What are the primary uses of Norvasc. How should Norvasc be taken for optimal effectiveness. What are the common side effects of Norvasc. When should you consult a doctor while taking Norvasc. How does Norvasc work to lower blood pressure. What precautions should be taken when using Norvasc. How does Norvasc compare to other blood pressure medications.

Understanding Norvasc: A Versatile Calcium Channel Blocker

Norvasc, also known by its generic name amlodipine, is a widely prescribed medication belonging to the calcium channel blocker class of drugs. Its primary function is to treat high blood pressure and certain types of chest pain (angina). By relaxing blood vessels, Norvasc allows for improved blood flow throughout the body, effectively reducing blood pressure and easing the strain on the heart.

Why is Norvasc prescribed? The medication serves two main purposes:

• To lower high blood pressure, thereby reducing the risk of strokes, heart attacks, and kidney problems
• To prevent and manage chest pain (angina), improving exercise tolerance and decreasing the frequency of angina attacks

It’s important to note that while Norvasc is effective in preventing angina, it should not be used to treat acute attacks of chest pain. For immediate relief during an angina episode, other medications such as sublingual nitroglycerin are typically prescribed.

Proper Usage and Dosage Guidelines for Norvasc

How should Norvasc be taken? The medication is typically administered orally, with or without food, usually once daily. The specific dosage depends on the individual’s medical condition and response to treatment. Here are some key points to remember:

• Always follow your doctor’s instructions regarding dosage and frequency
• If using the liquid form, check with your pharmacist about proper shaking and measuring techniques
• Take Norvasc at the same time each day to maintain consistent blood levels
• Continue taking the medication even if you feel well, as high blood pressure often has no symptoms

Can the dosage of Norvasc be adjusted? Yes, your doctor may gradually increase your dose to achieve optimal results. It’s crucial to follow these adjustments carefully and not to modify your dosage without medical supervision.

Special Considerations for Liquid Norvasc

If you’re prescribed the liquid form of Norvasc, pay attention to these details:

1. Some brands require shaking before use, while others don’t
2. Use a special measuring device or spoon to ensure accurate dosing
3. Avoid using household spoons, as they may not provide the correct dose

Identifying and Managing Norvasc Side Effects

What are the common side effects of Norvasc? While many people tolerate Norvasc well, some may experience side effects. Common ones include:

• Dizziness
• Lightheadedness
• Swelling in ankles or feet
• Flushing

Are there any serious side effects to watch for? Yes, although less common, some serious side effects may occur. These include:

• Fast, irregular, or pounding heartbeat
• Fainting
• Worsening chest pain (in people with severe heart disease)
• Symptoms of a heart attack (chest/jaw/left arm pain, shortness of breath, unusual sweating)

When should you seek immediate medical attention while taking Norvasc? If you experience any of the following, contact your doctor immediately:

• Signs of a serious allergic reaction (rash, itching/swelling, severe dizziness, trouble breathing)
• Worsening of chest pain or symptoms of a heart attack
• Any severe or persistent side effects

The Mechanism of Action: How Norvasc Works in Your Body

How does Norvasc lower blood pressure? Norvasc belongs to a class of drugs known as calcium channel blockers. Its mechanism of action involves:

1. Blocking calcium channels in the smooth muscles of blood vessels and the heart
2. Reducing the influx of calcium ions into these cells
3. Causing relaxation of blood vessels (vasodilation)
4. Decreasing peripheral vascular resistance
5. Lowering blood pressure as a result

Does Norvasc affect heart rate? Unlike some other blood pressure medications, Norvasc typically does not significantly affect heart rate. This characteristic makes it a suitable option for many patients, especially those with certain heart conditions.

Precautions and Interactions: Ensuring Safe Use of Norvasc

What precautions should be taken when using Norvasc? Before starting Norvasc, inform your healthcare provider about:

• Any allergies, especially to dihydropyridine calcium channel blockers
• Your complete medical history, particularly liver disease or aortic stenosis
• All medications, supplements, and herbal products you’re taking

Are there any lifestyle modifications to consider while on Norvasc? Yes, some important considerations include:

• Avoiding alcohol and marijuana, as they can increase dizziness
• Refraining from driving or operating machinery until you know how Norvasc affects you
• Informing your doctor about Norvasc use before any surgical procedures

Potential Drug Interactions

Which medications might interact with Norvasc? Several drugs can interact with Norvasc, potentially affecting its efficacy or increasing side effects. These include:

• Other blood pressure medications
• Certain antifungal medications
• Some antibiotics
• HIV protease inhibitors

Always provide your healthcare provider with a complete list of your medications to avoid potential interactions.

Norvasc in Special Populations: Considerations for Specific Groups

Is Norvasc safe for use during pregnancy and breastfeeding? The use of Norvasc in pregnant women requires careful consideration:

• Pregnancy: Norvasc should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus
• Breastfeeding: Norvasc is known to pass into breast milk, so caution is advised for nursing mothers

How is Norvasc used in elderly patients? Older adults may be more sensitive to the side effects of Norvasc, particularly dizziness and lightheadedness. Careful monitoring and possible dose adjustments may be necessary.

