Lao Zhang this year67I have been suffering from hypertension for several years, and I have been taking amlodipine to control my condition, and my blood pressure has been very stable for several years. But in the past few months, his diet has not been very regular, which has caused his blood pressure to fluctuate, which has caused him to be distressed.

After checking on the Internet, I saw someone saying that nifedipine was cheap and effective, so I went to the pharmacy to buy nifedipine ordinary tablets and took it. But within a few days of taking the medicine, he had severe headache and vomiting, and was diagnosed with cerebral hemorrhage after being sent to the hospital.

The doctor said that Lao Zhang's sudden cerebral hemorrhage had a lot to do with his self-change of antihypertensive drugs. Amlodipine is a long-acting antihypertensive drug, which can be taken once a day, while nifedipine ordinary tablets are short-acting antihypertensive drugs, and the effect can only be maintained4~0hours, after the effect of the drug has passed, the blood pressure will quickly rebound, which will induce cerebral hemorrhage.

There are not a few examples like Lao Zhang in life, although both blood pressure drugs have the word dipine, but there is a big difference in the way they take it, and blind replacement is likely to bring the same consequences!

OneDo you know all about dipine blood pressure drugs?

Data show that the number of hypertensive patients in China is as high45.0Most patients need to take long-term medication to control their condition, among which dipine antihypertensive drugs are one of the more commonly used. The pharmacological name of the antihypertensive drug is calcium channel blocker, which is mainly used to block the calcium ion channel on the vascular smooth muscle cells, directly dilate the blood vessels, and play a role in lowering blood pressure.

There are no absolute contraindications to dipine drugs, no adverse effects on glucose and lipid metabolism, and the antihypertensive effect is not affected by a high-salt diet, with the characteristics of stable and long-lasting antihypertensive reduction, as well as certain renal function protection, anti-arteriosclerosis and angina relief. It is suitable for geriatric hypertension, simple systolic hypertension, angina with stable angina and coronary arteries/atherosclerosis/Patients with lower extremity congestion.

However, it is not without its drawbacks, and some patients may experience facial flushing, palpitations, headaches, and lower extremity edema after taking the drug, which are caused by vasodilation, sympathetic nerve excitation, and telangiectasia.

According to the selectivity of vascular and cardiac effects, dihydropyridine and non-dihydropyridine antihypertensive drugs can be divided into dihydropyridine and non-dihydropyridine, the former mainly acts on blood vessels and has a strong antihypertensive effect, the common ones are nifedipine and amlodipine; The latter has a more obvious effect on the heart, helping to slow down the heart rate and inhibit myocardial contractility, the common ones are verapamil, diltiazem, etc.

According to pharmacokinetics and pharmacodynamics, the antihypertensive drugs of the dipine class can be divided into the first, second and third generations.

The first-generation drugs are mostly short-acting antihypertensive drugs, which have low bioavailability, and can quickly dilate blood vessels and activate the sympathetic nervous system after taking the drug, but they are easy to cause reflex tachycardia, palpitations and headache symptoms. These drugs have a short half-life, high clearance, and short duration of action, which makes them difficult to achieve24Hour coverage of blood pressure lowering, the common ones are nifedipine tablets.

The second-generation drug is in extended-release or controlled-release dosage form, which can be taken after taking the drug24The effect is evenly released every hour, and the effect is long-term and stable.

Third-generation drugs include amlodipine, levamlodipine, and lecadipine, which haveThe "membrane control" feature can make the blood pressure drop gently, and the blood pressure fluctuation caused by it is relatively small.

TwoNifedipine and amlodipine are both horizontal-type antihypertensive drugs, what is the difference?

Nifedipine and amlodipine both belong to the same class of antihypertensive drugs, but even if they are similar antihypertensive drugs, there are significant differences in their action characteristics and clinical applications.

