии и потребления нитроглицерина в других нитратов. Оказывает длительный дозозависимый гипотензивный эффект. Гипотензивное действие обусловлено прямым вазодилатирующим влиянием на гладкие мышцы сосудов. При артериальной гипертензии разовая доза обеспечивает клинически значимое снижение артериального давления (АД) на протяжении 24 ч. (в положении пациента \"лежа\" и \"стоя\"). Ортостатическая гипотензия при назначении амлодипина встречается достаточно редко. Не вызывает снижения фракции выброса левого желудочка. Уменьшает степень гипертрофии миокарда левого желудочка. Не оказывает влияния на сократимость и проводимость миокарда не вызывает рефлекторного увеличения частоты сердечных сокращений (ЧСС) тормозит агрегацию тромбоцитов увеличивает скорость клубочковой фильтрации обладает слабым натрийуретическим действием. При диабетической нефропатии не увеличивает выраженность микроальбуминурии. Не оказывает какого-либо неблагоприятного влияния на обмен веществ и концентрацию липидов плазмы крови и может применяться при терапии пациентов с бронхиальной астмой сахарным диабетом и подагрой. Значимое снижение АД наблюдается через 6-10 часов длительность эффекта-24 часа. У пациентов с заболеваниями сердечно-сосудистой системы включая коронарный атеросклероз с поражением одного сосуда и до стеноза 3-х и более артерий атеросклероз сонных артерий перенесших инфаркт миокарда чрезкожную транслюминальную ангиопластику (ТЛАП) коронарных артерий или пациентов со стенокардией применение амлодипина предупреждает развитие утолщения интимы-медии сонных артерий снижает смертность от инфаркта миокарда инсульта ТЛАП аорто-коронарного шунтирования; приводит к снижению частоты развития нестабильной стенокардии и прогрессирования хронической сердечной недостаточности (ХСН); снижает частоту вмешательств направленных на восстановление коронарного кровотока. Не повышает риск смерти или развития осложнений и летальных исходов у пациентов с ХСН (III-IV функциональный класс по классификации NYHA) на фоне терапии дигоксином диуретиками и ингибиторами антотензинпревращающего фермента (АПФ). У пациентов с ХСН (III-IV функциональный класс по классификации NYHA) неишемической этиологии при применении амлодипина существует вероятность возникновения отека легких. После приема внутрь амлодипин медленно абсорбируется из желудочно-кишечного тракта (ЖКТ). Средняя абсолютная биодоступность составляет 64% максимальная концентрация (Cmax) в сыворотке крови наблюдается через 6-9 часов. Равновесные концентрации (СSS) достигаются после 7-8 дней терапии. Прием пищи не влияет на абсорбцию амлодипина. Средний объем распределения составляет 21 л/кг массы тела что указывает на то что большая часть препарата находятся в тканях а меньшая - в крови. Большая часть препарата находящегося в крови (95%) связывается с белками плазмы крови. Амлодипин подвергается медленному но активному метаболизму в печени при отсутствии значимого эффекта \"первого прохождения\". Метаболиты не обладают существенной фармакологической активностью. После однократного приема период полувыведения (Т1/2) варьирует от 35 до 50 часов при повторном применения Т1/2 составляет приблизительно 45 часов. Около 60% от принятой внутрь дозы выводится почками преимущественно в виде метаболитов 10% - в неизмененном виде а 20-25% - через кишечник с желчью. Общий клиренс амлодипина составляет 0116 мл/с/кг (7 мл/мин./кг 042 л/ч/кг). У пожилых пациентов (старше 65 лет) выведение амлодипина замедлено (Т1/2равен 65 ч.) по сравнению с молодыми пациентами однако эта разница не имеет клинического значения. Удлинение Т1/2у пациентов с печеночной недостаточностью предполагает что при длительном применении кумуляция препарата в организме будет выше (Т1/2- до 60 ч.). Почечная недостаточность не оказывает существенного влияния та кинетику амлодипина. У пациентов с нарушением функции почек изменения концентрации амлодипина в плазме крови не коррелируют со степенью почечной недостаточности. Возможно незначительное увеличение Т1/2. 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