Norvasc in Patients with Liver Disease

Why is special consideration needed for patients with liver problems? The liver plays a crucial role in metabolizing Norvasc. Therefore:

• Patients with liver disease may require lower doses
• More frequent monitoring of liver function may be necessary
• The doctor may need to adjust the dosage based on the severity of liver impairment

Comparing Norvasc to Other Blood Pressure Medications

How does Norvasc compare to other antihypertensive drugs? Norvasc, as a calcium channel blocker, offers several advantages:

• Once-daily dosing for improved compliance
• Generally well-tolerated with fewer side effects compared to some other classes of blood pressure medications
• Effective in a wide range of patient populations
• Can be used alone or in combination with other antihypertensive drugs

Are there situations where other medications might be preferred over Norvasc? Yes, in certain cases, other medications may be more suitable:

• Patients with certain heart rhythm disorders may benefit more from beta-blockers
• Those with diabetes or kidney disease might be prescribed ACE inhibitors or ARBs as first-line treatments
• Individuals with specific comorbidities may require a different class of medication or a combination therapy

Combination Therapy with Norvasc

When might Norvasc be prescribed in combination with other medications? Combination therapy may be recommended in cases where:

1. Monotherapy with Norvasc doesn’t achieve target blood pressure
2. The patient has comorbid conditions that benefit from multiple medication approaches
3. There’s a need to address different aspects of cardiovascular health simultaneously

Long-term Use of Norvasc: What to Expect

What should patients know about the long-term use of Norvasc? When prescribed for chronic conditions like hypertension, Norvasc is typically used as a long-term medication. Here are some important points to consider:

• Regular blood pressure monitoring is essential to ensure the medication remains effective
• Periodic blood tests may be required to check for any changes in kidney or liver function
• The dosage may need adjustment over time based on your body’s response and any changes in your health status

Can Norvasc lose its effectiveness over time? While tolerance to some blood pressure medications can develop, Norvasc generally maintains its effectiveness over long periods. However, factors such as weight gain, dietary changes, or the development of other health conditions may necessitate adjustments in your treatment plan.

Lifestyle Modifications to Complement Norvasc Treatment

What lifestyle changes can enhance the effectiveness of Norvasc? To maximize the benefits of Norvasc and improve overall cardiovascular health, consider the following lifestyle modifications:

1. Maintain a healthy, low-sodium diet
2. Engage in regular physical activity as approved by your doctor
3. Achieve and maintain a healthy weight
4. Limit alcohol consumption
5. Quit smoking if you’re a smoker
6. Manage stress through relaxation techniques or counseling

How do these lifestyle changes work in conjunction with Norvasc? These modifications can:

• Enhance the blood pressure-lowering effects of Norvasc
• Reduce the risk of cardiovascular complications
• Potentially allow for lower medication doses over time
• Improve overall health and well-being

Managing Missed Doses and Potential Overdose

What should you do if you miss a dose of Norvasc? If you forget to take your Norvasc dose:

• Take it as soon as you remember if it’s within 12 hours of your usual dosing time
• Skip the missed dose and resume your regular schedule if it’s close to your next scheduled dose
• Never double up on doses to make up for a missed one

What are the signs of a Norvasc overdose? While rare, an overdose of Norvasc can occur. Symptoms may include:

• Severe dizziness or lightheadedness
• Fainting
• Extremely low blood pressure
• Rapid or slow heartbeat

If you suspect an overdose, seek emergency medical attention immediately.

Proper Storage and Disposal of Norvasc

How should Norvasc be stored? To maintain the effectiveness and safety of your medication:

• Store Norvasc at room temperature, away from light and moisture
• Keep it out of reach of children and pets
• Do not store in the bathroom

What’s the proper way to dispose of unused or expired Norvasc? To safely dispose of Norvasc:

1. Check if your local pharmacy has a medication take-back program
2. If not available, mix the medication with an undesirable substance (like used coffee grounds), seal it in a plastic bag, and throw it in the household trash
3. Remove any personal information from the empty medication container before discarding

By following these guidelines, you can ensure the safe and effective use of Norvasc while minimizing potential risks and maximizing its benefits in managing your blood pressure or angina symptoms. Always consult with your healthcare provider for personalized advice and never hesitate to ask questions about your medication regimen.

Norvasc Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Amlodipine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Amlodipine belongs to a class of drugs known as calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily.Amlodipine is also used to prevent certain types of chest pain (angina). It may help to increase your ability to exercise and decrease the frequency of angina attacks. It should not be used to treat attacks of chest pain when they occur. Use other medications (such as sublingual nitroglycerin) to relieve attacks of chest pain as directed by your doctor.

How to use Norvasc

Read the Patient Information Leaflet if available from your pharmacist before you start taking amlodipine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

If you are using the liquid form of this medication, check the manufacturer’s information or ask your pharmacist for specific directions. Some brands of the liquid form should be shaken before use, while other brands do not need to be shaken before use. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose

The dosage is based on your medical condition and response to treatment. Your doctor may gradually increase your dose. Follow your doctor’s instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

If used for angina, this medication must be taken regularly to be effective. It should not be used to treat angina when it occurs. Use other medications (such as sublingual nitroglycerin) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase, chest pain continues or worsens).

Side Effects

Dizziness, lightheadedness, swelling ankles/feet, or flushing may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fast/irregular/pounding heartbeat, fainting.

Although this medication is effective in preventing chest pain (angina), some people who already have severe heart disease may rarely develop worsening chest pain or a heart attack after starting this medication or increasing the dose. Get medical help right away if you experience: worsening chest pain, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking amlodipine, tell your doctor or pharmacist if you are allergic to it; or to other dihydropyridine calcium channel blockers (such as nisoldipine, nifedipine) or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain structural heart problem (aortic stenosis), very low blood pressure, liver disease.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the effects of this drug, especially dizziness.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Does Norvasc interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fainting, severe dizziness.

