S-amlodipine--the 2007 clinical review.

S-amlodipine is the only vaso-active enantiomer of amlodipine. This article reviews the published data in nearly 5000 patients. Randomised controlled trials of S-amlodipine at half the dose of racemate in the treatment of hypertension, have shown it to be as effective as racemic amlodipine. The postmarketing surveillance studies (n = 4089) of S-amlodipine confirmed its antihypertensive efficacy and showed that the incidence of peripheral oedema is negligible with S-amlodipine compared to racemic amlodipine. Further, the patients with peripheral oedema who were switched over from racemic amlodipine to S-amlodipine resolved their oedema associated with the racemate, while sustaining the blood pressure control. Subgroup analyses showed S-amlodipine to be effective and safe in elderly hypertensives and isolated systolic hypertension patients. A clinical study in normotensive angina patients confirmed the anti-anginal efficacy of S-amlodipine at half the dose of racemate. Fixed-dose combinations of S-amlodipine with atenolol and S-amlodipine with hydrochlorothiazide have been shown to be effective and well tolerated in clinical practice. In the light of its efficacy and favourable tolerability profile, S-amlodipine used alone or in combination with other antihypertensive or anti-anginal drugs, is a valuable treatment option in the management of hypertension and angina.