Tenocab 25 tablet: Each tablet contains Atenolol BP 25 mg and Amlodipine 5 mg as Besilate BP.
Tenocab 50 tablet: Each tablet contains Atenolol BP 50 mg and Amlodipine 5 mg as Besilate BP.
Tenocab is the preparation of Amlodipine and Atenolol.
Mechanism of action : Amlodipine Besilate is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. The contractile process of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine Besilate inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. It acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. Atenolol is phenylacetamide, a selective ßl blocker. It blocks the effects of adrenergic stimulation mediated through these receptors. The cardio selectivity is dose related. Atenolol causes a reduction in blood pressure by lowering cardiac output, decreasing the plasma renin activity and sympathetic outflow from CNS. Atenolol also causes a reduction in myocardial oxygen demand by virtue of its negative inotropic and negative chronotropic effects.
Route of administration: Tenocab should be taken in oral route. The recommended dosage is one tablet of Tenocab 25 and Tenocab 50 daily. If necessary, the dosage may be increased to two tablets daily. The dosage however should be individualized.
Patients with renal impairment : The combination can be used in patients with renal impairment. However, caution may be necessary if the creatinine clearance is less than 30 ml/min because of possible reduction in the excretion of unchanged atenolol.
Patients with hepatic impairment : Caution may be necessary in the use of the combination in patients with severe liver damage because of prolongation of the elimination half-life of amlodipine.
CYP3A4 inhibitors (ketoconazole, diltiazem) increase amlodipine exposure; verapamil and diltiazem increase bradycardia and AV block; NSAIDs attenuate blood pressure reduction.
This combination is contraindicated in patients with known hypersensitivity to amlodipine and atenolol or any of the components of this product.
Common: Fatigue, headache, edema, nausea, drowsiness, anxiety, depression.
Overdose
Though not documented, hypotension and less frequently congestive cardiac failure may occur in cases of overdose. Unabsorbed drugs may be removed by gastric lavage or administration of activated charcoal. Symptomatic treatment is suggested.
Category D. Atenolol crosses placenta, causing fetal growth restriction and bradycardia; use only if benefit justifies risk. Lactation: Excreted in breast milk; breastfeeding should be discontinued.
Store below 25°C in a cool, dry place. Protect from light and moisture. Keep out of reach of children.