Do not share this medication with others.

Lifestyle changes that may help this medication work better include exercising, stopping smoking, reducing stress, and eating a low-cholesterol/low-fat diet. Consult your doctor for more details.

Lab and/or medical tests (such as blood pressure) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store the tablets at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Different brands of the liquid form of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Norvasc 2.5 mg tablet

Color: whiteShape: diamondImprint: NORVASC 2.5

This medicine is a white, diamond, tablet imprinted with “NORVASC” and “2.5”.

Norvasc 5 mg tablet

Color: whiteShape: octagonalImprint: NORVASC 5

This medicine is a white, diamond, tablet imprinted with “NORVASC” and “2.5”.

Norvasc 10 mg tablet

Color: whiteShape: roundImprint: NORVASC 10

This medicine is a white, diamond, tablet imprinted with “NORVASC” and “2.5”.

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Drug Survey

Are you currently using Norvasc?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Side effects, dosage, uses, and more

1. Amlodipine oral tablet is available as a brand-name drug and a generic drug. Brand name: Norvasc.
2. Amlodipine comes only as a tablet you take by mouth.
3. Amlodipine oral tablet is used to treat high blood pressure, coronary artery disease, and angina.

Amlodipine’s possible side effects are described below.

More common side effects

The more common side effects that can occur with amlodipine include:

• swelling of your legs or ankles
• tiredness
• feeling sleepy
• abdominal pain
• nausea
• dizziness
• hot or warm feeling in your face (flushing)
• very fast heart rate (palpitations)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Low blood pressure. Symptoms can include:
  • severe dizziness
  • lightheadedness
  • fainting
• More chest pain or a heart attack. In rare cases, when you first start taking amlodipine or increase your dosage, your chest pain may get worse or you may have a heart attack. Symptoms can include:
  • chest pain or discomfort
  • upper body discomfort
  • shortness of breath
  • breaking out in a cold sweat
  • unusual tiredness
  • nausea
  • lightheadedness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

• Allergic reaction warning: If you’ve had an allergic reaction to amlodipine oral tablet or any of its ingredients, you should not take this drug. Ask your doctor about other medications that might be better options for you.

Amlodipine is a prescription drug. It comes as a tablet you take by mouth.

Amlodipine is available as the brand-name drug Norvasc. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Amlodipine may be taken in combination with other heart or blood pressure medications.

Why it’s used

Amlodipine is used to lower your blood pressure.

Amlodipine is also used to help blood flow more easily to your heart when the arteries in your heart are blocked.

Amlodipine is also used to treat coronary artery disease and angina (chest pain).

This drug can be used alone or in combination with other heart or blood pressure medications.

How it works

Amlodipine belongs to a class of drugs called calcium channel blockers. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Amlodipine blocks calcium from entering certain tissues and arteries. This makes it easier for them to relax so that blood can flow more easily to your heart. This in turn helps lower your blood pressure, and reduces your risk of heart attack or stroke. If you’re taking amlodipine for chest pain, this drug reduces your risk of hospitalization and surgeries due to chest pain.

How long it lasts

Amlodipine starts working right away after you take your first dose. It may take several days for the drug to reach its full effects for lowering your blood pressure or reducing your chest pain. With regular daily use, amlodipine’s effects typically last for about 24 hours.

The effects of amlodipine should last as long as you continue taking it as prescribed. If your doctor recommends stopping amlodipine, the drug will typically stay in your system for around 10 days after your last dose. It’s possible to continue experiencing effects of amlodipine after you stop taking the drug, especially during this 10-day period.

If you have questions about how long you’ll continue taking amlodipine or how long its effects last, talk with your doctor.

As with all medications, the cost of amlodipine can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of amlodipine oral tablets. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Financial and insurance assistance

Financial assistance to help you pay for amlodipine may be available.

Medicine Assistance Tool and NeedyMeds are two websites offering resources that may help decrease the price you pay for amlodipine. They also offer tools to help you find low cost healthcare, as well as educational resources. To learn more, visit their sites.

You can also refer to the coupons on this page for possible ways to save on amlodipine oral tablets.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Amlodipine may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of amlodipine, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• other medications you take
• how you react to the first dose

Drug forms and strengths

Generic: amlodipine

• Form: oral tablet
• Strengths: 2.5 milligrams (mg), 5 mg, 10 mg

Brand: Norvasc

• Form: oral tablet
• Strengths: 2.5 mg, 5 mg, 10 mg

Dosage for high blood pressure (hypertension)

Adult dosage (ages 18 to 64 years)

• Typical starting dosage: 2.5 mg to 5 mg taken once per day.
• Dosage increases: Your doctor may change your dosage based on your blood pressure goals. If your blood pressure is still not managed after 7 to 14 days of treatment, your doctor may increase your dosage.
• Maximum dosage: 10 mg per day.

Child dosage (ages 6 to 17 years)

• Typical dosage: 2.5 mg to 5 mg taken by mouth once per day. Doses above 5 mg have not been studied in children and are not usually prescribed.

Child dosage (ages 0 to 5 years)

This drug is not usually prescribed for use in children younger than 6 years.

