Comparative Pharmacology
Head-to-head clinical analysis: CADUET versus DILTZAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CADUET versus DILTZAC.
CADUET vs DILTZAC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amlodipine: Dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral vascular resistance. Atorvastatin: HMG-CoA reductase inhibitor that competitively inhibits the conversion of HMG-CoA to mevalonate, reducing cholesterol synthesis in the liver.
Diltiazem is a calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cells, resulting in dilation of coronary and systemic arteries and decreased myocardial contractility and conduction velocity.
CADUET (amlodipine/atorvastatin) is available as tablets of 2.5/10, 2.5/20, 2.5/40, 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40, and 10/80 mg amlodipine/atorvastatin. Initial dose depends on current antihypertensive and lipid-lowering therapy. Usual starting dose is 5/10 mg orally once daily; titrate at intervals of 2-4 weeks based on blood pressure and LDL-C goals. Maximum daily dose: amlodipine 10 mg; atorvastatin 80 mg.
Oral: 30-120 mg 3-4 times daily; maximum 480 mg/day. IV: 0.25 mg/kg over 2 min, then 0.35 mg/kg after 15 min if needed; continuous infusion 5-15 mg/hour.
None Documented
None Documented
Amlodipine: terminal half-life 30-50 h (enables once-daily dosing). Atorvastatin: terminal half-life ~14 h, but active metabolites (ortho- and para-hydroxy atorvastatin) have half-life 20-30 h; clinically, pharmacodynamic half-life (HMG-CoA reductase inhibition) is ~20-30 h.
Terminal elimination half-life: 3.5-5.0 hours (healthy adults). Prolonged in elderly (6-8 hours) and in hepatic impairment (10-12 hours).
Amlodipine: 60% renal (metabolites), 20-25% biliary/fecal. Atorvastatin: 1% renal (unchanged), 90% biliary/fecal (≥70% as metabolites).
Renal: 60-70% as metabolites, 2-4% unchanged; Biliary/Fecal: 20-30% as metabolites.
Category C
Category C
Calcium Channel Blocker + HMG-CoA Reductase Inhibitor
Calcium Channel Blocker