Names and pronunciation
(am-loe′di-peen) Katerzia, Norvasc
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Individual generic drug information
Extracted information for amLODIPine only.
(am-loe′di-peen) Katerzia, Norvasc
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Func. class.: Antianginal, antihyper- tensive, calcium channel blocker
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Chem. class.: Dihydropyridine
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Do not confuse: amLODIPine/aMILoride
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ACTION: Inhibits calcium ion influx across cell membrane during cardiac depolarization; produces relaxation of cor- onary vascular smooth muscle, peripheral vascular smooth muscle; dilates coronary vascular arteries; increases myocardial O2 delivery in patients with vasospastic angina
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USES: Chronic stable angina pectoris, hypertension, variant angina (Prinzmet- al’s angina)
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Extracted information for amLODIPine only.
CONTRAINDICATIONS: Hyper- sensitivity to this product or dihydropyri- dine, severe aortic stenosis, severe obstructive CAD Precautions: Pregnancy, breastfeeding, children, geriatric patients, HF, hypoten- sion, hepatic injury, GERD
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SIDE EFFECTS CNS: Headache, fatigue, dizziness, somnolence CV: Peripheral edema, bradycardia, hypotension, angina, edema, palpitations GI: Nausea, abdominal pain, anorexia, gingival hyperplasia, dyspepsia INTEG: Rash, pruritus OTHER: Flushing
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INTERACTIONS Increase: amLODIPine level—strong CPY3A4 inhibitors (clarithromycin, keto- conazole, ritonavir) Increase: level of cycloSPORINE Increase: myopathy—simvastatin
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TREATMENT OF OVERDOSE: Defibrillation, β-agonists, IV calcium inotropic agents, diuretics, atropine for AV block, vasopressor for hypotension
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Extracted information for amLODIPine only.
DOSAGE AND ROUTES Coronary artery disease • Adult: PO 5-10 mg/day • Geriatric: PO 5 mg/day, max 10 mg/day Hypertension • Adult: PO 2.5-5 mg/day initially, max 10 mg/day • Geriatric: PO 2.5 mg/day, may in- crease to 5 mg/day, max 10 mg/day • Child 6-17 yr (unlabeled): PO 2.5-5 mg/day • Child 1-5 yr (unlabeled): PO 0.1 mg/kg/dose daily initially, max 0.6 mg/ kg/dose Hepatic dose • Adult: PO 2.5 mg/day; may increase to 10 mg/day (antihypertensive); 5 mg/day, may increase to 10 mg/day (antianginal)
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Available forms: Tablets 2.5, 5, 10 mg; suspension 1 mg/mL
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Administer: A • Once a day without regard to meals
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Extracted information for amLODIPine only.
Assess: • Cardiac status: B/P, pulse, respira- tions, ECG; some patients have developed severe angina, acute MI after calcium channel blockers if obstructive CAD is severe • Fluid volume status, peripheral edema, dyspnea, jugular vein distention, crackles • Angina: intensity, location, duration of pain • Pregnancy/breastfeeding: identify if pregnancy is planned or suspected, or if breastfeeding
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Evaluate: • Therapeutic response: decreased an- ginal pain, decreased B/P, increased ex- ercise tolerance
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To take product as prescribed, not to double or skip dose, to take even if feeling better • To avoid hazardous activities until sta- bilized on product, dizziness is no longer a problem • To avoid OTC, Rx, herbs, supplements unless directed by prescriber • To comply in all areas of medical regimen: diet, exercise, stress reduction, product therapy, smoking cessation • To notify prescriber of irregular heart- beat; shortness of breath; swelling of feet, face, hands; severe dizziness; constipa- tion; nausea; hypotension; if chest pain does not improve, use nitroglycerin when angina is severe • To use correct technique when moni- toring pulse; to contact prescriber if pulse <50 bpm • To change positions slowly to prevent orthostatic hypotension • To continue with good oral hygiene to prevent gingival disease • To use sunscreen, protective clothing to prevent photosensitivity • To notify all health care providers of use of this product
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Extracted information for amLODIPine only.
PHARMACOKINETICS Peak 6-12 hr; half-life 30-50 hr; increased in geriatric patients, hepatic disease; metabolized by liver (CYP3A4); excreted in urine (90% as metabolites); protein binding >93%
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Filter the extracted dose blocks for this individual drug.
Coronary artery disease
• Adult: PO 5-10 mg/day
Candidate age grouping · source page 77
Coronary artery disease
• Geriatric: PO 5 mg/day, max 10 mg/day Hypertension
Candidate age grouping · source page 77
Coronary artery disease
• Adult: PO 2.5-5 mg/day initially, max 10 mg/day
Candidate age grouping · source page 77
Coronary artery disease
• Geriatric: PO 2.5 mg/day, may in- crease to 5 mg/day, max 10 mg/day
Candidate age grouping · source page 77
Coronary artery disease
• Child 6-17 yr (unlabeled): PO 2.5-5 mg/day
Candidate age grouping · source page 77
Coronary artery disease
• Child 1-5 yr (unlabeled): PO 0.1 mg/kg/dose daily initially, max 0.6 mg/ kg/dose Hepatic dose
Candidate age grouping · source page 77
Coronary artery disease
• Adult: PO 2.5 mg/day; may increase to 10 mg/day (antihypertensive); 5 mg/day, may increase to 10 mg/day (antianginal)
Candidate age grouping · source page 77