Senior dosage (ages 65 years and older)

• Typical dosage: 2.5 mg taken by mouth once per day.
• Note: Older adults may process drugs more slowly. A typical adult dosage may cause levels of amlodipine in your body to be higher than recommended. If you’re an older adult, you may need a lower dosage.

Dosage for coronary artery disease and angina

Adult dosage (ages 18 to 64 years)

• Typical starting dosage: 5 mg taken once per day.
• Maximum dosage: 10 mg per day.

Child dosage (ages 0 to 17 years)

A child’s dosage is not available for this use.

Senior dosage (ages 65 years and older)

• Typical dosage: 5 mg taken by mouth once per day.
• Note: Older adults may process drugs more slowly. A typical adult dosage may cause levels of amlodipine in your body to be higher than recommended. If you’re an older adult, you may need a lower dosage.

Special dosage considerations

For people with liver disease: The recommended dosage is 2.5 mg taken once per day. Amlodipine is processed by your liver. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk of side effects. If you have severe liver problems, you may need a lower dosage.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

You might wonder how amlodipine compares with losartan (Cozaar). These medications are used for many of the same conditions. You can refer to this article to learn how these drugs compare. Also, be sure to talk with your doctor about which drug is right for you.

Amlodipine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with amlodipine are listed below.

Heart medication

Taking diltiazem with amlodipine can increase the level of amlodipine in your body. This may cause more side effects.

Antifungal medications

Taking amlodipine with these drugs can increase the level of amlodipine in your body. This may cause more side effects. Examples of these drugs include:

• ketoconazole
• itraconazole
• voriconazole

Antibiotic

Taking clarithromycin with amlodipine can increase the level of amlodipine in your body. This may cause more side effects.

Medications for erection problems

Taking amlodipine with these drugs can increase your risk of low blood pressure (hypotension).

Examples of these drugs include:

• sildenafil (Viagra)
• tadalafil (Cialis)
• avanafil
• vardenafil (Levitra)

Cholesterol medication

Taking amlodipine with simvastatin can cause the levels of simvastatin to increase in your body. (Simvastatin is a cholesterol medication. ) This may increase the risk of simvastatin’s side effects.

Drugs that control your immune system

Taking amlodipine with these drugs can cause the levels of these medications to increase in your body. This may lead to more side effects. Examples of these drugs include:

• cyclosporine (Gengraf, Neoral, Sandimmune)
• tacrolimus

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Amlodipine can cause a severe allergic reaction. Symptoms include:

• trouble breathing
• swelling of your throat or tongue
• hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Do not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with liver problems: Amlodipine is processed by your liver. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk for more side effects. If you have severe liver problems, your doctor may lower your dosage.

For people with severe aortic stenosis: With severe aortic stenosis, the opening of one of your heart valves becomes very narrow, which limits blood flow to your body. If you have this condition, taking amlodipine may lead to low blood pressure. Your doctor may prescribe a low dosage of amlodipine and monitor you closely during treatment. Or they may recommend a different treatment option.

For people with severe obstructive coronary artery disease: With severe obstructive coronary artery disease, your arteries become very narrow. This limits blood flow and increases your risk of serious problems, such as a heart attack or worsening angina (chest pain). In rare cases, taking amlodipine can further increase this risk, especially when you first start taking it or your dosage is increased. If you have this condition, your doctor may prescribe a low dosage of amlodipine and monitor you closely during your treatment. Or they may recommend a different treatment option.

Warnings for other groups

For pregnant people: Research in animals has shown negative effects to the fetus when the pregnant animals were given amlodipine. However, there haven’t been enough studies done in humans to be certain how the drug might affect a human pregnancy.

Tell your doctor if you’re pregnant or planning to become pregnant. Amlodipine should be used during pregnancy only if the potential benefit justifies the potential risk.

For people who are breastfeeding: Some research has shown that amlodipine passes into breast milk. However, it’s not known if amlodipine can cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For older adults (seniors): As you age, your body may not process this drug as well as it once could. More of this drug may stay in your body longer. This puts you at risk for more side effects.

For children: This drug usually isn’t prescribed for use in children younger than 6 years.

Amlodipine oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all or stop taking it: If you don’t take amlodipine or stop taking it, your blood pressure or chest pain may get worse. This could lead to serious problems, such as a stroke or heart attack.

If you skip or miss doses: If you skip or miss doses, your blood pressure or chest pain may get worse. This could lead to serious problems, such as a stroke or heart attack.

What to do if you miss a dose: If you miss a dose, take it as soon as you remember. If it’s been more than 12 hours since you missed your dose, skip that dose and take the next dose at your regular time.

If you take too much: If you take too much amlodipine, you may experience dangerously low blood pressure. Symptoms can include:

• dizziness
• lightheadedness
• fainting
• very fast heart rate

If you think you’ve taken too much of this drug, call your doctor or seek guidance from America’s Poison Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

There is no antidote for this medication. If you take too much, you’ll be treated for whatever side effects you have.

How to tell if the drug is working: How to tell if amlodipine is working depends on the condition being treated. For high blood pressure, the drug should lower your blood pressure on tests. For angina or coronary artery disease, the drug should help prevent your symptoms (such as chest pain).

Keep these considerations in mind if your doctor prescribes amlodipine for you.

General

• Take amlodipine at the same time every day.
• You can cut or crush the tablet.

Storage

This drug must be stored at the right temperature:

• Store amlodipine at room temperature between 59°F and 86°F (15°C and 30°C).
• Store this drug in its original container and keep it tightly closed.
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure at home.

