L-amlodipine only lowers blood pressure, amlodipine also protects the cardiovascular? This article tells the truth and tells the truth

For the treatment of patients with hypertension, amlodipine and levamlodipine in calcium antagonist drugs must be familiar to many people. Many friends have always been the difference between amlodipine and levamlodipine. Unclear, some friends, and even many doctors believe that compared to the two drugs, L-amlodipine is more advantageous in reducing blood pressure and reducing the incidence of side effects, and amlodipine has better cardiovascular Protection function, is this really the case? Today we will discuss it carefully. What is the difference between Amlodipine and L-Amlodipine? Whether it is amlodipine or L-amlodipine, in the final analysis, it is still a drug. Their main component is amlodipine, but their specific chemical structure has certain differences. To explain this problem, we must first introduce you to the concept of chiral chemical structure. In some chemical drugs, although their molecular formula and molecular structure are consistent from a plane, they exist in three-dimensional space. There are two different configurations on the left and right. These two configurations are like our two hands, mirroring each other. Therefore, we call them chiral drugs, and the two stereo configurations of chiral drugs, we It is generally called “isomer”. Take amlodipine for example. L-amlodipine is the simple structure of the L-chiral isomer obtained after chiral resolution of amlodipine. The amlodipine tablets we see in daily medication , There is no resolution, and there is a racemic amlodipine of the left and right isomers. Why do chiral resolution of amlodipine separate the left-handed structure? This is because, in many drugs, the effect of the isomers of different configurations and the risk of drug safety are different. For amlodipine, compared with the dextran, its levosine is different. The structure is the active component that mainly plays a role in lowering blood pressure. Studies have shown that L-amlodipine is more than 1000 times more effective than D-amlodipine in reducing blood pressure. Therefore, for the separated L-amlodipine, it is equal to We have separated the components with antihypertensive activity, so in terms of antihypertensive effect, the daily dose of 2.5 mg of L-amlodipine tablets is equivalent to the antihypertensive effect of 5 mg of ordinary amlodipine tablets, while the daily dose of 5 mg , Generally equivalent to the antihypertensive effect of 10mg of amlodipine ordinary tablets. In addition to reducing the dosage, in clinical practice, it has also been found that in terms of drug action time, the half-life of the amlodipine racemate is about 35 hours, while the sustained antihypertensive time of L-amlodipine is longer, which can be as high as 50 hours, but whether it is 35 hours or 50 hours, these two drugs are taken orally once a day, they can play a role in smooth pressure control. For morning peak hypertension, these two drugs also have obvious control effects. In terms of the incidence of adverse reactions, clinical studies over the years have also shown that L-amlodipine has better drug activity. At the same time, due to the reduction of the dosage of the drug, without the influence of dextroisomers, the incidence of adverse reactions, also Lower. In nine hospitals including Xuanwu Hospital of Capital Medical University, Qilu Hospital of Shandong Province, and People’s Hospital of Hebei Province, a multi-center, randomized, open, and self-controlled research method was used to carry out “L-amlodipine and amlodipine, nifedipine, “Comparative study of adverse reactions caused by felodipine”, the results show that in the most common adverse reactions of edema taking dipine drugs, levamlodipine has certain advantages over several other drugs, and the degree of edema is more Mild, with the prolonged time of taking the drug, the body can tolerate a higher probability, in addition, the incidence of facial flushing adverse reactions, the incidence of amlodipine 15.3%, while the incidence of L-amlodipine There is also a significant reduction; and in terms of dizziness, headache, etc., L-amlodipine is not significantly different from other dipine drugs. Compared with levamlodipine, does amlodipine tablet have better cardiovascular protection? It can be seen from the comparison and introduction above that although both are amlodipine, the chiral resolution of L-amlodipine has certain advantages in improving the safety and compliance of the medication. But does D-Amlodipine have any pharmacological effects? There have been studies that, compared to L-amlodipine, the right-hand isomer of amlodipine can stimulate the endothelium to secrete nitric oxide, thereby achieving the effect of protecting the endothelium.