Mr. Wang, 53, has had high blood pressure for 5 years and has been taking nifedipine tablets to reduce blood pressure. However, he always forgets about taking antihypertensive drugs multiple times a day, so under the guidance of his doctor, Wang My husband changed the antihypertensive drug amlodipine besylate, but Mr. Wang found that his blood pressure was unstable after taking it for a few days. This made Mr. Wang very confused. They said that long-acting antihypertensive drugs lower blood pressure more stably. Why did he change it? After long-acting medicine, it becomes unstable?

Both amlodipine and nifedipine belong to the "dipine" class of antihypertensive drugs, which are the most widely used class of antihypertensive drugs in clinical practice. We call this class of drugs "dihydropyridines" "Calcium channel blockers", there are many types of drugs in this category, the most common ones are nifedipine and amlodipine.

First of all, in terms of molecular structure, amlodipine has a more unique molecular structure than nifedipine and is more long-lasting. The biggest difference between the two is the different action time and duration. Dipine antihypertensive drugs have gone through three generations of changes:

The first generation of nifedipine ordinary tablets are short-acting antihypertensive drugs. The drugs are in the body It takes 1 to 2 hours to reach the maximum blood concentration. It has a quick onset of action, but the drug effect is maintained for a short time. The half-life of the drug is 2.5 to 3 hours. Even if it is taken three times a day, blood pressure is difficult to stabilize;

The second-generation nifedipine controlled-release tablets and sustained-release tablets use special technology to delay the drug release rate, but their half-life is only about 10 hours. They should be taken at least twice a day to achieve the antihypertensive effect; < /p>

The third generation of amlodipine ordinary tablets takes 6 to 12 hours to reach maximum blood concentration in the body, and has a half-life of 35 to 50 hours. Taking it once a day can control blood pressure stably for a long time.

Secondly, from the perspective of pharmacokinetics of the drug, amlodipine has unique pharmacokinetic advantages and a more stable antihypertensive effect. There is no significant difference in blood pressure after missing a dose, which is crucial for elderly patients.

Third, amlodipine can better control blood pressure in the morning. Morning is the devil stage when blood pressure rises. Amlodipine can significantly reduce the rate of blood pressure increase in the morning, and its effect is better than nifedipine.

Fourth, in terms of clinical efficacy, amlodipine has better therapeutic effects and lower incidence of adverse reactions.

From these aspects, for patients who take medicine for a long time, you can choose a longer-acting amlodipine. For example, the common Ruishin on our market is levamin besylate. Clodipine, administered once a day, can steadily lower blood pressure. Of course, this does not mean that nifedipine is not good. If you can take the medicine regularly every day according to your blood pressure fluctuations, then it is also okay to take short-acting antihypertensive drugs.

This is because amlodipine tablets are long-acting antihypertensive drugs, but they take time to take effect, especially the benzene that Mr. Wang took. Amlodipine sulfonate is an ordinary tablet made by combining amlodipine with benzenesulfonic acid to form a salt. It mainly exists in the ionic form in the blood, but the ionic form of amlodipine is not easy to access calcium channels and is biodegradable. Slow, so it takes effect slowly.

Generally speaking, amlodipine will exert its antihypertensive effect after taking it, but it takes about 4 to 7 days to achieve a stable antihypertensive effect, and to achieve the strongest antihypertensive effect The effect takes one month. Therefore, patients should not be anxious after taking amlodipine. The onset of action is slower, but it does not mean that there is no effect. Moreover, the antihypertensive effect of amlodipine tablets is very long. The drug in the blood can still be maintained within 48 to 72 hours after taking the drug. At a certain concentration, even if you occasionally miss a dose for two consecutive days, your blood pressure can generally be controlled within a certain range.

Of course, if your blood pressure is unstable after taking amlodipine for a long time, it is recommended to consult your doctor in time to see if you need to adjust your medication, and do not increase the dosage or change the medication without authorization.