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C CARDIOVASCULAR SYSTEM

This group comprises substances used for the treatment of cardiovascular conditions.
Drugs used for the treatment of hypertension are classified in C02 - Antihypertensives, C03 - Diuretics, C07 - Beta blocking agents, C08 - Calcium channel blockers, and C09 - Agents acting on the renin-angiotensin system. For the classification of combination products of antihypertensives from different ATC groups, the following ranking should be used, from higher to lower precedence: C09, C07, C08, and C03.


C01 CARDIAC THERAPY
C02 ANTIHYPERTENSIVES

See also C03 - Diuretics, C07 - Beta blocking agents, C08 - Calcium channel blockers and C09 - Agents acting on the renin-angiotensin system.
Antihypertensives are mainly classified at 3rd levels according to the mechanism of action. Most headings are self-explanatory:
C02A Antiadrenergic agents, centrally acting
C02B Antiadrenergic agents, ganglion-blocking
C02C Antiadrenergic agents, peripherally acting
C02D Arteriolar smooth muscle, agents acting on
C02K Other antihypertensives
C02L Antihypertensives and diuretics in combination
C02N Combinations of antihypertensives in ATC gr. C02

The oral DDDs are based on the average doses needed to reduce the blood pressure to a normal level in patients with mild-moderate hypertension.
Parenteral DDDs are based on dosages used for the treatment of hypertensive crises and are based on the content of the active ingredient pr. vial (ampoule).

C03 DIURETICS

This group comprises diuretics, plain and in combination with potassium or other agents. Vasopressin antagonists are also included in this group. Potassium-sparing agents are classified in C03D and C03E.
Combinations with digitalis glycosides, see C01AA.
Combinations with antihypertensives, see C02L - Antihypertensives and diuretics in combination.
Combinations with beta blocking agents, see C07B - C07D.
Combinations with calcium channel blockers, see C08.
Combinations with agents acting on the renin angiotensin system, see C09B and C09D.

The DDDs for diuretics are based on monotherapy. Most diuretics are used both for the treatment of edema and hypertension in similar doses and the DDDs are therefore based on both indications.
The DDDs for combinations correspond to the DDD for the diuretic component, except for ATC group C03E, see comments under this level.

C04 PERIPHERAL VASODILATORS
C05 VASOPROTECTIVES


No DDDs are established in this group, since most of the drugs in this group are for topical use.

C07 BETA BLOCKING AGENTS
C08 CALCIUM CHANNEL BLOCKERS

The calcium channel blockers are classified according to selectivity of calcium channel activity and direct cardiac effects. The ATC 4th levels are subdivided according to chemical structure.
Combinations with ergot alkaloids (C04AE) are classified in this group by using the 50-series.
Combinations with diuretics are classified in C08G.
Combinations with ACE inhibitors are classified in C09BB.
Combinations with beta blocking agents are classified in C07FB.
Combinations with statins are classified in C10BX.

The DDDs for calcium channel blockers are based on the treatment of mild-moderate hypertension, although some are used for other indications (e.g. angina pectoris).
The DDDs for oral and parenteral preparations are equal and are based on the oral dose, since oral preparations represent the major fraction of the total consumption.

C09 AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM

The DDDs are based on the treatment of mild-moderate hypertension.
See comments to C02L concerning the principles for assignment of DDDs for combined preparations.

C10 LIPID MODIFYING AGENTS

The DDDs are based on the treatment of hypercholesterolemia.

Last updated: 2024-01-26