You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor’s appointments.

Your doctor may ask you to purchase a blood pressure monitor to check your blood pressure between office visits.

Clinical monitoring

Before starting and during your treatment with this drug, your doctor may check your:

• blood pressure
• liver function

These tests will help your doctor decide if amlodipine is safe for you to start and if you need a lower dosage.

Availability

Amlodipine should usually be in stock at any pharmacy. It’s not considered a specialty drug.

Hidden costs

You may need to purchase a home blood pressure monitor to keep track of your blood pressure. These are available at most pharmacies and online.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Arpimed

What Amlodipine is and what it is used for

The active ingredient in Amlodipine is amlodipine, which belongs to a group of medicines called calcium channel blockers.

Amlodipine is used to treat high blood pressure (hypertension) or a certain type of chest pain known as angina, a rare form of which is Prinzmetal’s angina or variant angina.

In patients with high blood pressure, this drug causes blood vessels to relax, making it easier for blood to pass through. In patients with angina pectoris, amlodipine improves the blood supply to the heart muscle and, accordingly, increases the flow of oxygen to it, thereby preventing the occurrence of pain in the chest. This drug does not provide immediate relief from chest pain due to angina pectoris.

What you need to know before you use Amlodipine

Do not take Amlodipine to other calcium antagonists. Allergies can be manifested by itching, redness of the skin, or difficulty breathing.

Warnings and precautions

Talk to your doctor or pharmacist before taking Amlodipine.

If you have or have had any of the following conditions, you should inform your doctor:

• Recent myocardial infarction
• Heart failure
• Severe increase in blood pressure (hypertensive crisis)
• Liver disease
• You are an elderly person and you need to increase the dose of the drug according to indications.

Children and adolescents

Amlodipine has not been studied in children under 6 years of age. Amlodipine can only be used in children and adolescents with arterial hypertension aged 6 to 17 years.

For more information, consult your doctor.

Other medicines and Amlodipine

Tell your doctor or pharmacist if you are currently taking or have recently taken any other medicines drugs, including over-the-counter drugs.

Amlodipine may or may be affected by other drugs such as:

• ketoconazole, itraconazole (antifungals)
• ritonavir, indinavir, nelfinavir (so-called protease inhibitors used to treat HIV))
• rifampicin, erythromycin, clarithromycin (antibiotics)
• Hypericum perforatum (preparations containing St. John’s wort)
• verapamil, diltiazem (heart drugs)
• dantrolene (infusion for severe fever)
• tacrolimus, sirolimus, temsirolimus and everolimus (medicines used to regulate the immune system).
• simvastatin (cholesterol-lowering drug)
• cyclosporine (immunosuppressant).

Amlodipine may lower blood pressure more when other medicines are used to treat high blood pressure.

Interaction with food and drink to a more pronounced decrease in blood pressure.

Pregnancy and breastfeeding

Pregnancy

The safety of amlodipine in pregnant women has not been established. If you suspect pregnancy or are planning to become pregnant, talk to your doctor before taking this medicine.

Breastfeeding

Amlodipine has been found to pass into breast milk. If you are breast-feeding or plan to breast-feed, consult your doctor before taking this medicine.

Driving and using machines

Amlodipine may affect the ability to drive or use machines. If you feel unwell, dizzy, tired or have a headache after taking the tablets, do not drive or operate machinery and contact your doctor immediately.

Amlodipine contains sodium

practically does not contain sodium.

How to take Amlodipine

Always take your medicine exactly as your doctor or pharmacist has told you. If you have any doubts about taking the drug, consult your doctor or pharmacist.

The recommended starting dose of amlodipine is 5 mg once daily. The dose of amlodipine can be increased up to 10 mg once a day.

This medicine can be taken before or after food and drinks. This medicine should be taken at the same time of day with water. Amlodipine should not be taken with grapefruit juice.

Use in children and adolescents

For children and adolescents (6 to 17 years of age), the recommended starting dose is 2.5 mg once daily. The maximum recommended dose is 5 mg once daily. Amlodipine 5 mg tablets may be divided into two equal doses.

It is important not to stop taking the drug. Don’t wait until you run out of pills before going to the doctor.

If you have taken more Amlodipine than recommended

Taking too many tablets can cause your blood pressure to drop to dangerous levels. This may cause dizziness, weakness, or fainting. With a very strong drop in blood pressure, shock can develop. The skin becomes cold and clammy, and unconsciousness may develop. If you have taken too many Amlodipine tablets, seek medical attention immediately.

If you forget to take Amlodipine

Don’t worry. If you forget to take a tablet, skip this dose. Take the next dose at the correct time. Do not take a double dose to make up for a missed dose.

If you stop taking Amlodipine

Your doctor will tell you how long to take this medicine. If you stop taking this drug before the recommended time, you may have a relapse.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, amlodipine can cause side effects, although not everyone gets them.

If you experience any of the following side effects after taking this drug, call your doctor immediately:

• sudden wheezing, chest pain, shortness of breath, or trouble breathing;
• swelling of the eyelids, face or lips;
• swelling of the tongue and throat, making breathing very difficult;
• severe skin reactions, including severe skin rash, urticaria, redness of the skin of the entire body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis) or other allergic reactions;
• myocardial infarction, cardiac arrhythmia;
• inflammation of the pancreas, which can manifest itself as severe pain in the abdomen and back, accompanied by a feeling of severe malaise.

