Istin

Istin is the brand name for amlodipine, a long-acting calcium channel blocker of the dihydropyridine class used in the treatment of hypertension (high blood pressure) and stable angina pectoris.

By relaxing the smooth muscle in blood vessel walls, amlodipine widens the arteries, reducing peripheral vascular resistance and lowering blood pressure.

In angina, it reduces the workload on the heart and improves coronary blood flow.

Amlodipine has a gradual onset of action and a long plasma half-life, providing smooth, 24-hour blood pressure control with once-daily dosing.

This pharmacokinetic profile makes it well suited to long-term cardiovascular management, as it avoids the peaks and troughs in blood pressure that may occur with shorter-acting agents.

Istin may be used alone or in combination with other antihypertensive medications such as ACE inhibitors, angiotensin receptor blockers, beta-blockers, or thiazide diuretics.

It is one of the most widely prescribed antihypertensive medications worldwide and has a well-established safety profile.

Take one Istin tablet once daily, at the same time each day, with or without food. Swallow the tablet whole with water.

Do not stop taking Istin without consulting your doctor, even if you feel well, as hypertension often has no symptoms. Blood pressure control depends on continuous daily use.

Your doctor may start you on a lower dose and increase it after one to two weeks if your blood pressure is not adequately controlled.

It may take several weeks to feel the full benefit, though blood pressure begins to fall within a few days of starting treatment.

The usual starting dose is 5 mg once daily. This may be increased to a maximum of 10 mg once daily if needed. In elderly patients or those with hepatic impairment, a starting dose of 2.

5 mg may be appropriate. No dose adjustment is required for renal impairment, as amlodipine is not significantly removed by dialysis.

The dose should be titrated according to individual response and tolerability.

Common side effects (up to 1 in 10 users) include ankle swelling (peripheral oedema), flushing, headache, dizziness, and fatigue.

These effects are dose-related and occur more frequently at 10 mg than at 5 mg. Uncommon effects include palpitations, nausea, abdominal pain, and altered bowel habit.

Rarely, gum hypertrophy (thickening of the gums) may occur with long-term use, which usually resolves on stopping the medication.

Serious adverse events such as severe hypotension, myocardial infarction, or arrhythmia are very rare.

Use with caution in patients with severe aortic stenosis, heart failure, and hepatic impairment.

Ankle swelling is a pharmacological effect caused by arteriolar dilatation, not fluid overload, and does not respond to diuretics.

If ankle swelling becomes troublesome, your doctor may reduce the dose or consider an alternative. Grapefruit juice may increase amlodipine levels and should be avoided in large quantities.

Inform your prescriber of all other medications you take, as certain drugs may interact.

Istin is contraindicated in patients with severe hypotension, cardiogenic shock, unstable angina (other than Prinzmetal's angina), haemodynamically significant aortic stenosis, and hypersensitivity to amlodipine, other dihydropyridines, or any excipient.

It should not be used within one to two weeks of a myocardial infarction or in decompensated heart failure.