Adis, a Wolters Kluwer Business, Auckland, New Zealand.
Drugs. 2010;70(2):191-213. doi: 10.2165/11204420-000000000-00000.
Amlodipine/atorvastatin (Caduet) is a single-tablet, fixed-dose combination of the dihydropyridine calcium channel antagonist amlodipine and the HMG-CoA reductase inhibitor atorvastatin. The bioavailability of amlodipine and atorvastatin with a single-tablet, fixed-dose amlodipine/atorvastatin combination was not significantly different to that with coadministered separate amlodipine and atorvastatin tablets. In well controlled clinical trials in patients with hypertension and dyslipidaemia, once-daily amlodipine and atorvastatin (administered as the single-tablet, fixed-dose combination or coadministered as two separate tablets) effectively reduced systolic BP (SBP) and low-density lipoprotein cholesterol (LDL-C) levels, and enabled more patients to achieve BP and LDL-C goals than single-agent or placebo therapy. There was no modification of the effect of amlodipine on SBP when administered in combination with atorvastatin and there was no modification of the effect of atorvastatin on LDL-C when administered in combination with amlodipine. In noncomparative, titration-to-goal, open-label 'real-world' trials, the single-tablet, fixed-dose combination of amlodipine/atorvastatin enabled patients with hypertension and dyslipidaemia to achieve both BP and LDL-C goals. Administration of a single tablet of amlodipine/atorvastatin, compared with coadministration of these agents as two separate tablets, improved patient adherence, according to a retrospective study that utilized prescription refill rates from a large US insurance database. Data from the large, randomized, double-blind, placebo-controlled ASCOT-LLA trial also demonstrated that the combination of amlodipine-based therapy and atorvastatin was effective in preventing cardiovascular (CV) endpoints in hypertensive patients at risk of CV disease (CVD). In summary, amlodipine/atorvastatin offers a convenient and effective approach to improving adherence and managing CV risk in hypertensive patients with dyslipidaemia or at risk of CVD.
氨氯地平/阿托伐他汀（Caduet）是二氢吡啶钙通道拮抗剂氨氯地平和 HMG-CoA 还原酶抑制剂阿托伐他汀的单一片剂固定剂量组合。单一片剂固定剂量氨氯地平/阿托伐他汀组合的氨氯地平和阿托伐他汀的生物利用度与联合使用分别的氨氯地平和阿托伐他汀片剂没有显著差异。在高血压和血脂异常患者的对照临床试验中，氨氯地平与阿托伐他汀的每日一次给药（以单一片剂固定剂量联合给药或联合给予两种单独的片剂）可有效降低收缩压（SBP）和低密度脂蛋白胆固醇（LDL-C）水平，并使更多的患者达到血压和 LDL-C 目标，而不是单一药物或安慰剂治疗。当与阿托伐他汀联合使用时，氨氯地平对 SBP 的作用没有改变，当与氨氯地平联合使用时，阿托伐他汀对 LDL-C 的作用没有改变。在非比较、滴定至目标、开放标签的“真实世界”试验中，氨氯地平/阿托伐他汀的单一片剂固定剂量联合使高血压和血脂异常患者能够同时达到血压和 LDL-C 目标。一项利用美国大型保险公司数据库的处方续配率的回顾性研究表明，与联合使用这两种药物作为两种单独的片剂相比，服用氨氯地平/阿托伐他汀的单一片剂可提高患者的依从性。大型、随机、双盲、安慰剂对照的 ASCOT-LLA 试验的数据还表明，氨氯地平为基础的治疗与阿托伐他汀联合在预防心血管（CV）终点方面在有心血管疾病（CVD）风险的高血压患者中是有效的。总之，氨氯地平/阿托伐他汀为改善高血压伴血脂异常或有 CVD 风险患者的依从性和管理 CV 风险提供了一种方便有效的方法。