The following side effect is very common . If this effect causes you problems, or if it lasts more than a week, you should contact your doctor.

Very common : may affect more than 1 in 10 people

• Edema (fluid retention).

Often the following side effects occur. If any of them cause you problems, or if they last more than a week, you should see your doctor.

Common: may affect up to 1 in 10 people

• Palpitations (feeling your own heartbeat), hot flashes
• Abdominal pain, nausea
• Defecation disorder, diarrhoea, constipation, indigestion
• Weakness, fatigue
• Impaired vision, double vision
• Muscle cramps
• Ankle edema.

The following is a list of other reported adverse reactions. If any of these side effects become serious or if you notice side effects not listed in this leaflet, please tell your doctor or pharmacist.

Uncommon: may affect up to 1 in 100 people,

• Mood changes, anxiety, depression, insomnia
• Trembling, taste disturbances, syncope
• Numbness or tingling in limbs, loss of pain sensation
• Ringing in the ears
• Low blood pressure
• Sneezing/runny nose caused by inflammation of the nasal mucosa (rhinitis)
• Cough
• Dry mouth, vomiting
• Hair loss, increased sweating, pruritus, red spots on the skin, discoloration of the skin
• Urinary disorder, frequent urge to urinate at night, frequent urination
• Inability to achieve an erection, malaise or breast enlargement in men
• Pain, deterioration of health
• Pain in joints or muscles, back pain
• Weight gain or loss.

Rare : may affect up to 1 in 1,000 people

• Confusion,

Very rare : may affect up to 1 in 10,000 people 20

Disorders including rigidity, tremor and/or movement disorders.

Reporting of side effects leaflet. You can also report side effects to Arpimed LLC by going to the website www.arpimed.com and filling out the appropriate form “Report a side effect or ineffectiveness of a drug” and to the Scientific Center for Expertise of Drugs and Medical Technologies named after. Academician E.Gabrielyan, by going to the website www.pharm.am in the section “Report a side effect of a drug” and fill out the form “Map of reporting a side effect of a drug”. Scientific center hotline: +37410200505; +37496220505 By reporting side effects, you help gather more information about the safety of this drug.

How to store Amlodipine

• The drug should be stored out of the reach of children, protected from moisture and light at a temperature of 15 ⁰ C -25 ⁰ C.
• Shelf life – 3 years. Do not take Amlodipine after the expiry date which is stated on the package. When specifying the expiration date, the last day of the specified month is meant.
• If the tablets have changed color or show other signs of deterioration, do not take the drug.
• Medicines should not be disposed of into wastewater or sewers. Ask your pharmacist how to dispose of a medicine you no longer need. These measures are aimed at protecting the environment.

Contents of the pack and additional information

What Amlodipine contains

One Amlodipine 10 mg tablet contains:

active substance: amlodipine (in the form of besylate) – 10 mg stearate.

What Amlodipine looks like and contents of the pack: oh on one side; without smell.

Tablets 10 mg

Carton containing 30 tablets with leaflet: 3 blisters of 10 tablets each.

Dispensing conditions

Available by prescription.

official instructions for use, analogues, price, availability in pharmacies

See where the instructions come from MEDI RU

Registration number:

P N015567/01-260707

Brand name: NORVASC ^®

International generic name:

amlodipine.

Dosage form:

tablets.

Composition

Active ingredient: amlodipine besilate at a dose of 6.935 mg and 13.870 mg, equivalent to 5 and 10 mg of amlodipine, respectively.

Excipients: fine crystalline cellulose, anhydrous calcium hydrogen phosphate, sodium starch glycolate type A, magnesium stearate.

Description

Tablets 5 mg – white or almost white tablets in the form of an emerald (octahedron with uneven sides) with the Pfizer logo on one side and AML-5 on the other.
Tablets 10 mg – white or almost white tablets in the form of an emerald (octahedron with uneven sides) with the Pfizer logo on one side and AML-10 on the other.

Pharmacotherapeutic group:

BMKK (blocker of “slow” calcium channels).

ATX code: C08CA01.

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

Amlodipine is a derivative of dihydropyridine. By binding to dihydropyridine receptors, it blocks “slow” calcium channels, inhibits the transmembrane transition of calcium into the smooth muscle cells of the heart and blood vessels (to a greater extent – into vascular smooth muscle cells than into cardiomyocytes). It has a hypotensive and antianginal effect.

The mechanism of the hypotensive action of amlodipine is due to a direct relaxing effect on vascular smooth muscle.

Amlodipine reduces myocardial ischemia in the following two ways:

1. Expands the peripheral arterioles and thus reduces the total peripheral resistance (afterload), while the heart rate remains practically unchanged, which leads to a decrease in energy consumption and myocardial oxygen demand.
2. Expands the coronary and peripheral arteries and arterioles in both normal and ischemic areas of the myocardium, which increases the supply of oxygen to the myocardium in patients with vasospastic angina (Prinzmetal’s angina) and prevents the development of coronary congestion caused by smoking.

In patients with arterial hypertension, a single daily dose of Norvasc provides a decrease in blood pressure (BP) for 24 hours (both in the “lying” and “standing” positions). Due to the slow onset of action, amlodipine does not cause a sharp decrease in blood pressure.

In patients with angina pectoris, a single daily dose of the drug increases the time of exercise, delays the development of another angina attack and ST segment depression (by 1 mm) during exercise, reduces the frequency of angina attacks and the consumption of nitroglycerin.

