Myotan CN 40/10 (Azilsartan Medoxomil and Cilnidipine Tablets) is a fixed dose combination drug containing Azilsartan Medoxomil Tablet and Cilnidipine Tablets and is used in the treatment of hypertension. Myotan CN is is marketed by J.B. Chemicals & Pharmaceuticals Ltd.
Azilsartan inhibits the pressor effects of an angiotensin II infusion in a dose-related manner. Azilsartan blocks the vasoconstrictor and aldosterone secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is, therefore, independent of the pathway for angiotensin II synthesis.
Azilsartan medoxomil is rapidly hydrolyzed to azilsartan, the active metabolite, in the gastrointestinal tract during absorption.
Cilnidipine is a third generation dihydropyridine calcium antagonist with a slow onset and long duration of action. Calcium antagonists inhibit influx of extracellular calcium ions into the cells, resulting in decreased vascular smooth muscle tone and vasodilation, leading to a reduction in blood pressure.
In human studies, cilnidipine had weak inotropic effects and suppressed cardiac sympathetic overactivity. Therefore it may decrease the risk and mortality from long term cardiovascular complications. Once-daily cilnidipine was associated with less reflex tachycardia and had fewer effect on the autonomic nervous system in hypertensive patients.