|Composition||Cilnidipine ,10 and Chlorthalidone 12.5mg Tablets.|
|Mechanism of Action||
Cilnidipine is a dihydropyridine calcium-channel blocker. It inhibits cellular influx of calcium, thus causing vasodilatation. It has greater selectivity for vascular smooth muscle. It has little or no action at the SA or AV nodes and -ve inotropic activity is rarely seen at therapeutic doses.
Chlortalidone is an oral, long acting antihypertensive/diuretic. It is a monosulfamyl diuretic that acts by enhancing the excretion of sodium and chloride ions, and water by interfering with the transport of sodium ions across the renal tubular epithelium. Their primary site of action appears to be at the cortical diluting segment in the nephron of the loop of Henle.
Rapid absorption. Cmax within 2 h. Highest level in the liver and also distribution in the kidneys, plasma, and other tissues. No tissue showed a particularly high accumulation of the drug following repeated oral administrations. Protein binding 98% The percentage urinary excretion of Cilnidipine following an oral dose is about 36%
Chlortalidone :Onset: 2 hr.
Absorption: Erratic absorption from the GI tract (oral).
Distribution: Binds to red blood cells; crosses the placenta and enters breast milk. Protein-binding: Weak.
Excretion: Urine (as unchanged drug); 40-60 hr (elimination half-life).
Dizziness; flushing; headache; hypotension; peripheral oedema; tachycardia; palpitations; GI disturbances; increased micturition frequency; lethargy; eye pain; depression; ischaemic chest pain; cerebral or myocardial ischaemia; transient blindness; rashes; fever; abnormal liver function; gingival hyperplasia; myalgia; tremor; impotence.
Hypotension, poor cardiac reserve, heart failure. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration. Pregnancy, lactation.
Adult: 5-10 mg once daily, increase to 20 mg once daily if necessary.
Chlortalidone:Adult: PO HTN 25 mg/day, up to 50 mg/day. Oedema Initial: 25-50 mg/day up to 100-200 mg/day in severe cases. Maintenance: 25-50 mg/day or on alternate days. Diabetes insipidus Initial: 100 mg twice daily. Maintenance: 50 mg/day.