Use in patients with ischemic heart disease (CHD)

In patients with cardiovascular diseases (including coronary atherosclerosis with lesions of one vessel and up to stenosis of 3 or more arteries and atherosclerosis of the carotid arteries), who have had a myocardial infarction, percutaneous transluminal angioplasty of the coronary arteries (TLP) or suffering from angina pectoris, the use of Norvasc prevents the development of intima-media thickening of the carotid arteries, significantly reduces mortality from cardiovascular causes, myocardial infarction, stroke, TLP. coronary artery bypass surgery, leads to a decrease in the number of hospitalizations for unstable angina and progression of chronic heart failure (CHF), reduces the frequency of interventions aimed at restoring coronary blood flow.

Use in patients with heart failure

Norvasc does not increase the risk of death or the development of complications and deaths in patients with chronic heart failure (CHF) III-IV functional class (according to NYHA) during therapy with digoxin, diuretics and ACE inhibitors. In patients with CHF I1I-IV functional class according to NYHA of non-ischemic etiology, when using Norvasc, there is a possibility of pulmonary edema. Norvasc does not have any adverse effect on metabolism and plasma lipid concentrations.

Pharmacokinetics

Suction. After oral administration at therapeutic doses, amlodipine is well absorbed, reaching peak blood concentrations 6-12 hours after ingestion. Absolute bioavailability is 64-80%. The volume of distribution is approximately 21 l/kg. Communication with plasma proteins is approximately 97.5%. Eating does not affect the absorption of amlodipine, it penetrates the blood-brain barrier.

Biotransformation/elimination. The elimination half-life (T1 / 2) from plasma is about 35-50 hours, which corresponds to the administration of the drug once a day. In patients with liver failure and severe CHF, T1 / 2 increases to 56-60 hours. The total clearance is 0.43 l / h / kg.

Steady-state plasma concentration is reached after 7-8 days of constant intake of amlodipine, it is metabolized in the liver to form inactive metabolites; 10% of the parent drug and 60% of the metabolites are excreted in the urine. Excretion in breast milk is unknown. It is not removed during hemodialysis. Use in patients with renal insufficiency. Tug from plasma in patients with renal insufficiency increases up to 60 hours. The change in the concentration of amlodipine in plasma does not correlate with the degree of impaired renal function.

Use in the elderly. In the elderly, the time required to reach the maximum concentration of amlodipine in the blood plasma, and its value, practically do not differ from those in younger people. In elderly people suffering from CHF, there was a tendency to reduce the clearance of amlodipine, which leads to an increase in the area under the concentration-time curve and T1 / 2, up to 65 hours.

INDICATIONS FOR USE

• Arterial hypertension (both in monotherapy and in combination with other antihypertensive drugs).
• Stable angina and vasospastic angina (Prinzmetal’s angina) (either alone or in combination with other antianginal agents).

CONTRAINDICATIONS

• Hypersensitivity to amlodipine and other dihydropyridip derivatives, as well as to excipients that make up the drug.
• Severe arterial hypotension

WITH CAUTION is prescribed to patients with hepatic insufficiency, CHF of non-ischemic class III-IV etiology, aortic stenosis, acute myocardial infarction (and within 1 month after it), under the age of 18 years (efficacy and safety not clearly established).

As with the appointment of other BMCC, care must be taken while taking amlodipine in patients with sick sinus syndrome, mitral stenosis, hypertrophic obstructive cardiomyopathy, arterial hypotension.

PREGNANCY AND BREASTFEEDING

The safety of Norvasc during pregnancy and lactation has not been established, therefore, use during pregnancy is possible only if the benefit to the mother outweighs the risk to the fetus and newborn. For the period of breastfeeding, it is recommended to stop either taking the drug or breastfeeding (data on the excretion of amlodipine in breast milk are not available).

DOSAGE AND ADMINISTRATION

Inside, once a day, washing down with the required volume of water (100 ml).

In hypertension and angina, the usual initial dose is 5 mg, depending on the patient’s individual response, it can be increased to a maximum of 10 mg.

Use in the elderly. It is recommended to use at usual doses, no change in the dose of the drug is required.

Use in patients with impaired liver function. Despite the fact that T1 / 2, Norvasca, like all BMCC, increases in patients with this pathology, no changes in the dosage of the drug in patients with impaired liver function are usually required (see section “Special Instructions”).

Use in renal failure. It is recommended to use in usual doses, however, a possible slight increase in T1 / 2 must be taken into account. Changing the dosage regimen of Norvasc with the simultaneous use of thiazide diuretics, beta-blockers or ACE inhibitors is not required.

SIDE EFFECTS

Further, the frequency of adverse reactions is understood as: frequent (> 1%), infrequent myocardial infarction and atrial fibrillation), myocardial infarction, chest pain, migraine.

On the part of the musculoskeletal system: not often – arthralgia, muscle cramps, myalgia, back pain, arthrosis, rarely – myasthenia gravis.

Central and peripheral nervous system: sensation of heat and “flushing” of blood to the skin of the face, increased fatigue, dizziness, headache, drowsiness, infrequently – malaise, fainting, increased sweating, asthenia, hypesthesia, paresthesia, peripheral neuropathy, tremor, insomnia, mood lability , unusual dreams, nervousness, depression, anxiety; rarely – convulsions, apathy, agitation; very rarely – ataxia, amnesia.