1、The onset time and duration of action are different

Nifedipine is a short-acting drug, after taking the drug2~0The peak drug concentration can be reached in hours, and the half-life of the drug is:3.0~0hours, extended-release dosage forms require at least daily medication2times, in order to achieve the effect of blood pressure. Amlodipine is a long-acting calcium antagonist and is needed after taking the drug12~0hours to reach the peak blood concentration, and the half-life of the drug is50~0hours, taken daily1tablets can achieve the effect of continuous blood pressure.

2、Indications vary

Nifedipine is suitable for patients with blood supply, coronary heart disease, exertional angina, and can also be used for patients with hypertension during pregnancy; Amlodipine is indicated for patients with hypertension, heart failure, and hypertension with high uric acid, stable angina, and variant angina.

3、Bad reactions are different

Both drugs are calcium channel blockers and have little difference in side effects. However, nifedipine is a short-acting antihypertensive drug, which may cause symptoms such as palpitations, headaches, and red ears when rapidly lowering blood pressure, and amlodipine basically does not have these side effects, but the risk of lower limb edema when taking amlodipine is higher than that of nifedipine.

4、drugs/Food interactions are different

Nifedipine should be avoided with grapefruit juice because grapefruit inhibits cytochromesP4 0A0system, which leads to an increase in the blood concentration of nifedipine and a prolongation of the action time, which is easy to cause hypotension; Amlodipine should be avoided in combination with digoxin during the taking period, otherwise it will increase the blood concentration of digoxin and lead to an increased risk of adverse reactions.

5、How to choose the right blood pressure medication for you

Different hypertensive patients have different trivia and antihypertensive drugs, and there is no absolute good or bad antihypertensive drugs, only suitable or not suitable for themselves. If you have liver insufficiency, heart failure, or simvastatin at the same time, you need to pass cytochromesP4 0A0For patients with systemic metabolism, nifedipine is recommended to be preferred for the use of dipine drugs; People with high uric acid can be given priority to amlodipine.

ThreeLong-term taking blood pressure medication, this4One thing to keep in mind

For patients with high blood pressure who need to take it for a long time, it is important to do these things well, so as not to burden their health with improper medication.

1、Don't stop without permission

Hypertension is a chronic, lifelong disease, and patients need to take long-term medication to control and stabilize their blood pressure. Once the drug is stopped, it will lead to a rebound of blood pressure, thereby increasing the risk of cardiovascular and cerebrovascular events, and will bring harm to targeted organs such as the brain, heart, and kidneys, and easily induce complications.

2、Do not change the dose arbitrarily

Changing the dose at will will break the original balance of drug efficacy, and it is easy to cause side effects.

3What to do if you miss a dose

If you are taking long-acting antihypertensive drugs for a long time, you do not need to take them72~0It can also maintain a certain blood concentration within hours, which can control blood pressure within a reasonable range. But if you miss the time>72hours, you can add a short-acting antihypertensive drug once, and then take it as a normal cycle.

If you are taking a short-acting antihypertensive drug, it is not necessary to make up the dose if you miss it at night, but it is recommended to take it during the day. Missed doses>2Half of the interval between doses should be made up immediately, and the time to postpone the next dose should be released.

4Remember to review regularly

People with high blood pressure need to monitor their blood pressure regularly to see how their blood pressure is changing and how well their medications are working. Inform the doctor of your blood pressure changes during the follow-up visit, and the doctor can adjust the type and dosage of the medication in time to better control the condition.

Patients with high blood pressure need to take medication for a long time to control their condition, if they find that their blood pressure is unstable in the process, they must seek medical advice in time, and do not change the drug or increase or decrease the dose at will, otherwise it is easy for the body to have side effects, and the gains outweigh the losses.

參考資料:

[1]What is the difference between antihypertensive drug nifedipine controlled-release tablets and amlodipine tablets? 》.Yat-sen Pharmacy14-0-0

[2]"Nifedipine and amlodipine are both calcium ion antagonists, what is the difference? 》.The new frontier of Metz Cardiovascular24-0-0

[3]Health Science|Have you taken the wrong blood pressure medication for so many years? Pay attention to these four points for high blood pressure! 》.Science popularization platform of Guangdong Cancer Rehabilitation Society22-0-0

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