Precautions and warnings

CHF, sick-sinus syndrome, severe ventricular dysfunction, hypertrophic cardiomyopathy, and severe aortic stenosis are all symptoms of impaired liver or renal function. In patients with idiopathic hypertrophic subaortic stenosis, use with caution. Children, the elderly. Lactation and pregnancy. Although Amlodipine is largely eliminated through the kidneys, the modest renal impairment does not appear to have an effect on plasma concentrations. However, severe renal impairment may necessitate a dosage reduction. Amlodipine cannot be dialyzed. When used in patients with reduced hepatic function, the half-life of amlodipine is prolonged. In these patients, amlodipine should be given at a reduced (5 mg) starting dose. When used in the treatment of heart failure, an increased number of cases of pulmonary edema have been recorded.

Drug Interactions

CYP3A4 inhibitors may cause an increase in plasma levels (for example, azole antifungals, ritonavir). Simvastatin and concomitant medication may raise the risk of myopathy, including rhabdomyolysis. Conivaptan and ciclosporin plasma levels may be increased.

Contraindications

Severe hypertension, hypersensitivity to amlodipine or other calcium channel antagonists.

Mode of actions

Amlodipine relaxes the smooth muscle of the peripheral and coronary arteries. During depolarization, it inhibits Ca ion entry into the slow channels or select voltage-sensitive channels of the vascular smooth muscle and heart, resulting in coronary vasodilation. In patients with vasospastic angina, it also improves myocardial oxygen delivery.

Dosage & Administration

Adult: PO Stable angina; HTN; Prinzmetal's angina Initial: 5 mg once daily; If the desired therapeutic effect cannot be achieved within 2-4 weeks, the dose may be increased to a maximum dose of 10 mg once daily.

Child: >12 yr Initially, 2.5 mg once daily, increased to 5 mg once daily if necessary.
Elderly: Initially, 2.5 mg once daily.
Hepatic impairment: Initially, 2.5 mg once daily.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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