Digestive tract: abdominal pain, nausea, infrequently – vomiting, changes in bowel habits (including constipation, flatulence), dyspepsia, diarrhea, anorexia, dry mouth, thirst, rarely – gingival hyperplasia, increased appetite, very rarely – gastritis, pancreatitis, hyperbilirubinemia, jaundice (usually cholestatic), increased activity of “liver” transaminases, hepatitis.

Hematopoietic system: very rarely – thrombocytopenic purpura, leukopenia, thrombocytopenia.

Metabolic disorders: very rare – hyperglycemia.

Respiratory system: not often – shortness of breath, rhinitis, very rarely – cough.

Genitourinary system: not often – frequent urination, painful urination, nocturia, impotence, very rarely – dysuria, polyuria.

Allergic reactions: not often – pruritus, rash, very rarely – angioedema, erythema multiforme, urticaria.

Other: infrequently – alopecia, ringing in the ears, gynecomastia, weight gain / decrease, visual disturbances, diplopia, accommodation disturbance, xerophthalmia, conjunctivitis, eye pain, taste perversion, chills, epistaxis, rarely – dermatitis; very rarely – parosmia, xeroderma, “cold” sweat, impaired skin pigmentation.

OVERDOSE

Symptoms: pronounced decrease in blood pressure with the possible development of reflex tachycardia and excessive peripheral vasodilation (there is a possibility of severe and persistent arterial hypotension, including the development of shock and death).

Treatment: Administration of activated charcoal (especially in the first 2 hours after an overdose), gastric lavage (in some cases), elevation of the limbs, active maintenance of cardiovascular function, monitoring of heart and lung function, control of circulating blood volume and diuresis.

To restore vascular tone and blood pressure, if there are no contraindications, it may be useful to use vasoconstrictor drugs. Use intravenous administration of calcium gluconate. Since amlodipine is largely bound to serum proteins, hemodialysis is not effective.

OTHER DRUG INTERACTIONS

It can be expected that inhibitors of microsomal oxidation will increase the plasma concentration of amlodipine, increasing the risk of side effects, and inducers of microsomal liver enzymes – to reduce.

Cimetidine: with the simultaneous use of amlodipine with cimetidine, the pharmacokinetics of amlodipine does not change.

Grapefruit juice: Simultaneous single dose of 240 ml of grapefruit juice and 10 mg of amlodipine orally is not accompanied by a significant change in the pharmacokinetics of amlodipine.

Unlike other BMCs, no clinically significant interaction of Norvasc (3rd generation BMC) was found when co-administered with non-steroidal anti-inflammatory drugs (NSAIDs), especially indomethacin.

It is possible to increase the antianginal and hypotensive effect of BMCC when used together with thiazide and “loop” diuretics, verapamil, ACE inhibitors, beta-blockers and nitrates , as well as increase their hypotensive effect when used together with alpha1-blockers, antipsychotics. Although no negative inotropic effect has generally been observed with Norvasc, some CBCAs may increase the negative inotropic effect of QT prolonging antiarrhythmic drugs (eg, amiodarone and quinidine).

When combined with the use of BMCC with lithium preparations (data are not available for Norvasc), it is possible to increase the manifestation of their neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

Amlodipine does not affect in vitro plasma protein binding of digoxin, phenigoin, warfarin and indomethacin .

Aluminum/Magnesium containing antacids: their single dose does not significantly affect the pharmacokinetics of amlodipine.

Sildepafii (Viagra): a single dose of 100 mg of sildenafil in patients with essential hypertension does not affect the pharmacokinetic parameters of amlodipine.

Atorvastatin: Repeated use of amlodipine 10 mg and atorvastatin 80 mg is not accompanied by significant changes in the pharmacokinetics of atorvastatin.

Digoxin: Co-administration of amlodipine with digoxin in healthy volunteers does not alter serum levels and renal clearance of digoxin.

Ethanol (alcoholic beverages): when administered once and repeatedly at a dose of 10 mg, amlodipine does not significantly affect the pharmacokinetics of ethanol.

Warfarin: amlodipine does not affect changes in prothrombin time caused by warfarin.

Cyclosporine: amlodipine does not cause significant changes in the pharmacokinetics of cyclosporine.

SPECIAL INSTRUCTIONS

In the treatment of arterial hypertension, Norvasc can be used in combination with thiazide diuretics, alpha- and beta-blockers, ACE inhibitors, long-acting nitrates, sublingual nitroglycerin, NSAIDs, antibiotics and oral hypoglycemic agents.

For the treatment of angina pectoris, Norvasc may be given alone or in combination with other antianginal agents, including in patients refractory to treatment with nitrates and/or beta-blockers at adequate doses. Norvasc does not have any adverse effect on metabolism and plasma lipids and can be used in the treatment of patients with bronchial asthma, diabetes mellitus and gout.

Norvasc can also be used in cases where the patient is predisposed to vasospasm/vasoconstriction.

Patients with low body weight, patients of short stature and patients with severe hepatic impairment may require a lower dosage. During treatment, body weight control and supervision by a dentist is necessary (to prevent soreness, bleeding and gum hyperplasia).

Effects on the ability to drive and use machinery

Although while taking Norvasc, no negative effect on the ability to drive a car or other technical means was observed, however, due to a possible excessive decrease in blood pressure, the development of dizziness, drowsiness, etc. side effects should be carefully considered for the individual effect of the drug in these situations, especially at the beginning of treatment and when changing the dosing regimen.